PH 3.2 Prescription Audit

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PH3.

Perform and interpret a critical appraisal (audit) of a given prescription

Prescription audit: Introduction

Prescription is a medico legal document written by an authorized health practitioner. It is both a moral
and legal obligation on the part of prescriber to write a correct ,rational and legible prescription. Thus
prescription audit refers to the evaluation of a given prescription to check for its completeness,
correctness, rationality and legibility.

Prescription Checklist Yes/No/NA


Name
Age
Patient details Sex
Weight
Address
Disease details Diagnosis
Name
Prescriber identification Registration Number
Hospital/Clinic, Department
Drug Name
Dose
Treatment details Duration
Direction and route of administration
Follow up advice
Appropriate Drug and Dose for the
diagnosis
Rationality Therapeutic duplication
Drug –Drug interaction
Legibility Legible /legible with difficulty/Illegible

The aim of such an audit is not to find faults but to rectify them. The ultimate goal of prescription audit
is to improve patient care and outcomes. Errors in prescribing increase chances of irrational drug use. It
may increase the cost of treatment as well as prolong the duration of therapy. Widespread emergence
of drug resistant microbial strains has also been blamed on injudicious and indiscriminate use of
antimicrobials. Prescribing errors also has harmful effects on patients health due to drug interactions
and adverse drug reactions.

Even when all prescribing information may be correct , but bad handwriting may nullify all the
advantages of a good prescription. Illegible prescription tend to increase medication errors. Extra
caution should be taken in case of Look alike, Sound Alike drugs. LASA drugs refers to different drugs
which are strikingly similar in their names (either generic or brand names or both) and similar in
packaging, clinical use, dosage and route. Examples

Therapeutic duplication is of special concern as even though it may seem obvious but is actually much
more difficult to detect, especially in Indian context. Therapeutic duplication refers to administration of
two or more drugs of the same therapeutic class where periods of drug administration overlap and
where that practice is not medically indicated. It could even be the same drug prescribed twice by
different doctors and being taken concomitantly. Such a case may arise in tertiary care centres when a
patient is being treated by different doctors. Due to availability of a large number of brands for the same
drug in India and the practice of writing brand names and not generic names in prescriptions makes it
more difficult to detect.
Aim : To perform a prescription Audit of the given prescription

Methodology: The given prescription will be audited using the prescription check list

Result:

Inference: The given prescription was correct/incorrect, rational/irrational and legible/illegible.

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