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Journal articles on the topic 'Prescriptions'
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Goud, Anil, Elizabeth Kiefer, Michelle S. Keller, Lyna Truong, Spencer SooHoo, and Richard V. Riggs. "Calculating maximum morphine equivalent daily dose from prescription directions for use in the electronic health record: a case report." JAMIA Open 2, no. 3 (May 27, 2019): 296–300. http://dx.doi.org/10.1093/jamiaopen/ooz018.
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Abstract To demonstrate a process of calculating the maximum potential morphine milligram equivalent daily dose (MEDD) based on the prescription Sig for use in quality improvement initiatives. To calculate an opioid prescription’s maximum potential Sig-MEDD, we developed SQL code to determine a prescription’s maximum units/day using discrete field data and text-parsing in the prescription instructions. We validated the derived units/day calculation using 3000 Sigs, then compared the Sig-MEDD calculation against the Epic-MEDD calculator. Of the 101 782 outpatient opioid prescriptions ordered over 1 year, 80% used discrete-field Sigs, 7% used free-text Sigs, and 3% used both types. We determined units/day and calculated a Sig-MEDD for 98.3% of all the prescriptions, 99.99% of discrete-Sig prescriptions, and 81.5% of free-text-Sig prescriptions. Analyzing opioid prescription Sigs to determine a maximum potential Sig-MEDD provides greater insight into a patient’s risk for opioid exposure.
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WANG, Zhihui, Min JI, Jin WAN, Bei WANG, Fei WANG, and Zihang SUN. "Establishment and application of intelligent pre-review platform of Chinese drug pieces prescriptions." Pharmaceutical Care and Research 20, no. 5 (October 31, 2020): 341–54. http://dx.doi.org/10.5428/pcar20200505.
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Objective： To realize pre-review of Chinese drug pieces prescriptions and improve the accuracy and efficiency of prescription review，so as to ensure the rationality of Chinese drug pieces prescriptions.Methods： The Chinese drug clinical prescription review system was developed，the pre-review rules and database of Chinese drug pieces prescriptions were established，and finally the smart pre-review of Chinese drug pieces prescriptions was realized.Results： The Chinese drug clinical prescription review system made the prescriptions review standards unified，fast and accurate.100% pre-review of Chinese drug pieces prescriptions was realized，and the rationality and standardization of Chinese drug pieces prescriptions obviously improved.Finally，the Chinese drug pieces clinical prescription pre-review system obtained the copyright of national computer software（No.2019SR0757904）.Conclusion： The Chinese drug clinical prescription pre-review system has realized the intelligent pre-review of Chinese drug pieces prescriptions，with good practicability.For this reason，it is worth further popularization.
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WANG, Zhihui, Min JI, Jin WAN, Bei WANG, Fei WANG, and Zihang SUN. "Establishment and application of intelligent pre-review platform of Chinese drug pieces prescriptions." Pharmaceutical Care and Research 20, no. 5 (October 31, 2020): 341–54. http://dx.doi.org/10.5428/pcar20200505.
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Objective： To realize pre-review of Chinese drug pieces prescriptions and improve the accuracy and efficiency of prescription review，so as to ensure the rationality of Chinese drug pieces prescriptions.Methods： The Chinese drug clinical prescription review system was developed，the pre-review rules and database of Chinese drug pieces prescriptions were established，and finally the smart pre-review of Chinese drug pieces prescriptions was realized.Results： The Chinese drug clinical prescription review system made the prescriptions review standards unified，fast and accurate.100% pre-review of Chinese drug pieces prescriptions was realized，and the rationality and standardization of Chinese drug pieces prescriptions obviously improved.Finally，the Chinese drug pieces clinical prescription pre-review system obtained the copyright of national computer software（No.2019SR0757904）.Conclusion： The Chinese drug clinical prescription pre-review system has realized the intelligent pre-review of Chinese drug pieces prescriptions，with good practicability.For this reason，it is worth further popularization.
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Zahan, Tahmina, Md Maniruzzaman Bhuiyan, and Md Ismail Khan. "Patterns of Prescription of Private Practitioners in Bangladesh." Journal of Dhaka Medical College 26, no. 1 (September 14, 2017): 48–51. http://dx.doi.org/10.3329/jdmc.v26i1.34001.
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A prescription - a written instruction of doctors to pharmacist to supply drugs in particular form to a patient and the directions to the patients regarding the use of medicines.This study was undertaken to observe the prescribing patterns of the practitioners in Bangladesh, 500 prescriptions were collected randomly from Dhaka city and analyzed using WHO/INRUD indicators. There were average 4.40drugs per prescription.Drugs were prescribed in generic name only in 0.30%. About 48% drugs were prescribed from the essential drug list, only prescriptions were complete. In respect to patient medication information, antibiotics were prescribed in 72% of the prescriptions; injections were prescribed in about 10% of the prescriptions.J Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 48-51
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Parihar, Narendra B., Esha A. Patel, and Seeta N. "Evaluation of prescription errors and polypharmacy practices in rural area at community pharmacy." International Journal of Basic & Clinical Pharmacology 10, no. 1 (December 23, 2020): 60. http://dx.doi.org/10.18203/2319-2003.ijbcp20205539.
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Background: Prescription refers to a written request from physician to patient for compounding and dispensing of medicines. The prescription comprises detail information of patient, physician, and drugs, absence of these prescription parameters may harm the patient’s safety. Inappropriate practices like polypharmacy prescriptions must be avoided as this may lead to non-compliance.Methods: A cross section observational study was conducted at a community pharmacy from September to November 2019. Permission was taken from the registered pharmacist. Prescriptions were collected from the subjects who visited the pharmacy in rural area. A checklist was prepared including all the parameters and the prescriptions were analyzed through Microsoft excel.Results: Out of 2227 prescriptions collected, patient’s name, age and weight were not written in 10.57%, 78.41%, and 12.33% of prescriptions respectively. Physician’s name, designation and registration number were not mentioned in 18.50%, 21.14%, 29.51% prescriptions respectively. Date of issue was lacking in 12.33% prescriptions. It was found that 44.49% prescriptions were illegible. It was observed that 82.81% prescriptions possessed dosage form of drug and 32.15% dose in it. The study showed that 19.2% prescriptions were polypharmacy prescriptions.Conclusions: Prescription is an authoritative document between doctor and pharmacist therefore it needs to be precise, fastidious, and scrupulous, monitoring to identify causes, analyze errors and blemishes in the prescription. One or other parameters were lacking in every prescription. ‘Educate to medicate’ this indicates that sound knowledge is requiring to prescribe therapeutically efficacious and accurate medicines in prescription.
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Shepherd, Elizabeth, Helen Douglas, and Leyla Osman. "A service evaluation of the accuracy of electronic prescriptions used to calculate nebulised medication adherence in adult with cystic fibrosis." Journal of the Association of Chartered Physiotherapists in Respiratory Care 54, no. 2 (April 2022): 47–59. http://dx.doi.org/10.56792/vwji7953.
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Adherence to nebulised medications in people with cystic fibrosis (CF) is known to be suboptimal. CFHealthHub uses an electronic prescription (e-prescription) as a denominator and chipped nebuliser devices which capture the frequency of nebulised medications inhaled by the patient. This enables a calculation of nebulised medication adherence to be made. However, e-prescriptions may contain errors which can affect the adherence calculation. This service evaluation sought to review the accuracy of CFHealthHub e-prescriptions at a single adult CF centre, to understand the nature and causes of any inaccuracies and to evaluate the effect of prescription complexity on prescription accuracy. A total of thirty e-prescriptions from CFHealthHub were compared to ‘gold standard’ prescriptions. Inaccuracies and types of error in the e-prescriptions were recorded and analysis was conducted to understand the effect of prescription complexity on this. The two prescriptions were discussed with participants to determine the causes of inaccuracies. Inaccuracies were found in 43% (13/30) of e-prescriptions and were significantly associated with alternating medication regimens (p = 0.025). There were four error types found within the e-prescriptions: inaccurate medication list, incorrect medication duration, incorrect medication frequency and prescription duplication errors. Medication list errors were significantly associated with alternating medication regimens (p = 0.007). Causes of e-prescription inaccuracy were due to failure to update the prescription following a change, errors in prescription entry and inaccuracies caused by using two different nebuliser devices. CFHealthHub e-prescriptions contain inaccuracies and prescription complexity can increase the risk of prescription inaccuracy, although the small sample size limits the ability of the service evaluation to draw strong conclusions. Causes of e-prescription accuracy should be addressed by the local CF team.
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Randhawa, Gurpreet Kaur, Navyug Raj Singh, Prithwijit Kundu, and Swati Prabhakar. "Evaluation of indoor prescriptions of depression in psychiatry department of a tertiary care hospital in North India." International Journal of Basic & Clinical Pharmacology 6, no. 11 (October 25, 2017): 2718. http://dx.doi.org/10.18203/2319-2003.ijbcp20174794.
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Background: Depression is one of most common psychiatric illnesses affecting the human population and poses significant economic burden to society. Prescription for depression usually involves multiple medications sometime irrationally prescribed.Methods: Present study involved evaluation of 65 indoor prescriptions of patients diagnosed with depression from Psychiatry Department in a tertiary care hospital. The prescriptions were evaluated on basis of WHO Core Indicators for writing a good prescription. The demographic characteristics of the patient population were studied. Number of drugs prescribed per prescription and the average number per prescription were calculated to assess polypharmacy. The cost involved in treatment using latest market data from drug information source and the rationality of prescriptions were also evaluated.Results: 80% of the prescriptions were not in accordance with the WHO Core Indicators. An average of 2.415±1.102 medications were prescribed per prescription indicating polypharmacy. Insignificant difference was observed in cost per prescription per month of medicines when compared with lowest priced products available in market.Conclusions: Polypharmacy was found in most prescriptions and monotherapy was instituted in five prescriptions only, with clonazepam as the most prescribed antidepressant drug. Majority of prescriptions did not conform to WHO core indicators for prescription writing.
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Dhavalshankh, Archana G., Vikram A. Rajadnya, and Kedar L. Patil. "Prescription auditing: an important tool for sensitization of resident doctors for rationale prescription and utilization of drug." International Journal of Basic & Clinical Pharmacology 8, no. 10 (September 25, 2019): 2237. http://dx.doi.org/10.18203/2319-2003.ijbcp20194263.
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Background: The main objective of the Maharashtra Health Systems Development Project (MHSDP) is to enhance the quality of care by improving health care; in the hospitals, in the state. Improvement in the prescribing practice of resident doctors working in the hospitals is one of the initiatives taken up, to improve the rationalizing service delivery. A prescription audit may become an important tool for sensitizing resident doctors for rational prescription and utilization of drug.Methods: An observational study was carried out during the period of March 2017 to May 2017 in tertiary care teaching hospital, Kolhapur. Total 247 first prescriptions written by resident for in-door-patient department were collected, scrutinized and analysed. Prescriptions were evaluated for completeness of prescription format while legibility was graded. Prescriptions were also analysed as per World Health Organization prescribing indicators.Results: In study 247 prescriptions with 1091 drugs with average 4.42% drugs per prescription, 49.8 % prescriptions wrote the drugs by generic name. We found that 44.1 % prescriptions written with drugs included in essential medicines list while antibiotics prescribed were 27.1%. In prescription format 34% had incorrect dosage, 67% of prescriptions omitted the duration of treatment. Direction for drug use was not mentioned in 25% of prescriptions. Weight was not mentioned on any prescriptions even for paediatric group.Conclusions: Through prescription auditing, sensitizing resident doctors for rational prescription and utilization of drug can be done to achieve the goal of the MHSDP of enhancing the quality of care by improving health care; in the hospitals, in the state.
