Prescription auditing

how to do a prescription auditing in a hospital setup,
and various parameters that can be used

1. By: DR. Sumit kumar mahato Junior resident (academic) Guide: Dr. U.S.P Keshri Assoc. prof. Department of Pharmacology RIMS, Ranchi Prescription Auditing

2. The prescription order is an important link between the doctor and the patient. The prescribing behavior of the doctor depends upon the input from various sources like patients , academic literatures, professional colleagues, commercial publicity and government regulations .

3. Various prescribing errors are result of ineffective use of these inputs and are very common in clinical practices. One of the most pressing problem encountered by public health providers and administrators in many countries is the rational use of drugs

4. Rational use of drugs is based on use of right drug, right dosage at right cost which is well reflected in the world health organization (WHO) definition : "Rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time , at the lowest cost to them and their community”

5. The rationality of prescribing pattern is of utmost importance because bad prescribing habits including misuse, overuse and underuse of medicines can lead to unsafe treatment, exacerbation of the disease, health hazards, economic burden on the patients and wastage of resources.

6. Auditing Evaluation of data, documents and resources to check performance of systems to meets specified standards

7. Medical Audit “A quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the implementation of change.”

8. Clinical Audit can be defined as the systematic critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patient

9. STEPS Defining standards, C ollecting data, I dentifying areas for improvement, M aking necessary changes B ackground for defining new standards .

10. BACKGROUND OF DEFINING NEW STANDARD O bserving current practice Comparing current practice to standards and implementing change Setting standards of care

11. Objectives Ensuring that drug therapy meets current standards of care Controlling drug cost Preventing problems related to medication Evaluating the effectiveness of drug therapy Identification of areas of practice that require further education of practitioners

12. AUDIT CYCLE Correct the problem

13. HOW TO IMPLEMENT

14. RANDOMLY SELECTED PRESCRIPTION IN PRESCRIPTION CHECK ALL THE PARAMETERS OF AUDIT AS PER CHECKLIST FILL THE PRESCRIPTION AUDIT CHECK LIST REPORT SUBMITTED TO DEPARTMENT AND QUALITY COMMITTEE ANALYZE THE FILLED DATA AFTER CHECKING THE PRESCRIPTION

15. Audit Parameters : Yes/ No/NA Name of patient Age OPD number Dose of drug Dosage of drug Route of drug Frequency / Time of administration Date Legible Known allergy documented Uniform location of treatment order Drug interaction, If Any Food drug interaction, If Any Signature of Doctor

16. Average number of medicines per encounter % of medicines prescribed by generic name % of encounters with an antibiotic prescribed % of encounters with an injection prescribed % of medicines prescribed which are from the essential medicines list or formulary list

17. Average consultation time Average dispensing times % of medicines actually dispensed % of medicines that are adequately labeled % of patients who know how to take their medicines

18. C onclusion Annual reviews of drug utilization may be used to provide background information for decisions on formulation of National essential list of medicine (NLEM ). The observed patterns of drug use can be compared with the current recommendations and guidelines for the treatment of a certain disease Assessment of effective Implementation of the generic prescription can be done Promote working with multidisciplinary teams

19. Allocate resources (financial, human) to provide better patient care Improve professional practice and quality standards Identify and eliminate wastage

20. THANK YOU