Study on Prescription Audit from a Rural Tertiary Care Hospital in North India

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.

Evaluation of Medication Errors by Prescription Audit at a Tertiary Care Teaching Hospital

“…22 In a similar study on topical corticosteroids, Sharma et al reported that the frequency of application was recorded in 93% of prescriptions. 12 In a study conducted by Dhamodharan et al which is similar to this study, at an outpatient tertiary care teaching hospital, dose and dosage schedule were mentioned in 98% of prescriptions, and route of drug administration was present in 98.8% of prescriptions. 25 In the present study, dosage schedule, route of administration, and frequency were mentioned in 100% of prescriptions.…”

“…Prescriptions are an important intervention for the physician, and it is an ethical and legal duty of the practitioner to write complete and legible prescriptions. 12 By enhancing standards of medical treatment, quality of life can be improved, and prescription audit is important for this because it is documented evidence to support diagnosis, treatment, and utilization of hospital facilities. 13…”

“…Prescriptions are an important intervention for the physician, and it is an ethical and legal duty of the practitioner to write complete and legible prescriptions. 12 By enhancing standards of medical treatment, quality of life can be improved, and prescription audit is important for this because it is documented evidence to support diagnosis, treatment, and utilization of hospital facilities. 13 This study was conducted in a tertiary care hospital to assess prescription errors and prescribing faults, analyze and document the information on the core prescribing indicators proposed by the WHO, and check the rationality of the prescriptions.…”

Social and cultural determinants of antibiotics prescriptions: analysis from a public community health centre in North India

“…On the positive side, from the total, 87.2% of the drugs prescribed were by their generic name, which is greater than another study from a tertiary care hospital in North India which found 68.5% of generic medicines (Sharma, et al, 2021). While the normative desired level on the use of generic medicine is 100% of prescriptions, this is practically impossible to achieve for various reasons, such as the perception of quality.…”

“…Patients coming from rural communities had limited literacy or knowledge regarding drugs. Further, patients themselves often demand antibiotics from the clinicians, as they felt they were not being treated appropriately without them ( Sharma et al, 2021 ). Figures 1 – 3 depict the dispensary inside the hospital, the common entrance of the hospital and pharmacy and the inhouse pharmacy where the study is conducted.…”