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Xiong, Wangping, Kaiqi Wang, Shixiong Liu, Zhaoyang Liu, Yimin Zhu, Peng Liu, Ming Yang, and Xian Zhou. "Multiple prescription pattern recognition model based on Siamese network." Mathematical Biosciences and Engineering 20, no. 10 (2023): 18695–716. http://dx.doi.org/10.3934/mbe.2023829.
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<abstract> <p>Prescription data is an important focus and breakthrough in the study of clinical treatment rules, and the complex multidimensional relationships between Traditional Chinese medicine (TCM) prescription data increase the difficulty of extracting knowledge from clinical data. This paper proposes a complex prescription recognition algorithm (MTCMC) based on the classification and matching of TCM prescriptions with classical prescriptions to identify the classical prescriptions contained in the prescriptions and provide a reference for mining TCM knowledge. The MTCMC algorithm first calculates the importance level of each drug in the complex prescriptions and determines the core prescription combinations of patients through the Analytic Hierarchy Process (AHP) combined with drug dosage. Secondly, a drug attribute tagging strategy was used to quantify the functional features of each drug in the core prescriptions; finally, a Bidirectional Long Short-Term Memory Network (BiLSTM) was used to extract the relational features of the core prescriptions, and a vector representation similarity matrix was constructed in combination with the Siamese network framework to calculate the similarity between the core prescriptions and the classical prescriptions. The experimental results show that the accuracy and F1 score of the prescription matching dataset constructed based on this paper reach 94.45% and 94.34% respectively, which is a significant improvement compared with the models of existing methods.</p> </abstract>
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Nuryatama, Dewa Gede Wahyu, and Made Krisna Adi Jaya. "FIGURE OF POTENTIAL MEDICATION ERROR IN MEDICINE PRESCRIPTION FOR OUTPATIENT SERVICES OF "X" HOSPITAL IN BALI." Journal of Pharmaceutical Science and Application 4, no. 2 (December 1, 2022): 51. http://dx.doi.org/10.24843/jpsa.2022.v04.i02.p02.
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Background: Medication errors (ME) in health services; in this case, hospitals are supposed to have zero accidents. Evaluation of the potential ME, such as doctor's prescription writing, must still be carried out in an effort to maintain service quality, especially in maintaining patient safety or preventing medication errors. Objective: This research aimed to see the figure of potential medication errors that occur in the prescribing process, in this case, is related to the completeness of the prescription seen from the administration and pharmaceutical approach, as well as the legibility of the prescriptions originating from outpatient services at one of the hospitals in Bali. Methods: This research was observational with a qualitative descriptive approach. Data collection was carried out retrospectively through medication prescriptions for patients received by pharmaceutical installations for outpatient services at hospitals from July until October 2022, totaling 110 prescriptions. Results: Results showed that 1.8% of prescriptions still did not write down the patient's name, then 9.1% of prescriptions had not written down the patient's age, 21.8% of prescriptions had not written down the patient's gender, and as many as 93.6% of prescriptions did not include the patient's weight, 2.7 % of prescriptions did not include the name of the doctor, 75.5% of the prescriptions did not include the doctor's SIP number, 1.8% of the prescriptions still did not write down the rules for using the drug, 10.9% of the prescriptions did not write down the strength of the drug dosage and 19.1% of the prescriptions did not provide information about dosage form to be administered to the patient. This study also shows 8.9% of the prescriptions are Illegible prescription. Conclusion: The results of the research found that administratively and pharmaceutically incomplete prescriptions and also Illegible prescription writing were still found. So the results of this study show how important it is to always evaluate the potential of medication errors, especially at the prescribing and transcribing phases, to improve patient safety.
Keywords: Medication error; Prescription; Hospital; Retrospective
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Melcer, Ted, Jay Walker, Jocelyn Sazon, Robby Domasing, Katheryne Perez, Vibha Bhatnagar, and Michael Galarneau. "Outpatient Pharmacy Prescriptions During the First Year Following Serious Combat Injury: A Retrospective Analysis." Military Medicine 185, no. 7-8 (March 16, 2020): e1091-e1100. http://dx.doi.org/10.1093/milmed/usaa038.
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Abstract Introduction Limited research has analyzed the full range of outpatient medication prescription activity following serious combat injury. The objectives of this study were to describe (1) outpatient medication prescriptions and refills during the first 12 months after serious combat injury, (2) longitudinal changes in medication prescriptions during the first-year postinjury, and (3) patient characteristics associated with outpatient prescriptions. Materials and methods This was a retrospective analysis of existing health and pharmacy data for a random sample of U.S. service members who sustained serious combat injuries in the Iraq and Afghanistan conflicts, 2010–2013 (n = 381). Serious injury was defined by an Injury Severity Score (ISS) of 9 or greater. These patients typically participate in military rehabilitation programs (eg, amputation care) where prescription medications are essential. Data sources were the Expeditionary Medical Encounter Database for injury-specific data, the Pharmacy Data Transaction Service for outpatient medication prescriptions and refills, and the Military Health System Data Repository for diagnostic codes of pain and psychological disorders. Military trauma nurses reviewed casualty records to identify types of injuries. Using the American Hospital Formulary Service Pharmacologic-Therapeutic Classification system, clinicians identified 13 categories of prescription medications (eg, opioid, psychotherapeutic, immunologic) for analysis. Multivariable negative binomial and logistic regression analyses evaluated significant associations between independent variables (eg, blast injury, traumatic brain injury [TBI], ISS, limb amputation, diagnoses of chronic pain, or psychological disorders) and prescription measures (ie, number or category of medication prescriptions). We also describe longitudinal changes in prescription activity postinjury across consecutive quarterly intervals (91 days) during the first-year postinjury. Results During the first-year postinjury, patients averaged 61 outpatient prescriptions, including all initial prescriptions and refills. They averaged eight different categories of medications, primarily opioid, immunologic, gastrointestinal/genitourinary, central nervous system (CNS), nonopioid analgesic, and psychotherapeutic medications (representing 82% of prescriptions) during the first year. Prescription activity generally declined across quarters. There was still substantial prescription activity during the fourth quarter, as 79% of patients had at least one prescription. From 39 to 49% of patients had fourth-quarter prescriptions for opioid, CNS, or psychotherapeutic medications. Longitudinally, we found that 24–34% of patients had an opioid, CNS, or psychotherapeutic prescription during each of the final three quarters. In multivariable analysis, ISS, limb amputation (particularly bilateral amputation), and diagnoses of chronic pain and post-traumatic stress disorder (PTSD) were associated with significantly higher counts of individual and multiple medication prescriptions. TBI was associated with significantly lower numbers of prescriptions for certain medications. Conclusions This is one of the first studies to provide a systematic analysis of outpatient medication prescriptions following serious combat injury. The results indicate substantial prescription activity from multiple medication categories throughout the first-year postinjury. Diagnoses of chronic pain, PTSD, and limb amputation and ISS were associated with significantly higher counts of prescriptions overall and more prescription medication categories. This study provides initial evidence to better understand medication prescription activity following serious combat injury. The results inform future research on medication prescription practices and planning for rehabilitation.
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Rangel, India, Maya T. Harrington, Nellie V. Movtchan, Lyndsay A. Kandi, Javier Janbieh, Jordan R. Pollock, Erwin Kruger, Jason H. Ko, and Chad M. Teven. "A Retrospective Study Analyzing Opioid Prescription Practices in Hand Surgery from 2013 to 2019." Plastic and Reconstructive Surgery - Global Open 11, no. 8 (August 2023): e5218. http://dx.doi.org/10.1097/gox.0000000000005218.
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Background: The potential for opioid prescription medication addiction and abuse has been a growing concern in healthcare. It is not uncommon for hand surgery patients to be overprescribed opioid medication for postoperative pain management. The objective of this study was to characterize changes in opioid prescription practices of hand surgeons treating Medicare Part D patients from 2013 to 2019. Methods: A retrospective analysis of Medicare Part D prescriber data from 2013 to 2019 was conducted. This database provides information on drugs paid for under the Medicare Part D Prescription Drug Program. For each prescriber and medication, the dataset includes the total number of prescriptions dispensed (original prescriptions and number of refills), and total medication cost. Results: In 2013, the 10 most common medications prescribed totaled 114,409 prescriptions, with 89,701 (78.4%) opioid prescriptions. In 2019, the 10 most common medications prescribed totaled 164,955 prescriptions, with 109,665 (66.5%) opioid prescriptions. Although total opioid prescriptions dropped, there was a 22% increase in the total number of prescriptions written. The two most common medications prescribed, hydrocodone-acetaminophen and oxycodone-acetaminophen, totaled 75,796 in 2013, compared with 76,518 in 2019. The overall number of prescriptions for nonsteroidal anti-inflammatory drugs increased by 157%, and the percentage of total opioids prescribed declined by 7.9%. Conclusions: The increase in total opioid prescriptions from 2013 to 2019 by hand surgeons in the Medicare Part D Prescription Drug Program lags behind the recommended shift to nonopioid pain management. The reasons for the overall rise in prescriptions deserve further exploration.
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Ved, Priti, and Tim Coupe. "Improving prescription quality in an in-patient mental health unit: three cycles of clinical audit." Psychiatric Bulletin 31, no. 8 (August 2007): 293–94. http://dx.doi.org/10.1192/pb.bp.106.012963.
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Aims and MethodWe undertook three cycles of clinical audit of prescription charts to improve the quality of the prescriptions written in an in-patient unit. Pharmacy and medical staff reviewed a total of 1466 prescriptions on 242 prescription charts against local guidelines and provided feedback to medical staff. The pharmacist also regularly reviewed prescription charts on the wards between audits.ResultsAfter three cycles of audit, 99.5% of prescriptions written were legible. The recording of drug allergies, section 58 status and patient age remained poor.Clinical ImplicationsA combination of clinical audit and continual pharmacist review of prescription charts can improve the quality of prescriptions written by medical staff in an in-patient unit.
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Sharma, Mukesh, Nikhil Payal, Leimapokpam Sumitra Devi, Divya Gautam, Manisha Khandait, Kapil Hazarika, and Moumita Sardar. "Study on Prescription Audit from a Rural Tertiary Care Hospital in North India." Journal of Pure and Applied Microbiology 15, no. 4 (October 15, 2021): 1931–39. http://dx.doi.org/10.22207/jpam.15.4.14.
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Evidence concerning prescription audits conducted in developing countries like India is scarce, especially from the rural parts of the country. Therefore, the present prescription audit was undertaken in a rural tertiary care hospital to investigate prescriptions for their completeness, in format of prescription, legibility of writing and it was assessed against the World Health Organization (WHO) recommendation of core indicators for prescription writing in order to investigate the rational usage of drugs. A total of 200 prescriptions were randomly selected, irrespective of clinical departments, patient characteristics and diagnosis over a period of six months. All the prescriptions were prospectively analyzed and conferred to an assessment of the quality of prescribing practice, general details, medical components, WHO core drug use indicators and legibility. Amongst the 200 prescriptions precisely monitored, we found that 100% prescriptions had general details of the patients such as name, age, gender, OPD/IPD registration number, hospital name & address and consulting unit/department. While evaluating the handwriting of the doctors, 83.5% (177/200) of the prescriptions had legible handwriting, wherein the degree of legibility showed 68.5% (137/200) prescriptions with easy legibility, 20% (40/200) difficult legibility while 11.5% (23/200) were illegible. Along with the different types of drugs obtained from the selected prescriptions, we found that antibiotics were prescribed in 51.5% (103/200) of the prescriptions. A prescription audit is a good tool to systemically review the day to day work, maintenance of records and assessment of accuracy of the diagnosis given by doctors and also the outcome of the treatment received.
