Prescription audit in outpatient department of a teaching hospital of North East India
DOI:
https://doi.org/10.18203/2320-6012.ijrms20181275Keywords:
Outpatient department, Prescription audit, TripuraAbstract
Background: Quality of the prescriptions generated from OPD of Agartala Government Medical College and Govinda Ballabh Pant Hospital is never assessed. The study objectives were to find out the quality in terms of legibility, completeness and adherence to WHO core prescribing indicators of the prescriptions generated from OPD of this hospital.
Methods: This hospital based cross-sectional study was conducted during 11th to 16th December 2017 among 442 prescriptions picked up from 12 OPDs by multi stage sampling technique and examined using a checklist designed to assess adherence to WHO core prescribing indicators, legibility and completeness. Data entry and analysis were performed with computer using SPSS 15.0. Descriptive statistics and Chi-square test were used to present data.
Results: Total 1169 items were prescribed in 442 prescriptions. Only 50.90% prescriptions were legible. Average number of drugs prescribed per encounter was 2.64, 223 (19.07%) were generic drugs, 14 (1.19%) were injections, 176 (15.05%) were antibiotics and 618 (52.86%) items were from the national essential drug list. History was written in 62.70%, findings were written in 52.70%, diagnosis was written in 40.00%, 87.80% prescriptions contained no review instructions, 84.60% contained complete directions to the pharmacist, 87.10% did not contain complete direction to the patients and signature section was incomplete in 99.80% of the prescriptions. Significantly higher proportions of the high ranked prescribers wrote generic items, review instructions and complete directions to the patients in their prescriptions (p < 0.05).
Conclusions: Most of the prescriptions generated from OPD of Agartala Government Medical College and Govinda Ballabh Pant Hospital were found to be incomplete, about half of them were illegible and sizeable proportions did not adhere to the WHO core prescribing indicators.
References
Ansari KU, Singh S, Pandey RC. Evaluation of prescribing pattern of doctors for rational drug therapy. Indian J Pharmacol. 1998;30(1):43.
Kanakambal S, Murugesh N, Shanthi M. Drug prescribing pattern in a Tertiary care teaching Hospital in Madurai. Ind J Pharmacol. 2001;33(3):223.
Patterson HR. The problems of audit and research. J R Coll Gen Pract. 1986;36(286):196.
Srishyla MV, Mahesh K, Nagarani MA, Mary CS, Andrade C, Venkataraman BV. Prescription audit in an Indian hospital setting using the DDD (Defined Daily Dose) concept. Indian J Pharmacol. 1994;26(1):23.
National List of Essential Medicines of India 2011. Available at: http://pharmaceuticals.gov.in/sites/ default/files/NLEM.pdf. Accessed 19 June 2017.
Budhiraja RD. Manual of Practical Pharmacy. 2nd Ed. Bombay: Popular Prakashan; 1993.
Bhattacharya A, Gupta H, Dewangan MK. Prescription pattern study of the drugs used in tertiary hospitals of the Bilaspur region. Asian J Pharm Clin Res. 2012;5(4):73-6.
World Health Organization. Essential Medicines and Health Products Information Portal. resource. Available at: http://apps.who.int/medicinedocs/en/d /Js2289e/3.1.html. Accessed 19 June 2017.
World Health Organization. How to investigate drug use in health facilities: selected drug use indicators, 1993.
SPSS Inc. Released 2006. SPSS for Windows, version 15.0. Chicago, SPSS Inc. Available at: http://www-01.ibm.com/support/docview.wss?uid=swg21476197
Centers for Disease Control and Prevention. Epi Info Version 7 for windows. Atlanta (GA), 1994. Available at: https://wwwn.cdc.gov/epiinfo/. Accessed 30 June 2017.
Pavani V. Study of Prescribing Pattern for Evaluation of Rational Drug Therapy in Warangal. Ind J Pharm Pract. 2011;4(4):77-9.
Bandyopadhyay D, Banerjee CN, Chattopadhyay S, Singha P. A study of prescription auditing in a tertiary care teaching hospital of Eastern India. J Drug Delivery Therapeutics. 2014;4(1):140-9.
