A STUDY OF PRESCRIPTION AUDITING IN A TERTIARY CARE TEACHING HOSPITAL OF EASTERN INDIA

Abstract

Background: prescription audit is a tool as well as a technique and its application is science as well as an art. Quality of life can be improved by enhancing the standards of medical treatment and that can only be assessed by prescription audit, because it is based on documented evidences to support diagnosis, treatment and justified utilization of hospital facilities. Effective prescription audit is important for health professionals, health service managers, patients, and the public. It supports health professionals in making sure their patients receive the best possible care. It can inform health service managers about the need for organizational changes, or new investment to support health professionals in their practice. Prescription audit is a quality improvement process that seeks to improve patient care. in this background the present study was conducted in this tertiary care teaching hospital of eastern India, as previously no such study conducted at this institution. Objective: Assessment of quality of medical care in a tertiary care teaching hospital, quantifying and describing the appropriateness of medical care by measuring the who core prescribing indicators, and assessment of rational prescription pattern in a tertiary care teaching hospital in eastern India.  Materials and method: this was an observational study undertaken between 1^st may 2012 and 31^st august 2013 at the OPD of burdwan medical college, west Bengal, India. Data for only first encounter prescriptions collected from the patients attending the OPD after fulfillment of inclusion criteria with the help of pre-inserted carbon and was analyzed by the parameters based on the objectives. Results: General medicine OPD contributing 45.38% patients with the most frequent diagnosis was the disease of the gastro-intestinal system (ICD 10 code- k00-k99) at rate of 12.33%. 19% of prescription contain more than single diagnosis with total numbers of drugs prescribed were 18559.  Most frequent antibacterial agent was fluoroquinolones subgroup (ATC code-JOIMA) at the rate of 7.78%. In this study it was observed that in 91.33% of prescription weight is not written, while in-appropriate drugs prescribed in 52.99% of prescription. Average number of drugs per encounter was 4.4; percentage of drugs prescribed by generic name was only 20.99%, while percentage of encounters with an antibiotic prescribed was 28.89%, & percentage of encounters with an injection prescribed was 28.99%. Percentage of drugs prescribed from essential drugs list or formulary was only 60.98%, and overall illegibility of prescription was 22.99%. Conclusion: the results of this study show the prevailing prescribing habits at our institution. This study reveals that the auditing of prescription in terms of rationality, it remains poor. The value of such audits in generating and testing hypotheses on inappropriate prescribing will definitely create an intervention to improve prescribing habits and ultimately patient care will be improved.

Key Word: Essential Medicine, Prescription Auditing, International Classification of Diseases (ICD 10)