An audit of outpatient prescriptions in a tertiary care center of eastern Uttar Pradesh: a cross-sectional study

Abstract

Background: Prescription audits are essential for evaluating prescription writing practices, ensuring rational drug use, minimizing errors, and improving patient safety. This study assesses the quality of prescriptions in the outpatient departments (OPDs) of a tertiary care center in Eastern Uttar Pradesh based on WHO guidelines and NABH recommendations.

Methods: A cross-sectional observational study was conducted between August and October 2024 across 10 clinical OPDs, analyzing 1000 prescriptions (100 per department). Prescriptions were evaluated for legibility, completeness, patient follow-up and referral documentation. Data collection was performed using a WHO-based checklist and analyzed using descriptive statistics.

Results: While 100% of prescriptions included patient identifiers, only 18% were legibly written, and 30% had proper prescriber identification. Generic prescribing was low (21%), with a majority of prescriptions using brand names. Allergy status was documented in only 10% of prescriptions, raising patient safety concerns. Follow-up instructions were missing in 41% of prescriptions, and medications were not numbered in any prescription, potentially increasing the risk of errors. Senior residents showed better compliance in prescriber identification, but consultants provided more definitive diagnoses and follow-up instructions.

Conclusions: While basic documentation standards were maintained, deficiencies in legibility, prescriber identification, generic prescribing, allergy documentation, and medication numbering highlight areas for improvement. Strengthening prescriber training, enforcing structured prescription templates, conducting regular audits, and implementing digital prescribing systems can significantly improve prescription quality and patient safety.