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Piovani, Daniele, Antonio Clavenna, Chiara Pavoni, and Maurizio Bonati. "DRUG PRESCRIPTION PROFILE AND PERINATAL DETERMINANTS DURING THE FIRST YEAR OF LIFE." Archives of Disease in Childhood 101, no. 1 (December 14, 2015): e1.33-e1. http://dx.doi.org/10.1136/archdischild-2015-310148.39.
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The aim of the study was to investigate the drug prescription profile during the first year of life in a cohort of newborns, and the influence of perinatal and socio-demographic factors on drug prescription.A total of 61,479 neonates born in 2011 were included. The data source was the database of reimbursed prescriptions of the Lombardy region, Italy. Drug prescriptions were classified according to the Anatomical Therapeutic Chemical (ATC) classification system. Drug prevalence was calculated as the percentage of neonates receiving at least one drug prescription in one year. Chi-square test was used to compare prevalence of drug prescription in males and females.In all, 42,204 infants (68.7%) received at least one drug prescription, with a prevalence slightly higher in males than females (71.1% versus 66.1%; χ2=178 p<0.01). The drug classes most commonly prescribed in the first year of life were antibiotics (39.5% of infants), anti-asthmatics (32.6%), and corticosteroids for systemic use (9.8%).The median age of first prescription was 20.6 (Interquartile range: 9.4–33.3) weeks. Males received the first prescription about one week before females (20.1 versus 21.3, respectively). The first prescription concerned mainly anti-asthmatics (40.5%), and antibiotics (37.9%), and amoxicillin (16.3%), beclomethasone (16.0%), and amoxicillin+clavulanic acid (15.0%) were the most prescribed drugs.In conclusion, in the first year of life, 7 out of 10 infants received drug prescriptions. Males were more exposed than females, a finding consistent with the epidemiology of diseases in infancy. The analysis concerning the influence of maternal and perinatal factors is ongoing.
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Afsan, Mohammad, Muhammad Mahbubul Alam, Nushrat Noor, Abul Kalam Mohyammad Yousuf, and MM Ekramul Haque. "Audit of Typical Prescription Format Among the Prescribers of a Garment Medical Centre in Bangladesh." Update Dental College Journal 1, no. 2 (February 28, 2013): 07–12. http://dx.doi.org/10.3329/updcj.v1i2.13979.
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Objective: To audit the typical prescription or general format according to WHO guidelines for good prescription writing.Materials and methods: A cross-sectional descriptive study was conducted after collecting data from medical records to observe standard of prescriptions and identify factors underlying inappropriate prescription writing.Place and period of study: A total of 300 prescriptions of the patients (garment workers) who had attended in Hannan Textile and Garment Medical Centre, Board Bazar, Dhaka, Bangladesh in between January and November2008 were considered for analysis. Results: Audit of the prescription pattern revealed that most of the prescriptions did not conform to the pattern of a typical prescription. The patients identity was mentioned in all prescriptions (100%). Date of the prescription and superscription symbol (Rx) were also mentioned in all prescriptions (100%). Inscription which includes name of the drug, dosage form and total amount of medication prescribed was mentioned in all prescriptions (100%) but dose and duration of treatment were mentioned in 66% and 70% prescriptions respectively. In this study, about 91.67% instructions to the pharmacist and 50% special instructions to the patient regarding the dosage form and total amount to be dispensed were found adequately. Almost 100% of the prescriptions adequately mentioned the dosage schedules and also precautions/warnings about the drug therapy. Almost 100% of the prescriptions were signed by the doctors mentioning their full name, address with qualification and registration number. But telephone/mobile number of the doctors was not found in all prescriptions (100%). Most common diagnosis among garment workers was ARI (19.33%). Most commonly prescribed group of drug was antiulcerent (17.13%) and most commonly prescribed antibiotic was amoxicillin (13.67%). Most of the drugs were prescribed in oral form (97.77%). No single drug interaction (0%) was found in any prescription. The fixed dose-drug combinations (FDCs) accounted for 67% drugs prescribed. The most commonly FDC was multivitamin and multimineral which was not included in essential medicine list (EML).Conclusion: Large numbers of prescriptions did not conform to ideal pattern and lack in their rationality. This study revealed a lot of scope for educating the prescribers to improve prescribing practices.DOI: http://dx.doi.org/10.3329/updcj.v1i2.13979 Update Dent. Coll. j. 2011: 1(2): 07-12
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Arianpour, Khashayar, Brandon Nguyen, Brian Yuhan, Peter F. Svider, Jean Anderson Eloy, and Adam J. Folbe. "Opioid Prescription Among Sinus Surgeons." American Journal of Rhinology & Allergy 32, no. 4 (May 21, 2018): 323–29. http://dx.doi.org/10.1177/1945892418773578.
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Background Misuse and diversion of opioids have contributed to the U.S. opioid crisis, making an understanding of specialty-specific and procedure-specific trends essential. Objective The objective of this analysis was to evaluate nationwide trends in opioid prescribing patterns among sinus surgeons performing functional endoscopic sinus surgery and maxillary sinus balloon dilation, specifically examining factors associated with variations. Methods High-volume sinus surgeons were identified through the Centers for Medicare and Medicaid Services database and cross-referenced against prescriptions to Medicare Part D beneficiaries during 2013 through 2015. Number of opioid prescriptions, prescription lengths, and demographic information were obtained. Results This cohort of 570 surgeons wrote 21,042 opioid prescriptions (5.4 days per prescription) in 2015, with 80.3% and 54.7% writing >10 and >25 prescriptions, respectively. Surgeons writing a greater amount of prescriptions wrote lengthier courses throughout all 3 years ( P = .01, P = .002, P = .003). Female otolaryngologists wrote lengthier prescriptions (6.2 vs 5.3 days, P = .01). Early career otolaryngologists (≤10 years) offered fewer prescriptions compared to those who had greater experience (31.1 vs 39.3, P = .02). Moreover, 73.6% of fellowship-trained otolaryngologists offered >10 prescriptions versus 82.7% of nonfellowship-trained otolaryngologists ( P = .02). Practitioners in the South on average prescribed the greatest amount of opioids ( P < .05). Conclusion A majority of sinus surgeons prescribe ≥25 opioid prescriptions annually, with otolaryngologists who write a greater amount of prescriptions writing lengthier courses. As the mean opioid prescription length is 5.4 days, recent legislation limiting opioid prescriptions to 5 days may only have a modest impact for preventing the diversion of perioperative opioid prescriptions. These data suggest further standardized guidelines may be beneficial in elucidating the appropriate indications for the prescription of opioids among sinus surgeons.
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A P, Ravinandan, Hunsur Nagendra Vishwas, Shashank S. Hosur, Ashika K V, and Kavya S. "A study of prescription errors in South Indian City, Karnataka- An observational study." IP International Journal of Comprehensive and Advanced Pharmacology 8, no. 2 (May 15, 2023): 125–29. http://dx.doi.org/10.18231/j.ijcaap.2023.021.
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A prescription is a written order to provide instructions regarding patient medications by the physician. Prescription include directions for the pharmacist to dispense the medication, directions for the patient regarding administration of drugs. Patient demographics and prescriber details are the legal requirements of the prescription writing.An observational study was conducted and data collection forms were used to collect the information from the patient. Confidentiality was maintained to secure the patient information, prescription details, throughout the study. All the prescriptions are analyzed for general details, medical components, and legal requirements. The data obtained were summed up and simple statistical analysis was performed to draw the results. All the prescriptions had general details mentioned in it.The mentioning of demographic details in prescription were found to be 48.07%.The clarity of the prescription related to legibility of handwriting was achieved in 92.24%.Poly-therapy was observed in 73 prescriptions. Most of the prescriptions did not provided description on the direction on usage of medications.Our study highlights the need to train prescribing doctors on writing rational prescriptions for quality improvement.
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Yun, Seung Won, and Pusoon Chun. "Real world tablet-splitting prescription status of enteric-coated tablets of diclofenac sodium and aspirin." Yakhak Hoeji 67, no. 4 (August 31, 2023): 268–76. http://dx.doi.org/10.17480/psk.2023.67.4.268.
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This study aimed to investigate tablet-splitting prescription of enteric-coated tablets of diclofenac sodium and aspirin. We conducted a retrospective cross-sectional study using claims data collected by the Health Insurance Review and Assessment Service (HIRA) of Korea during 2016-2020. Of the 1,227,666 prescriptions of aspirin 100 mg enteric-coated tablet, 941 tablet-splitting prescriptions were identified, accounting for 0.1%. Of the 941 prescriptions, 41.7% (392) were prescribed for the elderly individuals aged 65 years. Of the 334 tablet-splitting cases with 15 or more consecutive days of prescription, 58.7% (196) were found in the elderly. Furthermore, 37.0% (37/100), 37.1% (13/35), and 40.4% (36/89) of cases with consecutive days of prescription of 31-60, 61-90 days, and more than 90 days, respectively, gastrointestinal disorders were found. Of the 53,868 prescriptions of diclofenac sodium 25 mg enteric-coated tablet, 2,248 tablet-splitting prescriptions were identified, accounting for 4.2%. Furthermore, of the 2,248 prescriptions, 53.0% (1,192) were prescribed for children under 5 years old, and 33.1% (744) were prescribed for children aged 5-9 years, respectively. We found that tablet-splitting prescription rate of diclofenac sodium 25 mg was high, especially in children. Gastrointestinal disorders were common in the tablet-splitting prescriptions of aspirin 100 mg, especially in the cases with 15 or more consecutive days of prescription.
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Yu, Chunlan, and Shanmei Xu. "Application of Prescription Reviews for Traditional Chinese Medicine to Improve Medical Disputes and Patient Satisfaction." Evidence-Based Complementary and Alternative Medicine 2022 (July 7, 2022): 1–7. http://dx.doi.org/10.1155/2022/5889284.
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Objective. Medical disputes and patient satisfaction are related to inappropriate prescribing practices. We aim to investigate the clinical application of prescription reviews for traditional Chinese medicine (TCM). Method. TCM prescriptions performed prescription reviews in 372 patients from the year 2019 to 2020 were set as the observation group and those from the year 2017 to 2018 without prescription reviews as the control group (n = 341). According to the Criteria for Assessing Prescription Quality in Chinese Hospitals (CAPQCH) items, “Irrational” and “Rational” TCM prescriptions were determined mainly based on the following category: nonstandard prescriptions, inappropriate prescriptions, and hypernormal prescriptions. The incidence of medical disputes and the degree of patient satisfaction were compared between the two groups. Result. No difference was found in age and gender between the control group and the observation group. The number of irrational TCM prescriptions from the year 2017 to 2020 was 6, 8, 2, and 3, respectively, with the percentage of 3.725%, 4.480%, 1.201%, and 1.446%. The irrational rate in the observation group (1.344%) was significantly lower than that in the control group (4.106%). Specifically, a higher rate of nonstandard prescriptions was revealed in the control group as compared with the observation group. Moreover, a reduced incidence of medical disputes was revealed in the observation group relative to the control group accompanying with the increased degree of patient satisfaction. Conclusion. Prescription reviews have high application value in the management of Chinese pharmacies, which can improve the rationality of prescriptions, increase patient satisfaction, and reduce medical disputes.