Mishra S, Sharma P. Prescription audit and drug utilization pattern in a tertiary care teaching hospital in Bhopal. Int J Basic Clin Pharmacol. 2016;5:1845-49.
Wali A, Ali A, Siddiqui TM, Jafri H. Assessing Prescription Writing Skills of House Officers in Dental Teaching Hospitals of Karachi, Pakistan. World J Dentistry. 2012;3(4):294-6.
Ahsan M, Shaifali I, Mallick AK, Singh HK, Verma S, Shekhar A. Prescription auditing based on World Health Organization (WHO) prescribing indicators in a teaching hospital in North India. Int J Med Res Rev. 2016;4(10):1847-52.
Kumari S, Haider S, Kashyap V, Singh SB. A study on pattern of prescription writing practices at Rajendra Institute of Medical Sciences, Ranchi. Indian J Prev Soc Med. 2014;45(1):24-8.
Siddarth V, Arya S, Gupta SK. A study of prescribing practices in outpatient department of an apex tertiary care institute of India. Int J Res Foundation Hosp Health Adm. 2014;2(1):31-5.
Prasad K, Ranasinghe B. Pattern of private sector drug prescription in Galle: A descriptive cross-sectional study. Gall Med J. 2006;4:64-8.
Albarrak AI, Rashidi EA, Fatani RK, Ageel SI, Mohammed R. Assessment of legibility and completeness of handwritten and electronic prescriptions. Saudi Pharm J. 2014;22(6):522-7.
Delhi Medical Council. Model prescription format. Available at: http://www.delhimedicalcouncil.Org/ pdf/modalprescription.Pdf. Accessed 26 May 2015.
Jain S, Khan ZY, Upadhyaya P, Kumar A. Assessment of prescription pattern in a private teaching hospital in India. Inter J Pharma Sci. 2013;3(3):219-22.
Kumari R, Idris M, Bhushan V, Khanna A, Agrawal M, Singh S. Assessment of prescription pattern at the public health facilities of Lucknow district. Indian J Pharmacol. 2008;40(6):243.
Sudarsan M, Sitikantha B, Aparajita D. Audit and Quality Assessment of Prescriptions in an Urban Health Centre of Kolkata. J Med Pub Heal. 2016;6(3):136-9.
Karande S, Sankhe P, Kulkarni M. Patterns of Prescription and Drug Dispensing. Ind J Pediatr. 2005;72:117-21.
Biswas NR, Biswas RS, Pal PS, Jain SK, Malhotra SP, Gupta A, et al. Patterns of prescriptions and drug use in two tertiary hospitals in Delhi. Ind J Physiol Pharmacol. 2000;44(1):109-12.
Hazra A, Tripathi SK, Alam MS. Prescribing and dispensing activities at the health facilities of a non-governmental organization. Natl Med J India. 2000;13(4):177-82.
Gawande U, Deshmukh S, Kadam S, Potdar G, Salvitthal H. Prescription audit of patients attendees in public health facilities in Maharashtra, India with special reference to rational use of antibiotics. Int J Res Med Sci. 2015;3:3655-64.
Acharya HR, Barvaliya JM, Paliwal NP, Tripathi CB. Prescription audit in outpatient departments of a tertiary care teaching hospital: A cross-sectional study. Euro J Pharma Med Res. 2017;4(3):372-9.
Sharif SI, Shaqra MA, Hajjar H, Shamout A, Wess L. Patterns of drug Prescribing In a hospital in Dubai, United Arab Emirates. Libyan J Med. 2008;3(1):10-12.
Shelat PR, Kumbar SK. Analysis of Out Door Patients’ Prescriptions According to World Health Organization (WHO) Prescribing Indicators Among Private Hospitals in Western India. J Clin Diag Res. 2015;9(3):FC01-FC04.
Medical Council of India. Code of Medical Ethics Regulations, 2002. Available at: https://www.mciindia.org/ActivitiWebClient/rulesnregulations/codeofMedicalEthicsRegulations2002. Accessed 26 May 2015.
