Prescription audit in a Tertiary Health- Care facility at Batticaloa, Sri Lanka

Abstract

Irrational prescribing is common especially in developing countries. Identification of internationally comparable indicators of medicines use are important for a country to implement strategies and regulations to improve usage of medicines. Prescription errors contribute to a huge proportion of medication errors since we are specifically focused on prescription errors. WHO in collaboration with the international network of national use of drug (INRUD) has developed core drug use indicators to evaluate and compare practices in health care settings, which includes indicators on prescribing facilities. this survey evaluated the medication use indicators in teaching hospital Batticaloa, according to those core prescribing indicators. The objective is to describe the commonly prescribed medicines, WHO core prescribing indicators and prescription errors in all five medical wards of THB for the year 2022. This descriptive retrospective cross-sectional study was conducted in all the medical wards at Teaching Hospital Batticaloa Representing tertiary healthcare facility of Batticaloa for the year 2022.Prescriptions are obtained from the BHT recorded in all the medical wards using stratified random sampling. Seven samples were selected from each ward for each month adding up to 672 samples in total. A total of 672 prescription were analyzed. The 5 most commonly prescribed medicines were Paracetamol (41.071%), Atorvastatin (32.887%), Omeprazole (25.595%), Salbutamol (24.851%) and Domperidone (19.792%). The average number of medicines per encounter was 5.42. percentage encounters with an antibiotic or an injection was 31.8% and 51.0%, respectively. Percentage of medicines prescribed by generic name and from the EML was 78.3% and 100% respectively. Basic information regarding name, age, gender was presented as 99.7%, 99.4% and 99.6% respectively. The legibility of the prescriptions we audited was 95.2%. Highest percentage of medications were given in enteral route (78.33%). 14.5% of the drugs were given in injectable dosage form. A high degree of polypharmacy was noted. The use of injectable medicines, antibiotics and generic name prescribing was not satisfactory. Prescribing from the EML was 100%. Basic information regarding name, age, gender was satisfactory; closer to 100%. Even though legibility was relatively low comparison to other parameters. overall prescribing pattern in THB, according to the core drug use indicators needs improvement in many aspects. Further investigation into the degree of rational prescribing associating it with clinical information will be important.