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Firas Widianto, Izhhar, Akhmad Kharis Nugroh, and Chairun Wiedyaningsih. "The Role of E-Prescription in Reducing Medication Error in The Prescribing Stage at The Puskesmas Mojoanyar, East Java." BIO Web of Conferences 75 (2023): 05019. http://dx.doi.org/10.1051/bioconf/20237505019.
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Electronic prescription or e-prescription has been considered as a solution to overcome errors in the early stage of medicines use. However, the electronic prescribing is still not widely implemented in Indonesia. The purpose of this study was to identify the role of electronic prescription in minimizing the incidence of medication errors at the prescribing stage. A cross-sectional study was conducted to compare errors between electronic and hand-written prescriptions in primary health care Mojoanyar. Mojokerto, East Java. Prescriptions were collected retrospectively using purposive and quota sampling based on predetermined criteria. A checklist form was used to collect and review prescriptions during the period February March 2021 (hand-written prescriptions) and December 2022 January 2023 (e-prescriptions). Errors in prescribing were identified in aspects related to the prescription writing process (incompleteness information; illegibility writing) and aspects related to drug selection decisions (drug interaction, drug dosage form, drug dosing and therapeutic duplication). The Chi-square test was used for testing relationships between categorical variables as appropriate. The data were presented in frequency and percentage using descriptive statistics. A total of 2570 prescriptions from 656 patients were reviewed for errors in which 1275 (328 patients) hand-written and 1295 (328 patients) electronic prescriptions. The results showed that incompleteness information was found to be significantly higher in hand-written compared to electronic prescriptions (p < 0.05). Illegible writing was only found in 92 (7.22%) hand-written prescriptions. The risk of drug interactions and other errors in drug selection decisions were not reduced by electronic prescribing. Electronic prescription was able to reduce prescribing errors, especially in the writing process, while for treatment decision it was necessary to add feature to the electronic support system.
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Roy, Caitlin, Holly Mansell, Charity Evans, Shenzhen Yao, Casey Phillips, Carmen Johnson, and David Blackburn. "Opioid Prescribing Among Hospitalized Patients in Tertiary Care Hospitals: A Retrospective Cohort Study." Canadian Journal of Addiction 15, no. 2 (June 2024): 24–32. http://dx.doi.org/10.1097/cxa.0000000000000206.
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ABSTRACT Objectives: Hospitalization may be an important source of opioid prescriptions in the community. We aimed to describe opioid prescribing for inpatients of 2 tertiary care hospitals in Canada. Methods: We conducted a retrospective cohort study in 2 Canadian hospitals using electronic discharge abstracts and inpatient prescription records for adults admitted to medicine or surgery units between 2017 and 2019. Opioid prescriptions were characterized by dosage, duration, and concomitant prescriptions. A random effects logistic regression model was built to identify independent predictors of opioid prescriptions on the day of discharge in patients with a medicine admission. Results: Of the 56,302 patients included, the mean age was 62 years, 19,946 (52.2%) were female, 32,472 (57.7%) were admitted to a medicine unit, and 15,114 (26.8%) to surgery. At least 1 inpatient opioid prescription was observed for 65.1% of all admissions (n=36,626/56,302). Among all patients receiving inpatient opioid prescriptions, virtually all were prescribed a strong opioid (96.8%, 35,437), and 67.8% (24,834) included an intravenous route of administration. Inpatient opioid prescriptions were active for an average of 87.1% of the hospitalization; however, most individuals received as-needed opioid prescriptions only (70.7%, 25,899). On the day of discharge, at least 1 active inpatient opioid prescription was identified in 55.2% (24,467) of all patients in the cohort. Two factors were highly predictive of an active inpatient opioid prescription on the day of discharge: duration of the opioid prescription and opioids prescribed as needed only. Conclusions: Inpatient opioid prescriptions are currently ordered for a high percentage of hospitalized patients, and they often remain active on the day of discharge. The prescribing patterns identified provide targets for strategies to reduce unnecessary opioid exposure. Objectifs: L’hospitalisation peut être une source importante de prescriptions d’opioïdes dans la communauté. Nous avons cherché à décrire la prescription d’opioïdes chez les patients hospitalisés dans deux hôpitaux de soins tertiaires au Canada. Méthodes: Nous avons mené une étude de cohorte rétrospective dans deux hôpitaux canadiens en utilisant les résumés de sorties électroniques et les dossiers de prescriptions des patients hospitalisés pour les adultes admis dans les unités de médecine ou de chirurgie entre 2017 et 2019. Les prescriptions d’opioïdes ont été caractérisées par le dosage, la durée et les prescriptions concomitantes. Un modèle de régression logistique à effets aléatoires a été construit pour identifier les prédicteurs indépendants des prescriptions d’opioïdes le jour de la sortie chez les patients ayant été admis en médecine. Résultats: Sur les 56 302 patients inclus, l'âge moyen était de 62 ans, 19 946 (52,2%) étaient des femmes, 32 472 (57,7%) ont été admis dans une unité de médecine et 15 114 (26,8%) en chirurgie. Au moins une prescription d’opioïdes pour les patients hospitalisés a été observée pour 65,1% de toutes les admissions (n=36 626/56 302). Parmi les patients ayant reçu une prescription d’opioïdes en hospitalisation, la quasi-totalité s’est vu prescrire un opioïde fort (96,8%, 35 437), et 67,8% (24 834) ont été administrés par voie intraveineuse. Les prescriptions d’opioïdes pour les patients hospitalisés ont été actives pendant 87,1% de la durée de l’hospitalisation en moyenne ; cependant, la plupart des personnes ont reçu des prescriptions d’opioïdes uniquement en cas de besoin (70,7%, 25 899). Le jour de la sortie, au moins une prescription active d’opioïdes en milieu hospitalier a été identifiée chez 55,2% (24 467) de tous les patients de la cohorte. Deux facteurs étaient hautement prédictifs d’une prescription active d’opioïdes pour patients hospitalisés le jour de la sortie : la durée de la prescription d’opioïdes et les opioïdes prescrits uniquement en cas de besoin. Conclusions: Les ordonnances d’opioïdes pour les patients hospitalisés sont actuellement prescrites pour un pourcentage élevé de patients hospitalisés et elles restent souvent actives le jour de la sortie. Les schémas de prescriptions identifiés fournissent des cibles pour des stratégies visant à réduire l’exposition inutile aux opioïdes.
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Sharma, Nazuk, D. C. Dhasmana, Taruna Sharma, and Alpa Gupta. "Quality of prescriptions in hospitalized children suffering from acute and persistent diarrhoea." International Journal of Basic & Clinical Pharmacology 8, no. 4 (March 23, 2019): 792. http://dx.doi.org/10.18203/2319-2003.ijbcp20191119.
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Background: Diarrhoea is a major public health problem in children worldwide. It continues to be a major health challenge, especially in developing countries, despite the availability of regularly updated standard treatment guidelines. Non-compliance to such guidelines by the physicians has been a long standing story. The treatment is often marred with incapacitating prescription of drugs besides neglecting even the basic tenets of good prescribing. As a result, the quality of such prescriptions for diarrhoeal disorders in children remains poor. To gauge the magnitude of this problem in this setup towards possible corrective measures, the study was aimed to audit prescription practices in the management of acute and persistent diarrhoea in hospitalised children up to five years of age.Methods: An observational study was conducted in 100 patients of either gender in the age group up to 5 years admitted with acute and persistent diarrhoea. A detailed medical history from the parents/guardians and the details of prescription from the time of admission till the discharge of the patient were obtained. Quality of prescriptions was analysed using prescription quality index (PQI) tool, a validated comprehensive tool described by Hassan et al in 2010. Based on this tool, prescription with the total PQI score of ≤ 31 were interpreted as poor quality, scores with 32 to 33 as medium quality and scores 34 to 43 as high quality with a possible maximum score of ‘43’.Results: Based on the PQI tool for 100 children, 60 prescriptions were found to be of poor quality. Only 2 prescriptions were of medium quality, whereas 38 prescriptions were in high quality range. Average mean±SD score of prescriptions with poor quality was 25.2±1.48, ranging from 21 to 31. The mean±SD of prescriptions with medium quality was observed to be 32±0 and for prescriptions of high quality was 38.07±2.28. The total average mean score of all prescriptions was 30.23±6.50. Poor quality prescriptions were particularly observed for the patients with the diarrhoea with No dehydration.Conclusions: Prescription appropriateness in spite of available guidelines continues to be a big challenge in the adequate management of patients with diarrhoeal disorders under the age group of five years in a tertiary care centre in India.
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Zhou, Shuchun. "Data Mining and Analysis of the Compatibility Law of Traditional Chinese Medicines Based on FP-Growth Algorithm." Journal of Mathematics 2021 (December 17, 2021): 1–10. http://dx.doi.org/10.1155/2021/1045152.
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The compatibility law of prescriptions is the core link of TCM theory of “theory, method, prescription and medicine,” which is of great significance for guiding clinical practice, new drug development and revealing the scientific connotation of TCM theory, and is also one of the hot spots and difficulties of TCM modernization research. How to efficiently analyze the frequency of drug use, core combination, and association rules between drugs in prescription is a basic core problem in the study of prescription compatibility law. In this paper, a systematic study was made on the compatibility rules of traditional Chinese antiviral classical prescriptions and the mechanism of traditional Chinese medicine molecules. FP-growth algorithm was used to analyze association rules of 961 classical prescriptions collected and to explore the compatibility rules of traditional Chinese antiviral classical prescriptions. In terms of compatibility law of traditional Chinese antiviral prescriptions, this paper studied the compatibility law of traditional Chinese antiviral prescriptions based on the FP-growth algorithm and made exploratory research on the compatibility law information of 961 traditional classical antiviral prescriptions. Firstly, FP tree was constructed based on the classic recipe data set. Then, frequent item set rules were established, and association rules contained in FP tree were extracted. Finally, the frequency and association rules of antiviral TCM prescriptions were analyzed according to dosage forms (decoction, pill, paste, and ingot). The results show that the FP-growth algorithm adopted in this paper has excellent algorithm performance and strong generalization and robustness in the screening and mining of large-scale prescription data sets, which can provide important processing tools and technical methods for the study of the compatibility rule of traditional Chinese medicine prescriptions.
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Stasiak, Philip, Marc Afilalo, Tanya Castelino, Xiaoqing Xue, Antoinette Colacone, Nathalie Soucy, and Jerrald Dankoff. "Detection and correction of prescription errors by an emergency department pharmacy service." CJEM 16, no. 03 (May 2014): 193–206. http://dx.doi.org/10.2310/8000.2013.130975.
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ABSTRACTObjectives:Emergency departments (EDs) are recognized as a high-risk setting for prescription errors. Pharmacist involvement may be important in reviewing prescriptions to identify and correct errors. The objectives of this study were to describe the frequency and type of prescription errors detected by pharmacists in EDs, determine the proportion of errors that could be corrected, and identify factors associated with prescription errors.Methods:This prospective observational study was conducted in a tertiary care teaching ED on 25 consecutive weekdays. Pharmacists reviewed all documented prescriptions and flagged and corrected errors for patients in the ED. We collected information on patient demographics, details on prescription errors, and the pharmacists’ recommendations.Results:A total of 3,136 ED prescriptions were reviewed. The proportion of prescriptions in which a pharmacist identified an error was 3.2% (99 of 3,136; 95% confidence interval [CI] 2.5–3.8). The types of identified errors were wrong dose (28 of 99, 28.3%), incomplete prescription (27 of 99, 27.3%), wrong frequency (15 of 99, 15.2%), wrong drug (11 of 99, 11.1%), wrong route (1 of 99, 1.0%), and other (17 of 99, 17.2%). The pharmacy service intervened and corrected 78 (78 of 99, 78.8%) errors. Factors associated with prescription errors were patient age over 65 (odds ratio [OR] 2.34; 95% CI 1.32–4.13), prescriptions with more than one medication (OR 5.03; 95% CI 2.54–9.96), and those written by emergency medicine residents compared to attending emergency physicians (OR 2.21, 95% CI 1.18–4.14).Conclusions:Pharmacists in a tertiary ED are able to correct the majority of prescriptions in which they find errors. Errors are more likely to be identified in prescriptions written for older patients, those containing multiple medication orders, and those prescribed by emergency residents.
