Diversity of Physicians’ Handwriting and Name Stamp in Chemotherapy Prescriptions: Potential Target for Fraud

  • Asiyeh Amouei PharmD, Department of Pharmaceutical Care, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  • Molouk Hadjibabaie PharmD, Faculty of Pharmacy and Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran.
  • Ava Mansouri PharmD, Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
  • Aarefeh Jafarzadeh kohneloo Ph.D candidate, Department of Epidemiology and Biostatistics, Faculty of Health, Tehran University of Medical Sciences, Tehran, Iran.
  • Maryam Taghizadeh-Ghehi Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
Antineoplastic Agents, Prescriptions, Handwriting, Physicians *


Backgrounds: Verification and authentication of the paper-based handwritten prescriptions is of great importance for antineoplastic medications that are good targets for forgery and fraud. Pharmacists usually investigate handwriting, signature and name stamp of prescribers to verify prescriptions in Iran. Anecdotal reports of variations in handwriting and name stamp of physicians who wrote antineoplastic prescriptions raised concerns in this regard. The aim of the study was to investigate the reported diversity and evaluate the quality of writing physician identity and required items in antineoplastic prescriptions.
Methods: All insured hand-written prescriptions contained at least one antineoplastic medication and were dispensed by four main authorized community pharmacies dispensing antineoplastic medications in Tehran during one month were included. Prescriptions that were written by specialties other than oncology-related fields were excluded. Prescriptions of each physician were evaluated considering handwriting and name stamp by experienced pharmacy staff and the frequency of detected handwriting and name stamp types was recorded.
Results: Of the 11022 included prescriptions, 10944 were eligible and written by 241 physicians. Median (third quartile) number of physicians’ prescriptions was 17 (51). Maximum number of observed handwriting and name stamp types were eight and six respectively. High prescribers tended to have several handwriting and name stamp types.
Conclusion: The observed diversity and variation in handwriting and name stamp of the physicians in antineoplastic prescriptions may facilitate the entrance of forged prescription and makes fraud detection difficult. Administrative and regulatory interventions in addition to notification of health care professionals about the observed potential might be necessary.


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How to Cite
Amouei A, Hadjibabaie M, Mansouri A, Jafarzadeh kohneloo A, Taghizadeh-Ghehi M. Diversity of Physicians’ Handwriting and Name Stamp in Chemotherapy Prescriptions: Potential Target for Fraud. J Pharm Care. 4(3-4):86-90.
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