A study to assess the degree of adherence of prescription to WHO and MCI guidelines at a tertiary health care teaching hospital in North India

Abstract

Background: Prescription errors are one of the most common preventable medication errors. The occurrence of medication errors can compromise the patient confidence in the healthcare system and also increase healthcare costs. The aim of this study was to randomly audit medical prescriptions and associated factors at the outpatient department of a tertiary care teaching institute in Lucknow. Methodology: A total of 420 prescriptions were randomly selected and reviewed. Data on the prescribed drugs were collected from prescription papers using a structured format and analysed using SPSS software. Data on patient demographics, indication for each medication, dosage, dosage form, regimen and concurrent medications were collected. Data on duration of medication were not evaluated. Results: Out of 420 prescriptions included for review, date of prescription was documented in only 59% of cases. Signature of doctor was present in 94.2% prescriptions although the name of the prescriber was mentioned in only 27% prescriptions. The average number of drugs per prescription was 3.89%. Errors related to dosing were documented in 44% cases. Injectable drugs were prescribed in 26.6% prescriptions, whereas antibiotics were written in 13.8%. The percentage of drugs prescribed by generic name was only 7.61%. The understanding of patients regarding prescription of medication given to them, especially with regards to legibility of dose and timing was 55.7%. Conclusion: The results of our study prove that prescribing errors are a major cause of preventable iatrogenic injury to patients. They may be rectified by educational intervention as well as standardised prescription charts.