Prescription audit in outpatient department of a tertiary care teaching hospital of North India

Abstract

Introduction:
Prescription audits, based on guidelines from the World Health Organization, help to reduce drug-related errors that are one of the common sources of preventable harm, therefore improving patient care. Irrational drug prescriptions have become a global phenomenon and India is no exception, as it tops the list in the sheer usage of antibiotics. This observational study intends to assess and analyse the prescribing patterns of the prescriptions drawn at a tertiary care teaching hospital in North India against the core indicators from the World Health Organization.
Materials and Methods :
A prospective, observational study was conducted in the OPDs of a tertiary care hospital for three months. 150 prescriptions were randomly picked for this study and analysed using WHO-prescribing indicators. The data were collected during regular hours in the OPDs and analysed by descriptive statistics.
Results:
Superscription analysis revealed most of the prescriptions recorded essential patient details, but a diagnosis was mentioned in only 26% of them. The inscription analysis showed that 96% of prescriptions conformed to the standard treatment requirements. Majority of prescriptions mentioned the brand names and generic names accounted for only 4% of prescriptions. Brief medical history was provided in 42% and clinical examination findings in 78% of the prescription. Subscription analysis revealed that all prescriptions were signed, but the prescribers' registration numbers were not included.
Discussion:
There were numerous shortcomings highlighted about prescriptions practice such as antibiotic misuse and failure to provide generic names. The 74% of prescriptions where no diagnosis was included exposes a possible result in the error chain, and poor documentation of patient history may disrupt continuity of care.
Conclusion:
Results reveal that though most of the prescriptions broadly conformed to the WHO-prescribing indicators, there are critical lapses in prescription quality like lack of recording of diagnoses, over-prescription of antibiotics, and lesser use of generic drugs. It's very important to deal with these issues to implore patient safety and promote rational drug use.