Prescription Audit towards Quality Indicators at a Tertiary Care Teaching Hospital in South India

Document Type : Original Article

Authors

1 Professor & Head, Department of Pharmacology, Vydehi Institute of Medical Sciences & Research Centre

2 Department of Pharmacology, Vydehi institute of medical sciences and Research centre.

3 Department of General Medicine, Vydehi institute of medical sciences and Research centre

4 NABH Co-ordinator, Department of quality & control, Vydehi institute of medical sciences and Research centre.

Abstract

Introduction:
The World Health Organization has laid down guidelines for rational prescriptions. Adherence to those guidelines is an important aspect of medication safety. In India, such adherence is mandatory towards National Accreditation Board for Hospitals and Health-care Providers (NABH) accreditation of health-care facilities. The audition of the prescriptions is therefore a quality improvement process that indirectly benefits the health-care stakeholders. Such an audit is part of the NABH Management of Medication and is monitored by the Pharmacy and Therapeutics (P&T) committee in most hospitals.
Materials and Methods:
This prospective study was conducted between December 2018 and November 2019. An audit was carried out using 4800 case sheets from different in-patient departments of Vydehi Institute of Medical Sciences and Research Centre, Bengaluru, India. The data were recorded in a predefined audit form.
Results:
Out of 4800 prescriptions, 71% (n=3408) of the audited orders had drugs written down in the capital; moreover, 97% (n=4656) and 47% (n=2256) of the prescriptions were legible and were written in generics, respectively. Furthermore, 97% (n=4656) of the orders had a physician’s signature, and 70% (3360) of them had a clinical review. It should be noted that only 1% (n=48) of the orders had drug-drug and drug-food documented interactions.
Conclusion:
According to the results of this study, physicians did not document suggestions regarding drug-drug and drug-food interactions. Moreover, there were fewer numbers of prescriptions written in generics. In addition, the majority of the medication orders were legible and adhered to standards in the 12th month. This may be due to sharing the monthly audit reports with various departments and the continuous feedback process involving the P&T committee.

Keywords

References

  1. World Health Organization (WHO) The World Medicine Situation. Geneva: World Health Organization Press. World Health Organization; 2004. Available at https://apps. who.int/ medicinedocs/ pdf/s6160e/s6160e.pdf, accessed on December 10 2018.
  2. Batta A, Singh B. Rational approach to prescription writing: A preview. Neurol India 2018; 66:928-33.
  3. Medical Council of India: Code of Medical Ethics Regulations. 2002. Available from https:// www.mciindia.org/CMS/rules-regulations/code-of-medical-ethics-regulations-2002.
  4. NABH: Pre Accreditation Entry Level Standards for AYUSH Hospitals 2018. Available from https://www. nabh.co/Announcement/ AYUSH%20Hosp%20Entry%20Level.pdf
  5. Documented policies and procedures guide the safe and rational prescription of medications. Available at: https://www. nabh.co/Announcement/DraftAccreditationStandardsfor Hospital4thEdition.pdf, accessed on December 20, 2018.
  6. Naresh Sah, Balakeshwa Ramaiah*, Raju Koneri. The Pharmacist Role in Clinical Audit at an Indian Accredited Hospital: An Interventional Study. IJOPP 2019; Volume 12, Issue 2; 117-125.
  7. WHO. How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators – EDM Research Series No. 007. 1993. (Last accessed on 2015 May 05). Available from: http://www.apps.who.int/medicinedocs/en/d/Js2289e/
  8. Batta A, Madan N, Kalra BS, Arora S. Prescription audit, drug utilization pattern and adverse drug reaction monitoring in outpatients of orthopedic department of tertiary care teaching hospital: A pilot study. MAMC J Med Sci 2019;5: 77-82.
  9. Singh T, Banerjee B, Garg S, Sharma S. A prescription audit using the World Health Organization-recommended core drug use indicators in a rural hospital of Delhi. J Educ Health Promot. 2019;8:37.
  10. Muraraiah S, Rajarathna K, Vishwanath M, Ramaswamy A, Kamath SD, Seshu S et al. Evaluation of WHO prescribing indicators among orthopaedic in-patients at a tertiary care hospital. J Chem Pharm Res 2014;6:278-80.
  11. Rajeshwari Hanumantharaya N. Drug utilization study in postoperative patients in obstetrics and gynaecology ward of tertiary care hospital. Int J Basic Clin Pharmacol 2016;5:           329-34.
  12. Potharaju HR, Kabra SG. Prescription audit of outpatient attendees of secondary level government hospitals in Maharashtra. Indian J Pharmacol 2011;43:150-6.
  13. Bhowmik S, Jana S, Das A, Saren P. Prescription audit study from a tertiary care private hospital (TCPH) in Kolkata, India. QAI J Healthc Qual Patient Saf 2019;1: 13-8.
  14. Toverud EL, Hartmann K, Hakonsen H. A systematic review of physicians' and pharmacists' perspectives on generic drug use: What are the global challenges? .Appl Health Econ Health Policy 2015;13(1): 35-45.
  15.  Medical Council of India: Circular on Generic Medicine. 2017. Available from https://old.mciindia.org/circulars/Public-Notice-Generic-Drugs-21.04.2017.pdf.
Journal of Patient Safety & Quality Improvement
Volume 8, Issue 2
April 2020
Pages 99-105

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