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Marupaka, Janardhan, Laxmipathi Kodam, Naveen Kumar Tamma, and Srinivasu Karedla. "Prescription audit of patients in a teritiary care hospital." International Journal of Basic & Clinical Pharmacology 9, no. 11 (October 21, 2020): 1650. http://dx.doi.org/10.18203/2319-2003.ijbcp20204435.
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Background: This study was prescribed errors to promote irrational use of drug and decrease patience compliance. Prescription audit can improve prescribing practices and patients to receive high quality drugs.Methods: The study was observational carried out in 150 patients attending outpatient department for period of 6 months from April 2019 to October 2019. Data was analysed using WHO core indicatorsResults: 16% of prescriptions demographic details like age, sex, age were incomplete. In few (15%) prescriptions omission of diagnosis and irrational combination was reported. Dosing errors like doses and duration of treatment were not mentioned in some of prescriptions. Percentage of antibiotics per prescription was found to be 23.64%, which is much higher than the ideal value recommended by WHO.Conclusions: The average number of drugs was higher in prescriptions and trend of polypharmacy was noted with antibiotics usage. Dosing error and few prescriptions were irrational FDCs. Generic drugs were written in majority of prescriptions from essential drug list. Our study need to highlight to write rational prescription by adhering to WHO guidelines with feed back to prescribers and training session regarding safe use of drugs.
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Ng-Mak, Daisy S., Ya-Ting Chen, Tony W. Ho, Bianca Stanford, and Montse Roset. "Results of a 2-year retrospective cohort study of newly prescribed triptan users in European nationwide practice databases." Cephalalgia 32, no. 12 (July 24, 2012): 875–87. http://dx.doi.org/10.1177/0333102412449929.
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Objective: This study was conducted to characterize prescription refill patterns for triptans among European patients with new prescriptions of triptans. Background: Persistency with prescriptions of triptan monotherapy for migraine headache among newly prescribed users in European primary-care practices has not been well described. Methods: Using electronic medical databases in the UK ( N = 3618), France ( N = 2051) and Germany ( N = 954), we conducted a retrospective cohort analysis to identify refill patterns over 2 years among migraineurs receiving new prescriptions of triptan monotherapy in 2006. Results: Of all patients, >33% of migraineurs with new triptan prescriptions received ≥1 refill of their index triptan prescriptions (UK, 44.3%; France, 34.2%; Germany, 37.7%). More than 50% never received index-triptan refill prescriptions (UK, 55.7%; France, 65.8%; Germany, 63.3%). Small proportions of patients (<7.0%) switched to alternative triptans, and even fewer switched to different prescription-medication classes (UK and Germany, 2.3%; France, 4.0%). More than 48% of patients received no further prescriptions for migraine after index prescriptions (UK, 48.5%; France, 54.9%; Germany, 54.7%). After the second year, >83.0% of patients in each country had no further prescriptions for migraine medications, <14.0% remained persistent with index prescriptions, <4.0% switched to other triptans, and <3.0% switched to alternative medication classes. Conclusions: In migraine patients who received new prescriptions of triptan monotherapy from their primary-care physicians, poor triptan prescription refill frequency was observed in Europe. Although consistent with potential clinical challenges in migraine management, our findings should be interpreted with caution given certain inherent limitations associated with the database study design. Further research is warranted to confirm our findings and to identify reasons for, or predictors of, triptan discontinuation.
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Chai, Grace, Jing Xu, James Osterhout, Mark A. Liberatore, Kathleen L. Miller, Carolyn Wolff, Marisa Cruz, Peter Lurie, and Gerald Dal Pan. "New Opioid Analgesic Approvals and Outpatient Utilization of Opioid Analgesics in the United States, 1997 through 2015." Anesthesiology 128, no. 5 (May 1, 2018): 953–66. http://dx.doi.org/10.1097/aln.0000000000002187.
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Abstract Background The opioid epidemic, driven in part by increased prescribing, is a public health emergency. This study examines dispensed prescription patterns and approvals of new opioid analgesic products to investigate whether the introduction of these new drugs increases prescribing. Methods Prescribing patterns based on dispensed prescription claims from the U.S. retail setting were assessed with new brand and generic opioid analgesic products approved in the United States from 1997 through 2015. Results From 1997 through 2015, the U.S. Food and Drug Administration (Silver Spring, Maryland) approved 263 opioid analgesic products, including 33 brand products. Dispensed prescriptions initially increased 80% from 145 million prescriptions in 1997 to a peak of 260 million prescriptions in 2012 before decreasing by 12% to 228 million prescriptions in 2015. Morphine milligram equivalents dispensed per prescription increased from 486 in 1997 to a peak of 950 in 2010, before decreasing to 905 in 2015. In 2015, generic products accounted for 96% (218/228 million prescriptions) of all opioid analgesic prescriptions dispensed. The remaining prescriptions were dispensed for brand products, of which nearly half were dispensed for one brand product (OxyContin, Purdue, USA). Conclusions There has been a dramatic increase in prescriptions dispensed for opioid analgesics since 1997 and an increasing number of opioid analgesic approvals; however, the number of prescriptions dispensed has declined since 2012 despite an increasing number of approvals. Examination of dispensed prescriptions shows a shifting and complex market where multiple factors likely influence prescribing; the approval of new products alone may not be sufficient to be a primary driver of increased prescribing.
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U. S., Nuthan Kumar, Nalini G. K., Deepak P., Prema M., Geeta Rathod, and Mohith N. "Prescription audit of outpatients in tertiary care government hospital." International Journal of Basic & Clinical Pharmacology 7, no. 4 (March 23, 2018): 636. http://dx.doi.org/10.18203/2319-2003.ijbcp20181161.
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Background: Prescription audit is a tool as well as a technique by its application,all professionals will improve the quality of prescribing drugs. Standards of medical treatment can be assessed by prescription audit. It is based on documented evidences to support diagnosis, treatment and justified utilization of hospital facilities. Prescription audit is a quality improvement process that seeks to improve patient care. In this background the present study was conducted. The objectives of the study were to know the frequently prescribed drugs in OPD, number of the drugs used per prescription and to find out the rationality.Methods: Study was conducted at Sri Chamarajendra Hospital, HIMS, Hassan in OPD of General Medicine.1000 prescriptions were collected and noted down the frequently used medication, number of drugs prescribed and their type of formulations for the particular diagnosis.Results: From the study it is noted that 1910 drugs out of 1000 prescriptions were prescribed which is approximately 1.91 drugs per prescription about 55% of the prescriptions contained single drug. Very few received 4-5 drugs (7%). Almost all the drugs in prescriptions were in Generic names. Around 95% of prescriptions doses were mentioned in mg, ml etc. The most commonly prescribed drugs in order are Antibiotics, antidiabetics antihypertensives, bronchodilators, steroids antiemetics and ORS were prescribed.Conclusions: Polypharmacy was not found in our prescriptions which indicates our prescriptions improved the patient conditions. This type of study will ensure to know the ‘P’ drug development and select the essential medicine list for various levels of health care.
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Owusu-Ansah, Sylvia, Oluwakemi Badaki, Jamie Perin, Martha Stevens, Jennifer Anders, and Robert Wood. "Under Prescription of Epinephrine to Medicaid Patients in the Pediatric Emergency Department." Global Pediatric Health 6 (January 2019): 2333794X1985496. http://dx.doi.org/10.1177/2333794x19854960.
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Objective. To describe pediatric Medicaid patients with pediatric emergency department (PED) visits for anaphylaxis who received epinephrine auto-injector (EAI) prescriptions in the ED versus those who did not; and to compare patients who filled their prescriptions versus those who did not. Methods. We conducted a cross-sectional study of Medicaid patients aged 0 to 21 years presenting to 2 PEDs, with symptoms meeting the National Institute of Allergy and Infectious Diseases criteria for anaphylaxis, between July 2012 and July 2014. Results. We identified 86 patients across the 2 hospitals with a confirmed diagnosis of anaphylaxis in the PED. Of these, 55 (64%, 95% confidence interval [CI] = 53% to 74%) received a prescription for an EAI during their ED visit. Forty-two (68%; 95% CI = 56% to 80%) received a prescription for EAI in Hospital 1 versus 13 (54%; 95% CI = 33% to 74%) in Hospital 2. Medicaid prescription fill rates were available for Hospital 1. Of the 42 who received an EAI prescription, 36 (86%; 95% CI = 75% to 96%) filled these prescriptions with Medicaid. Of the 20 (32%) out of 62 patients with anaphylaxis who did not receive prescriptions for an EAI, only 5 had previously filled prescriptions for epinephrine. Conclusion. Previous Medicaid patient prescription adherence data suggested that these patients would have a low EAI prescription fill rate. We found Medicaid patients who received prescriptions for an EAI after the ED visit for anaphylaxis filled them; however, a considerable proportion of anaphylaxis visits had no EAI prescription provided at discharge.
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Doble, Brett, Rupert Payne, Amelia Harshfield, and Edward C. F. Wilson. "Retrospective, multicohort analysis of the Clinical Practice Research Datalink (CPRD) to determine differences in the cost of medication wastage, dispensing fees and prescriber time of issuing either short (<60 days) or long (≥60 days) prescription lengths in primary care for common, chronic conditions in the UK." BMJ Open 7, no. 12 (December 2017): e019382. http://dx.doi.org/10.1136/bmjopen-2017-019382.
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ObjectivesTo investigate patterns of early repeat prescriptions and treatment switching over an 11-year period to estimate differences in the cost of medication wastage, dispensing fees and prescriber time for short (<60 days) and long (≥60 days) prescription lengths from the perspective of the National Health Service in the UK.SettingRetrospective, multiple cohort study of primary care prescriptions from the Clinical Practice Research Datalink.ParticipantsFive random samples of 50 000 patients each prescribed oral drugs for (1) glucose control in type 2 diabetes mellitus (T2DM); (2) hypertension in T2DM; (3) statins (lipid management) in T2DM; (4) secondary prevention of myocardial infarction; and (5) depression.Primary and secondary outcome measuresThe volume of medication wastage from early repeat prescriptions and three other types of treatment switches was quantified and costed. Dispensing fees and prescriber time were also determined. Total unnecessary costs (TUC; cost of medication wastage, dispensing fees and prescriber time) associated with <60 day and ≥60 day prescriptions, standardised to a 120-day period, were then compared.ResultsLonger prescription lengths were associated with more medication waste per prescription. However, when including dispensing fees and prescriber time, longer prescription lengths resulted in lower TUC. This finding was consistent across all five cohorts. Savings ranged from £8.38 to £12.06 per prescription per 120 days if a single long prescription was issued instead of multiple short prescriptions. Prescriber time costs accounted for the largest component of TUC.ConclusionsShorter prescription lengths could potentially reduce medication wastage, but they may also increase dispensing fees and/or the time burden of issuing prescriptions.
