Prospective study of irrational prescribing in an Indian tertiary care hospital: Omission of prescription and inappropriate prescription in a multidisciplinary unit

Abstract

Taking right medicine at the right time is vital to ensure safety and speedy recovery of the patient. The aim of this study was to conduct a comprehensive review systematic analysis and outcomes of the medication discrepancies which occur as a result of inappropriate prescribing in a hospital setting. A cross sectional study was performed between July 2018 to April 2019 at Star hospitals, South India. A total of 300 prescriptions were collected from different inpatient departments by two practising clinical pharmacists. We used the standard World Health Organization methodology to achieve the study objectives. A feasible sampling technique was used to collect the prescriptions from various departments. Various clinical drug databases like Medscape, Micromedex, and Pub Med were referred. A total of 300 prescriptions were collected and reviewed which comprised 62 % Documentation discrepancies, 19.6 % of omission errors, 10.3 % of prescriptions exceeding the maximum dose, 0.8 % were of prescriptions contained therapeutic duplications. Drugs prescribed out of the formulary also contributed to medication related errors. Mid-level health care practioners were also involved on this study. The study evidenced the potential of inappropriate prescription occurring in the hospital setting ranging from patient admission to discharge. Several factors such as multiple co-morbidities, ploy pharmacy, hassle at the work environment and poor communication among allied health care professionals were found to be the major causes of potential inappropriate prescribing. Execution of efficient strategies will help in controlling the harmful outcomes as a result of irrational prescribing.