Prescription Auditing of Patients Admitted at Psychiatry ward of a Tertiary Care Hospital of Western UP
Introduction: The World Health Organization (WHO) proposed core-prescribing indicators for prescription audit and drug utilization studies. The focus of Indian studies has mainly been on the WHO core-prescribing indicators such as the range and number of drugs per prescription. Critical evaluation of prescriptions including rational auditing of prescriptions of patients admitted at Psychiatry Ward of Jawaharlal Nehru Medical College Hospital, A.M.U., Aligarh, from the period of 31/05/2013 to 30/05/2015.
Materials and Methods: Permission for retrospective study to access medical records of the past 2 years of all patients admitted in the Psychiatry ward from 31/05/2013 to 30/05/2015 was obtained from the competent authority. Prescriptions of 44 patients (26 female, 18 male) were available in the Central Record Section during this period. The following parameters were taken to analyse and audit prescriptions as per WHO prescribing indicators: 1) Patient details, 2) Mention of diagnosis, legibility & spelling mistakes, 3) Details of the consultant, 4) Use of antibiotics/antipsychotics by various routes, 5) Provision of proper instructions to patients and 6) Additional parameters - Percentage of prescriptions with nutritional supplements and antacids.
Results: Only 36% of prescriptions contained the full names of patients, while age, sex and address were present in 84.09% of the prescriptions. 100% prescriptions were found written with complete diagnosis and contained the signature of the concerned doctor. None of the prescription had the doctor’s contact number. A mean number of 3.18 drugs were written per prescription. All prescriptions were legible and 2.27% contained spelling mistakes. Insufficient instructions for both oral and injectable drugs were mentioned on all prescriptions.
Conclusion: As per WHO laid guidelines, study related to drug use indicators are simple as a supervisory tool to assess prescribing patterns by individual doctors. These prescription studies provide scope to improvement in prescribing patterns and promotion of rational use of drug among practitioners.
2. Phillips J, Beam S, Brinker A, Holquist C, Honig P, Lee LY, Pamer C. Retrospective analysis of mortalities associated with medication errors. American Journal of Health-System Pharmacy. 2001 Oct 1; 58(19):1835-41.
3. How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators. Available from: http://apps.who.int/medicinedocs/en/d/Js2289e/3.1.html
4. Chaturvedi SK, Sinha P, Chandra PS, Desai G. Improving quality of prescriptions with clinical audit. Indian J Med Sci. 2008 Nov; 62(11):461-4.
5. Medication safety issue brief, Look-alike, sound-alike drugs. American Hospital Association; American Society of Health-System Pharmacists; Hospitals & Health Networks.
Hosp Health Netw. 2005 Oct; 79(10):57-8.
6. SAVINGS An Economic Analysis of Generic Drug Usage in the U.S. General Pharmaceutical Association. 2011 Sep; 10.
7. Steven Reinberg. U.S. Hospitals Overuse, Misuse Antibiotics, CDC Says. HealthDay Reporter. Available from: http://consumer.healthday.com/infectious-disease-information-21/antibiotics-news-30/hospitals-overuse-misuse-antibiotics-cdc-685478.html