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Shrestha, Binaya. "Evaluation of Prescription Errors in Teaching Hospital." Journal of Universal College of Medical Sciences 11, no. 03 (December 31, 2023): 42–45. http://dx.doi.org/10.3126/jucms.v11i03.61599.
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INTRODUCTION Prescription errors have been frequent problem in health care settings. Due to prescription error patients lose their faith towards healthcare providers. Therefore the study of prescription errors is necessary to promote rational use of medicine. The aim of the study was to assess the prescription errors found in the different wards of our institution. MATERIAL AND METHODS A prospective observational study was conducted from June 2022 to January 2023 in a tertiary care teaching hospital in Kathmandu. Prescriptions of 350 patients admitted to the different wards of the hospital were included in the study after obtain ing ethical clearance from institutional review committee. A convenience sampling technique was used for collection of the data and the primary data were collected from the patient cardex and recorded in pre-designed proforma consisting of information about, diagnosis of disease and findings related to prescription errors. Data were entered in the MS excel and further analysis was done using IBM Statistical Package for Social Sciences (SPSS) version 21. RESULTS A total of 350 prescriptions belonging to patients admitted to the different wards were analyzed. Prescription errors were detect- ed in 86 prescriptions. Errors of omission were found in 19 prescriptions and 67 prescriptions showed error of commission. Among errors of commission drug interactions were most common. CONCLUSION Nearly one fourth of prescriptions analyzed showed prescription error. Among them most common were errors of commission. Prevalence of drug interactions is significant and needs to be monitored more promptly in our institution.
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Kusumakar, Ananta, P. G. Naveen Kumar, Mahesh Ravindra Khairnar, Harloveen Sabharwal, and Zainab Akram. "Evaluation of Prescription Writing Skills of Medical Professional Practicing in Varanasi City: A Cross-Sectional Survey." Journal of Indian Association of Public Health Dentistry 21, no. 2 (2023): 174–77. http://dx.doi.org/10.4103/jiaphd.jiaphd_112_22.
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Objective: Prescription writing is an integral part of medical profession. Incorrect prescription writing may lead to errors in instructions about the identity of the recipient, the identity of the drug, the formulation, dose, route, timing, frequency, and duration of administration. Hence, the present survey was undertaken to assess the prescription writing skills of doctors practicing in Varanasi city. Materials and Methods: This was a cross-sectional observational study, and 700 prescriptions dispensed by various doctors were collected for 7 consecutive days from 15 randomly selected pharmacy shops. Collected prescriptions were assessed for patient’s information, doctor’s information, and their legibility using predefined criteria by a calibrated examiner. Results: All the collected prescriptions lacked one or more aspects of patient’s or doctor’s details. About 46.2% of prescriptions lacked details about one or more drugs. Conclusion: Regarding the legibility of the prescription, it requires awareness programs for doctors to improve the quality of prescriptions. Changes in the registration system can be helpful in preventing errors in the details of the patients and doctors.
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Wati, Muvita Rina, Istiqomah Dwi Oktaviani, Ahmad Fahmy Bin Yahya, Bondan Ardiningtyas, and Anna Wahyuni Widayati. "Pharmacist Experience in Discovering Forged Prescriptions in Pharmacies In the Special Region of Yogyakarta." Majalah Farmaseutik 19, no. 1 (April 3, 2023): 30. http://dx.doi.org/10.22146/farmaseutik.v19i1.83383.
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Pharmacies were a source of narcotics and other addictive agents by 2.1% of respondents to a survey conducted by BNN and LIPI in 2019. One way for drug abusers to obtain drugs is to use forged prescriptions. Therefore, the accuracy of pharmacists in prescription's screening is needed to reduce the prevalence of drug abuse. Research on prescription counterfeiting has been carried out in various developed countries, but similar research has never been conducted in Indonesia. This study aims to determine the patterns, characteristics, and experience of pharmacists in the Special Region of Yogyakarta (DIY) pharmacy in responding to counterfeit prescription findings. This research is an observational study with a survey method using a research instrument in the form of a questionnaire. A total of 152 pharmacists in DIY were involved as respondents and filled out questionnaires both online using the Google Form and offline from November to December 2019. The research data were analyzed descriptively. Based on the results of the study, most of respondents 85%) had encountered counterfeit prescriptions. They were identified by the following characteristics, including the doctor's writings that were not the same as usual (60%), the amount of medicine was irrational/added with 'iter' (59%), absence of doctor’s registration number (41%), stamp (44%), and doctor's signature (32%). The most common drug classes written on fake prescriptions include psychotropics, followed by other drug classes, namely drugs that are often abuse, narcotics, antibiotics, and other ethical drugs (misoprostol and levonogestrel). In identifying counterfeit prescriptions, pharmacists need a guideline, training, and coaching. In addition, clear supervision and reporting channels are needed so that prescription counterfeiting can be reported and seriously followed up by involving Indonesian Pharmacist Association (IAI), Health Office (Dinas Kesehatan), and Indonesia Food and Drug Administration (POM).
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Srinivasa, Jyothsnya, and Shubhatara Swamy. "Analysis of prescriptions for completeness in a tertiary care teaching hospital." International Journal of Basic & Clinical Pharmacology 9, no. 12 (November 25, 2020): 1849. http://dx.doi.org/10.18203/2319-2003.ijbcp20204956.
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Background: Prescribing errors are major problems among medication errors. Prescribing errors include mistakes or inaccuracies when choosing and ordering treatments, such as wrong doses or illegible prescriptions. Most of these errors result in no harm or have low to moderate harm however, some result in severe harm or death. There are economic consequences attributed to prescribing errors.Methods: The aim of the study was to analyse the prescriptions for completeness. The prospective observational study was conducted in outpatient department of different specialities in a tertiary care teaching hospital. Prescriptions with atleast one antibiotic, was collected through duplicate copies from the prescribing doctors. The data obtained from prescriptions were analysed and the conclusions were drawn using descriptive analysis.Results: A total of 1516 prescriptions with 3957 drugs were prescribed, out of which 1697 were antibiotics. Average number of drugs per prescription was 2.6 and average number of antibiotics per prescription was 1.1. Patient’s name, age, and gender were mentioned in 99%, 87.8%, and 96% of prescriptions respectively. Generic drug names were used in 0.7% of prescriptions. Out of 1681 antibiotics prescribed in 1574 had appropriate dosage form.Conclusions: The present study highlights the problem of incomplete prescriptions and extensive use of brand names. Intervention strategies focused on education and training, introduction of strict feedback control and monitoring systems are highly effective in reducing prescription errors.
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Van Brug, Heather E., Rob G. H. H. Nelissen, Willem M. Lijfering, Liza N. Van Steenbergen, Frits R. Rosendaal, Eveline L. A. Van Dorp, Marcel L. Bouvy, Albert Dahan, and Maaike G. J. Gademan. "Opioid prescribing patterns after arthroplasty of the knee and hip: a Dutch nationwide cohort study from 2013 to 2018." Acta Orthopaedica 93 (July 15, 2022): 667–81. http://dx.doi.org/10.2340/17453674.2022.3993.
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Background and purpose: Numbers on opioid prescriptions over time in arthroplasty patients are currently lacking. Therefore we determined the annual opioid prescribing rate in patients who received a hip/knee arthroplasty (HA/KA) between 2013 and 2018.Patients and methods: The Dutch Foundation for Pharmaceutical Statistics, which provides national coverage of medication prescriptions, was linked to the Dutch Arthroplasty Register, which provides arthroplasty procedures. The opioid prescription rates were expressed as the number of defined daily dosages (DDD) and morphine milligram equivalent (MME) per person year (PY) and stratified for primary and revision arthroplasty. Amongst subgroups for age (< 75; ≥ 75 years) and sex for primary osteoarthritis arthroplasties, prescription rates stratified for opioid type (weak/strong) and prevalent preoperative opioid prescriptions (yes/no) wereassessed.Results: 48,051 primary KAs and 53,964 HAs were included, and 3,540 revision KAs and 4,118 HAs. In 2013, after primary KA 58% were dispensed ≥ 1 opioid within the first year; this increased to 89% in 2018. For primary HA these numbers increased from 38% to 75%. In KAs the prescription rates increased from 13.1 DDD/PY to 14.4 DDD/PY, mainly due to oxycodone prescriptions (2.9 DDD/PY to 7.3 DDD/PY), while tramadol decreased (7.3 DDD/PY to 4.6 DDD/PY). The number of MME/PY also increased (888 MME/PY to 1224 MME/PY). Similar changes were observed for HA and revision arthroplasties. Irrespective of joint, prescription of opioid medication increased over time, with highest levels in groups with preoperative opioid prescriptions while weak opioid prescriptions decreased.Interpretation: In the Netherlands, between 2013 and 2018 postoperative opioid prescriptions after KA and HA increased, mainly due to increased oxycodone prescriptions with highest levels after surgeries with preoperative prescriptions.
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Alves Carneiro, Vera L., and José Manuel González-Méijome. "Prevalence of refractive error in Portugal estimated from ophthalmic lens manufacturing data: Ten-years analysis." PLOS ONE 18, no. 4 (April 21, 2023): e0284703. http://dx.doi.org/10.1371/journal.pone.0284703.
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Purpose To investigate the prevalence, distribution and trends of refractive error from ophthalmic lens manufacturing data over a ten-year period. Methods Fully anonymized data from ophthalmic lenses, for the years between 2010 and 2020, provided by the leading ophthalmic lens manufacturer operating in Portugal were analysed (no human participants were involved in the research). Prescriptions delivered were divided in single vision prescriptions and progressive/multifocal prescriptions and categorized into 14 spherical equivalent ranges. Given the lack of absolute values, indirect estimates and a qualitative analysis of the current situation and trends on refractive error epidemiology was carried out. Results Dataset from manufacturer comprises percentage values of ophthalmic lenses dispensed in Portugal. The distribution of ophthalmic prescriptions for single vision prescriptions presents most of the observations in the range [-1.49, -0.50] diopters, in every year from 2010 to 2020. For the progressive prescription’s lenses, most of the observations is in an interval of two ranges, [0.50, 1.49] and [1.50, 2.99] diopters. From 2010 to 2020 the proportion of single vision ophthalmic lens prescriptions for myopia increased from 38.13% to 46.21%; the proportion for high myopia increased from 2.76% to 4.45%; and the proportion for hyperopia decreased from 40.85% to 31.36%. Conclusions Ophthalmic lens manufacturing data can be a valuable source for long-term analysis of refractive error prescription and trends over time. It was possible to observe a trend of increasing prevalence of myopia and high myopia from 40.89% in 2010 to 50.66% in 2020. That increase trend has important implications for public health and in the planning of services.
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Eteraf Oskouei, Tahereh, Elaheh Vatankhah, and Moslem Najafi. "The Status of Potentially Inappropriate Medication Prescription by General Physicians for The Elderly in Tabriz (Iran) According to Beers Criteria." Salmand 16, no. 2 (July 1, 2021): 274–87. http://dx.doi.org/10.32598/sija.16.2.3045.1.
