Assessing prescribing practices in Indian health facilities: a comprehensive review

Abstract

Prescription patterns play a critical role in healthcare delivery, affecting the efficacy of medication therapy and resource utilization. Rational prescribing practices are essential for safe and effective healthcare, necessitating comprehensive prescriptions containing medication details, prescriber information, and patient instructions. This review explores prescription completeness and rationality, utilizing WHO prescribing indicators and other completeness metrics, across Indian healthcare facilities. A systematic search was conducted in PubMed and Google Scholar for original research articles published between 2013 and 2023, focusing on WHO-recommended prescribing indicators and completeness criteria. Inclusion criteria covered articles in English, spanning primary, secondary, or tertiary care settings. Data from selected articles were extracted and analysed. Data were synthesized from sixty-seven studies, depicting various prescribing practices. The assessment encompassed prescribing, patient care, and facility indicators. Findings highlighted challenges such as illegible prescriptions, incomplete details, polypharmacy, brand name dominance, and inappropriate antibiotic use. Despite WHO recommendations, generic prescribing was limited. This review reiterates the need for interventions to enhance prescription quality, patient safety, and cost-effectiveness. Recommendations include adopting electronic prescribing systems, standardizing prescription formats, conducting regular prescription audits, implementing educational programs, promoting generic drug use, and adhering to essential medicines lists. These multifaceted strategies can improve prescribing practices and ultimately contribute to enhanced healthcare outcomes in India.