Abstract
Evidence concerning prescription audits conducted in developing countries like India is scarce, especially from the rural parts of the country. Therefore, the present prescription audit was undertaken in a rural tertiary care hospital to investigate prescriptions for their completeness, in format of prescription, legibility of writing and it was assessed against the World Health Organization (WHO) recommendation of core indicators for prescription writing in order to investigate the rational usage of drugs. A total of 200 prescriptions were randomly selected, irrespective of clinical departments, patient characteristics and diagnosis over a period of six months. All the prescriptions were prospectively analyzed and conferred to an assessment of the quality of prescribing practice, general details, medical components, WHO core drug use indicators and legibility. Amongst the 200 prescriptions precisely monitored, we found that 100% prescriptions had general details of the patients such as name, age, gender, OPD/IPD registration number, hospital name & address and consulting unit/department. While evaluating the handwriting of the doctors, 83.5% (177/200) of the prescriptions had legible handwriting, wherein the degree of legibility showed 68.5% (137/200) prescriptions with easy legibility, 20% (40/200) difficult legibility while 11.5% (23/200) were illegible. Along with the different types of drugs obtained from the selected prescriptions, we found that antibiotics were prescribed in 51.5% (103/200) of the prescriptions. A prescription audit is a good tool to systemically review the day to day work, maintenance of records and assessment of accuracy of the diagnosis given by doctors and also the outcome of the treatment received.
Highlights
A prescription audit (PA) is a systematic and critical analysis of the quality of prescribed medical care, which includes procedures used for diagnostic and treatment purposes, the appropriate use of various resources, and the resulting outcome on the quality of life of patients
The present prescription audit was undertaken in a rural tertiary care hospital to investigate prescriptions for their completeness, in format of prescription, legibility of writing and it was assessed against the World Health Organization (WHO) recommendation of core indicators for prescription writing in order to investigate the rational usage of drugs
Complete confidentiality of patients was maintained throughout the research process and informed written consent was obtained at initiation
Summary
A prescription audit (PA) is a systematic and critical analysis of the quality of prescribed medical care, which includes procedures used for diagnostic and treatment purposes, the appropriate use of various resources, and the resulting outcome on the quality of life of patients. Prescription writing assessment is considered an important parameter to ensure rational drug use.[5] Rational use of drugs is essential to achieve good quality health care for patients as well as for the community.[5] It ensures that patients are advised medications which are appropriate for their clinical needs and in doses that suits each patient’s individual requirements and that they are prescribed for adequate period with minimum cost to patients and the community.[6] Irrational prescription may lead to ineffective treatment, which may subject the patient to prolongation or exacerbation of illness, unnecessary mental distress, untoward side effects and higher expenses.[7] The World Health Organization (WHO) formulates a set of “core prescribing indicators” which aims at improvement of rational drug use for outpatient practices It includes indicators for prescription, indicators for patient care and indicators for various facilities.[8] Based on such indicators, various studies have been done in countries across the globe, including India.[1,2,4,5,8] With the use of such prescribing indicators, auditing prescription forms is an important part of drug utilization studies. These include, but are not limited to average time for consultation, average time for dispensing of medicines/ drugs, actual percentage of dispensed drugs, percentage of drugs labelled correctly, knowledge of patients regarding correct drug dosage and facility indicators which include availability of key drugs and an essential drug formulary.[9]
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