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Objectives: Prescribing medication for the elderly is an important health issue. This study aimed to investigate the status of Potentially Inappropriate Medications (PIMs) prescription for the elderly by general physicians in Tabriz, Iran. Methods & Materials: This descriptive cross-sectional study was conducted in 2019 on the prescriptions of general physicians for the elderly in Tabriz, Iran. After initial screening of 16842 prescriptions belonged to two insurance systems (social security insurance and health insurance), 1500 prescriptions were selected. The Beers criteria 2019 was used to assess PIM prescription status and their alternatives were suggested if needed. Data were expressed as Mean±Standard Deviation (SD) and No. (%), and analyzed in SPSS v. 21 software. The Mann-Whitney U test was used to examine the differences in the study factors between the prescriptions related to two insurance systems. The relationship between patients’ age and PIM prescription was examined using Spearman correlation test. Results: The Mean±SD number of drugs in each prescription was 3.93±1.5 and the Mean±SD number of prescribed PIMs was 0.74±0.8. Polypharmacy was observed in 32.6% of the prescriptions, and 53.9% had at least one PIM. Non-steroidal anti-inflammatory drugs, antihistamines and benzodiazepines were the most PIM groups (45.6, 10.9 and 10.6%, respectively). The most common prescribed PIMs were Adult cold, Diclofenac, Glibenclamide, Ketorolac and Diphenhydramine. Number of PIMs in each prescription did were not statistically different between the prescriptions related to two insurance systems (P=0.343). Moreover, patients’ age and gender had no significant relationship with PIM prescription (P=0.312 and P=0.660, respectively). Conclusion: About 54% of the prescriptions issued by general physicians for the elderly in Tabriz contain PIMs, and polypharmacy is present in about one third of the prescriptions. In order to improve this condition, it is necessary to hold appropriate training and continuous retraining courses in geriatric medicine for general physicians. Supervisions by the Iranian Ministry of Health and Iranian Medical Council can also play an important role in improving the current situation.
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Maciel, Tayane Dreher, and Eduardo Manoel Pereira. "Evaluation of the legal aspects of prescriptions of drugs subject to prescription retention in a communitarian dispensing pharmacy in Joinville / Avaliação dos aspectos legais da prescrição de medicamentos sujeitos a retenção de receita numa farmácia comunitária de distribuição em Joinville." Brazilian Journal of Development 8, no. 6 (June 1, 2022): 42480–93. http://dx.doi.org/10.34117/bjdv8n6-001.
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The prescription is the legal document that defines the patient’s drug therapy, thus it must be intelligible and readable to allow the dispensation of the correct drugs to the patient in the right dose, route of administration and quantity. Incomplete and illegible prescriptions lead to misunderstanding and consequently, medication errors, which may cause from ineffectiveness to serious adverse reactions. Hence, this study aimed to evaluate the legal aspects of drug prescriptions subject to prescription retention in a Basic Health Unit (BHU) of Joinville (Santa Catarina state). For this purpose, the adequacy and legibility of information concerning patients, prescribers, and psychotropic and antimicrobial drugs of the prescriptions dispensed by a BHU from July 15 to August 15, 2018, were analyzed totaling 500 prescriptions, of which 250 were psychotropic and 250 were antimicrobial, about 17% handwritten and 83% typed. No prescriptions mentioned the patients' telephone number and few prescriptions omitted gender and address, especially the handwritten ones. Concerning the prescribers' data, few omissions were observed, related to their contact data. All drugs were prescribed in the Brazilian Common Denomination (BCD), and all psychotropic prescriptions had no omissions of route and quantity, while the handwritten prescriptions of antimicrobials comprised 10-15% omission of these data. Regarding legibility, less than 5% of the prescriptions were partially readable and an even smaller proportion were illegible. Non-standardized abbreviations were observed in 55,6% of the prescriptions. Data allow observing that, although some errors still persist the adoption of typed prescription minimized the problems of legibility, but not the omission of information. The improvement of the prescribing writing applications can also help to minimize omissions and make the prescriptions more comprehensible and ensure adequate guidance on the rational use of medicines.
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Hou, Jiaxin, Ping Song, Zijuan Zhao, Yan Qiang, Juanjuan Zhao, and Qianqian Yang. "TCM Prescription Generation via Knowledge Source Guidance Network Combined with Herbal Candidate Mechanism." Computational and Mathematical Methods in Medicine 2023 (January 5, 2023): 1–18. http://dx.doi.org/10.1155/2023/3301605.
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Traditional Chinese medicine (TCM) prescriptions have made great contributions to the treatment of diseases and health preservation. To alleviate the shortage of TCM resources and improve the professionalism of automatically generated prescriptions, this paper deeply explores the connection between symptoms and herbs through deep learning technology, and realizes the automatic generation of TCM prescriptions. Particularly, this paper considers the significance of referring to similar underlying prescriptions as herbal candidates in the TCM prescribing process. Moreover, this paper incorporates the idea of referring to the potential guidance information of corresponding prescriptions when model extracts symptoms representations. To provide a reference for inexperienced young TCM doctors when they prescribe, this paper proposes a dual-branch guidance strategy combined with candidate attention model (DGSCAM) to automatically generate TCM prescriptions based on symptoms text. The format of the data used this paper is the “symptoms-prescription” data pair. The specific method is as follows. First, DGSCAM realizes the extraction of key information of prescription-guided symptoms through a dual-branch network. Then, herbal candidates in the form of prescriptions that can treat symptoms are proposed in view of the compatibility knowledge of TCM prescriptions. To our knowledge, this is the first attempt to use prescriptions as herbal candidates in the prescription generation process. We conduct extensive experiments on a mixed public and clinical dataset, achieving 37.39% precision, 25.04% recall, and 29.99% F1 score, with an average doctor score of 7.7 out of 10. The experimental results show that our proposed model is valid and can generate more specialized TCM prescriptions than the baseline models. The DGSCAM developed by us has broad application scenarios and greatly promotes the research on intelligent TCM prescribing.
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Raj, Purnima, Subhankar Choudhury, Sumati Kundu, Satyam Patel, and Bhagwati Sidar. "Study of prescription pattern in a tertiary care hospital in Chhattisgarh, India: an observational study." International Journal of Basic & Clinical Pharmacology 7, no. 4 (March 23, 2018): 598. http://dx.doi.org/10.18203/2319-2003.ijbcp20181003.
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Background: Prescription audit is one of the methods to assess the drug utilization pattern and rational use of drugs. In our country the value of drugs prescribed is in crores but a significant proportion of drugs is prescribed irrationally. This is probably due to defect in prescription pattern, lack of knowledge in health care personnel, pressure from drug manufacturing companies and many more. To promote rational use of drugs, standard policies must be set and this can be achieved only after auditing current prescription practices.Methods: A prospective study was carried out in Medical college hospital, Raigarh in the month of January 2018. Around 1000 prescriptions were collected randomly from pharmacy and the prescriptions were analysed on various parameters like patient’s demography, parts of a prescription, information related to doctor and drugs.Results: In this study, we found that percentage of generic drugs were 58.02% and 70.43% drugs were from essential drug list. Only 13.19% FDCs were used. 34 prescriptions were illegible and capital letters were used only in 26 prescriptions. We also found deficiency in parts of a prescription like inscription part (13.3%), subscription part (26.9%) and in doctor’s identity (33.2%). The majority of drugs were antimicrobials (23.81%) followed by anti-inflammatory and analgesics (21.1%).Conclusions: This study shows that the use of generic drugs and essential drugs is on the lower side as compared to standard guidelines. The prescription pattern was defective in many prescriptions. This study shows incompleteness of prescriptions and proper steps are needed to guide the physicians to promote rational use of drugs.
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Hazra, Moumita. "A pharmacoepidemiological study of prescription patterns of β2 sympathomimetic bronchodilators in exacerbation of non-severe asthma in tertiary care hospitals, not needing hospitalization." International Journal of Basic & Clinical Pharmacology 8, no. 12 (November 25, 2019): 2674. http://dx.doi.org/10.18203/2319-2003.ijbcp20195276.
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Background: Arformoterol, the (R, R) enantiomer of the racemic (R, R / S, S) diastereomer, formoterol, is a short and long acting β2 agonist bronchodilator. Levosalbutamol, the (R, R) enantiomer of racemic diastereomer (R, R / S, S) salbutamol, has a greater affinity for the β2 receptor. Occupation of β2 receptors by agonists result in the activation of the Gs-adenylyl cyclase-cAMP-PKA pathway, followed by phosphorylative events leading to bronchial smooth muscle relaxation. The aim of this pharmacoepidemiological study was to analyse the prescription patterns, and prescription content analysis, of arformoterol, levosalbutamol, formoterol or salbutamol, in non-severe asthma exacerbation in tertiary care hospitals, not needing hospitalization.Methods: It was a multi-centre, retrospective, observational and analytical study of 100 asthmatic patients’ hospital medical records, treated with 3 doses of arformoterol, levosalbutamol, formoterol or salbutamol nebulization, followed by peak expiratory flow rates (PEFR) measurement at the baseline and 6 minutes, after each dose; along with adverse effects recording. The number of prescriptions of 100 patients was recorded, the percentage of prescriptions was calculated, and the prescription content analysis was done.Results: PEFR of the patients showed significant increase after the first, second and third doses of bronchodilator nebulisation, with negligible adverse effects. Salbutamol was most commonly prescribed (45 prescriptions, 45%), followed by levosalbutamol (35 prescriptions, 35%), formoterol (15 prescriptions, 15%) and arformoterol (5 prescriptions, 5%). All aspects of prescription content analysis showed 100% completeness.Conclusions: Arformoterol was more effective, but equally safe, as compared to levosalbutamol, formoterol and salbutamol. Prescription frequency of salbutamol was followed by levosalbutamol, formoterol and arformoterol. Prescription content analyses showed 100% completeness.
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Khan, Muhammad Wasiullah, Saleh Khurshied, Nawal Khurshid, Rafay Iqbal, M. Azeem Khizer, and Hammad Ahmed. "PRESCRIPTION AUDIT IN OUTPATIENT DEPARTMENTS OF TERTIARY CARE HOSPITALS; FACTS AND RECOMMENDATIONS." PAFMJ 71, no. 2 (April 29, 2021): 507–11. http://dx.doi.org/10.51253/pafmj.v71i2.2794.
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Objective: To evaluate written prescriptions according to a checklist based on WHO guidelines (prescription audit). To compare prescriptions of senior and junior physicians and to provide data and recommendations.
Study Design: Cross-sectional, analytic study.
Place and Duration of Study: Pak Emirates Military Hospital, and Combined Military Hospital, Rawalpindi Pakistan, from March to Aug 2018.
Methodology: A total of 205 prescriptions using convenient sampling technique were analyzed according to a checklist based on WHO guidelines for standard prescription writing. Data was analyzed using SPSS-22.
Results: Out of total 205 prescriptions, 83 (40%) prescriptions belong to senior and 122 (60%) to junior physicians. Fifty (25%) prescriptions lacked patient name, 49 (24%) lacked age. Gender was mentioned in only 117 (57%) prescriptions. Date, diagnosis and dosage of drug were written in 170 (83%), 172 (84%) and 177 (86%) respectively while dosage form and route of administration were mentioned in 144 (70%) and 102 (50%) respectively. Generic name was written in only 75 (37%) prescriptions. Name and stamp of the doctor were available on 135 (66%) and 125 (61%) prescriptions respectively. A statistically significant association was observed between senior and junior physicians in terms of error in name of patient and dosage form (p=0.002& 0.005 respectively).
Conclusions: Prescriptions were mainly deficient in the generic names of drugs. Route of administration was missing in half of the prescriptions. None of the parameters was totally accurate. Prescriptions from junior physicians had more errors.
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Raja, Maria Abdul Ghafoor, Manal Naif Aljuraisy, Nawaf Mohamed Alotaibi, and Muhammad Wahab Amjad. "Analysis of degree of errors in handwritten medication prescriptions in Rafha, Saudi Arabia." Tropical Journal of Pharmaceutical Research 18, no. 6 (May 27, 2021): 1347–52. http://dx.doi.org/10.4314/tjpr.v18i6.28.
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Purpose: To assess the prevalence of handwritten prescription errors in Rafha Central Hospital in Saudi Arabia, and to determine the most predominant type of prescription error.
Methods: A cross-sectional study was carried out on randomly selected samples of hand-written prescriptions in out-patient and in-patient pharmacies of Rafha Central Hospital over a five-month period (October 2016 to February 2017). A data collection sheet specially designed for this purpose was used to collect relevant information. The collected prescriptions were analyzed for the presence of prescription errors based on prescription parameters defined by the World Health Organization (WHO) and current guidelines published in British National Formulary (BNF). Descriptive statistics and Microsoft Office were used for processing and analyzing the data collected.
Results: Overall, 1019 prescription errors were identified. More than half of the total errors (610; 60 %) were associated with missing patient's information. Moreover, the parameters related to drug and prescriber information were absent in 204 (20 %) and 5 (0.4 %) prescriptions, respectively. In addition, 200 (19 %) miscellaneous errors related to date, legible handwriting and directions for patients were identified.
Conclusion: This study discovered errors in hand-written prescriptions. A majority of the prescriptions did not adhere to accepted guidelines. The most common errors are absence of generic names of drugs, non-indication of duration of therapy or prescriber’s contact address, and absence of patient’s weight. Moreover, illegible handwriting was obvious in a substantial number of prescriptions.
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Paulina Maya Octasari and Patriana Agustin Windasari. "Evaluasi Kelengkapan Administratif dan Farmasetis Resep di Poliklinik Anak Rumah Sakit Karanggede Sisma Medika Boyolali." Journal Clinical Pharmacy and Pharmaceutical Science 1, no. 2 (October 25, 2022): 53–61. http://dx.doi.org/10.61740/jcp2s.v1i2.8.
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Prescription screening is one of the pharmaceutical services carried out by reviewing prescriptions according to administrative, pharmaceutical and clinical requirements. Administrative and pharmaceutical requirements ensure the legality of prescriptions, correct identification and successful treatment of patients. The purpose of this study was to evaluate the administrative and pharmaceutical completeness of prescriptions at the Children's Polyclinic Karanggede Sisma Medika Hospital Boyolali. This research was carried out in an observational descriptive manner with retrospective data from prescriptions at the Children's Polyclinic at Karanggede Sisma Medika Boyolali Hospital for the period July – September 2021, with a total sample of 215 prescription sheets. The complete administrative prescription data includes the patient's name, medical record number, gender, date of birth, doctor's name, doctor's initials and date of prescription. Complete prescription pharmaceutical data include the name of the drug, the dosage form, the strength of the preparation, the dosage unit, the amount of the drug, the rules for use and how to use it. The data were analyzed quantitatively to determine the percentage of administrative completeness, pharmaceutical completeness, and both. The study was conducted with 215 prescriptions. The results of this study showed that 43.72% of prescriptions were administratively complete which consisted of 100% of the patient's names. As many as 60% are complete pharmaceutically consisting of the name of the drug, the form of the drug and the amount of the drug by 100%, and 28.37% complete both.
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Miasso, Adriana Inocenti, Regina Célia de Oliveira, Ana Elisa Bauer de Camargo Silva, Divaldo Pereira de Lyra Junior, Fernanda Raphael Escobar Gimenes, Flávio Trevisan Fakih, and Sílvia Helena De Bortoli Cassiani. "Prescription errors in Brazilian hospitals: a multi-centre exploratory survey." Cadernos de Saúde Pública 25, no. 2 (February 2009): 313–20. http://dx.doi.org/10.1590/s0102-311x2009000200009.
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In Brazil, millions of prescriptions do not follow the legal requirements necessary to guarantee the correct dispensing and administration of medication. This multi-centre exploratory study aimed to analyze the appropriateness of prescriptions at four Brazilian hospitals and to identify possible errors caused by inadequacies. The sample consisted of 864 prescriptions obtained at hospital medical clinics in January 2003. Data was collected by three nurse researchers during one week using a standard data sheet that included items about: the type of prescription; legibility; completeness; use of abbreviations; existence of changes and erasures. There were statistically significant differences between incomplete electronic prescriptions at hospital A, and handwritten ones from hospitals C (Ç2 = 12.703 and p < 0.001) and D (Ç2 = 14.074 and p < 0.001). Abbreviations were used in more than 80% of prescriptions at hospitals B, C and D. Changes were found in prescriptions at all hospitals, with higher levels at hospitals B (35.2%) and A (25.3%). This study identified a range of vulnerable points in the prescription phase of the medication system at the hospitals. Physicians, pharmacists and nurses should therefore jointly propose strategies to avoid these prescription errors.
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Shahnawaz, Shabrina Shammi, Md Hasan Sharif, Tasnin Afrin, Fatema Ferdusi, Kazi Foyzur Rahman, and Anwar Habib. "Distribution of Diseases and their Prescription Pattern at Outpatients Department of Gynecology and Obstetrics in a Tertiary Care Hospital in Bangladesh." Journal of Current and Advance Medical Research 10, no. 1 (November 29, 2023): 13–18. http://dx.doi.org/10.3329/jcamr.v10i1.69418.
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Background: Different gynaecological and obstetrics conditions are commonly encountered by the physicians in the outdoor patient. Objective: The purpose of the present study was to observe the distribution of diseases and their prescription pattern at outpatients Department of Gynaecology and Obstetrics in a tertiary care hospital in Bangladesh. Methodology: This cross-sectional study was carried out among patients attending the outpatient’s department (OPD) of Obstetrics and Gynaecology from October 2014 to April 2015 in Rajshahi Medical College and Hospital, Rajshahi, Bangladesh. The demographic details, average number of drugs per prescriptions, percentage of drugs prescribed by generic names, percentage of encounters with an antibiotic and an injection prescribed, percentage of drugs prescribed from essential drug list (EDL) of Bangladesh, percentage of encounters with prescription of antiulcerant, NSAID, multivitamin and multimineral, iron preparation and a calcium preparation were noted. Results: A total number of 384 prescriptions were collected from Out Patient Department of Obstetrics and Gynaecology of Rajshahi Medical College and Hospital, Rajshahi, Bangladesh. Among 384 prescriptions date, name and age of the patient was written in 384 prescriptions which was 100.0% cases. Weight was written in 190(49.5%) and absent in 194(50.5%) prescriptions. Strength of drugs were written in 11(2.9%) prescriptions and not written in 373(97.1%) prescriptions. Duration of treatment was written in 100.0% prescriptions. Subscription is absent in 100.0% prescriptions. Direction to the patient was present in all prescriptions, but follow up advice were written only in 9(2.3%) prescriptions. Sign present in all prescriptions. There were about 169(44.0%) prescriptions have written the diagnosis and 215(56.0%) prescriptions did not have any diagnosis written. Conclusion: In conclusion the date, name and age of the patient are written in all prescriptions and strength of drugs are absent in almost all prescriptions. Journal of Current and Advance Medical Research, January 2023;10(1):13-18
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Obaid, Hafiz, Ahmed Umer Sohaib, Abu Bakar Munir, Jamshaid Akbar, Muhammad Qamar-uz Zaman, Muhammad Arslan Amjad, and Sharjeel Ahmad. "Prescription Errors Still a Challenge in Pakistan - A Cross-Sectional Study from Central Punjab, Pakistan." RADS Journal of Pharmacy and Pharmaceutical Sciences 7, no. 4 (January 30, 2020): 181–85. http://dx.doi.org/10.37962/jpps.v7i4.327.
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Objective: To evaluate the prescription writing pattern and errors in prescriptions at different health care units of Central Punjab, Pakistan.
Methods: A descriptive cross-sectional study design was adopted to conduct the present study. Data collection was done for a period of one month i.e. March 2018 from selected community pharmacies of five different cities of Central Punjab, Pakistan. Patients were approached irrespective of age and gender and data was recorded on a pre-designed Performa. The total sample size was 750 (150 prescriptions from each pharmacy). SPSS (Statistical Program for Social Sciences, version 20.0) was used for statistical analysis of data.
Results: Out of 750 prescriptions, 662 prescriptions were included in final analysis. Patient name was found written in almost all prescriptions 660 (99.7%) while physician name was missing on 519 (78.4%). Healthcare provider registration number and qualification were not on 654 (98.8%) and 527 (79.6%) prescriptions respectively. Poly-pharmacy was observed in 103 (16%) prescriptions and no prescription was found with generic name.
Conclusion: The study results highlighted the imperative need to devise policies that should be regulated and implemented by the healthcare authorities to make our prescriptions in line with the prescribed guidelines.
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Matson, Steven C., Cathleen Bentley, Vicki Hughes Dughman, and Andrea E. Bonny. "Receipt of Prescribed Controlled Substances by Adolescents and Young Adults Prior to Presenting for Opiate Dependence Treatment." Journal of Addiction 2013 (2013): 1–6. http://dx.doi.org/10.1155/2013/680705.
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Purpose. The objective of this study was to document the number of controlled substance prescriptions filled by adolescents and young adult patients in the 2 years prior to presentation for opiate dependence treatment.Methods. Opiate-dependent youth () presenting to our Medication-Assisted Treatment for Addiction program from January 1, 2008 to June 30, 2010 were identified via electronic medical record. Subjects were further classified based on their opiate use as dependent to heroin-only, prescription (Rx) opiate-only, or combined heroin + Rx opiate only. The Ohio Automated Rx Reporting System (OARRS) was used to identify each subject's controlled substance prescription history. Negative binomial regression was used to examine the relationships between patient characteristics and the total number of prescriptions filled.Results. Twenty-five percent of subjects had filled ≥6 prescriptions, and 15% had filled ≥11 prescriptions. The mean number of prescriptions filled was 5 (range: 0–59). Thirteen percent had filled ≥6 opiate/narcotic prescriptions, and 8% had filled ≥11 prescriptions.Conclusions. A subset of opiate-dependent youth had filled multiple opiate/narcotic prescriptions providing some evidence that physician-provided prescriptions may be a source of opiate abuse or diversion for a minority of opiate-dependent adolescents and young adults.
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Olczyk, Carla Joice Tomczak, and Eduardo Manoel Pereira. "Analysis of antimicrobial and psychotropic prescriptions in the central medication unit of the city of Guaramirim (Santa Catarina State - Brazil) / Análise de prescrições de antimicrobianos e psicotrópicos na unidade central de medicamentos da cidade de Guaramirim (Estado de Santa Catarina - Brasil)." Brazilian Journal of Development 8, no. 5 (May 20, 2022): 39527–42. http://dx.doi.org/10.34117/bjdv8n5-443.
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The doctor’s prescription defines the patient’s treatment. In order to use medicine within maximum efficacy and minimum toxicity parameters, the prescription must be properly filled and readable. Although specific laws are applied to guide prescription elaboration, errors persist, and depending on its nature, they may cause from lack of efficacy to adverse effects. The purpose of this study was to evaluate the quality of prescriptions for psychotropic and antimicrobial drugs dispensed by the central pharmacy of the city of Guaramirim, Santa Catarina state, from February 1 to April 30, 2019. A total of 3,780 prescriptions were analyzed, 3,388 of psychotropic drugs and 392 of antimicrobials. The most frequent errors found were omission of telephone number, and address of patients and physicians. Regarding the drugs prescribed, it was observed lack of information on dose, route, and quantity of the drugs, and also the frequent presence of non-standard abbreviations. Most prescriptions were readable, but despite typed prescriptions may solve illegibility issues, which did not reach homogeneously data omission, and it is essential that pharmacists position themselves so as not to dispense wrong prescriptions and that patients demand greater clarification of the prescription at the time of consultation.