RESUMEN
Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’sexpertise. Analysis of quality of prescriptions can be carried out by various methods and by using certain toolsas well. Prescription Quality Index (PQI) is one such validated tool for analyzing the prescription quality. Thepresent study was undertaken on 2155 prescriptions to analyse the prescriptions of outdoor patients by usingPrescription Quality Index tool. Each prescription was evaluated by using questionnaire of PQI tool. The toolconsists of 22 questions, based on the answers of which a score was calculated for each prescription. Thena collective mean score for all the prescriptions was calculated. Depending upon individual scores, theprescriptions were graded in to poor, medium and high-quality prescriptions. The mean PQI score for all the2155 prescriptions was 28.94 ± 0.23. We found that 1015 (46.10 %) prescriptions were of poor quality, 46(2.13 %) were of medium quality and 1094 (50.77 %) were of good quality. The overall mean score of all theprescriptions falls in to the poor-quality prescription category according to PQI. It was concluded that therewere many lacunas that require the attention of prescribers in order to attain and maintain high standardprescription quality.
RESUMEN
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 ��.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盨D score of prescriptions with poor quality was 25.2�48, ranging from 21 to 31. The mean盨D of prescriptions with medium quality was observed to be 32�and for prescriptions of high quality was 38.07�28. The total average mean score of all prescriptions was 30.23�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.
RESUMEN
Background: Prescribing quality is a matter of major concern worldwide. This study was carried out to determine the quality of prescribing in chronic diseases at primary health care (PHC) and secondary health care (SHC) settings using the new prescription quality index (PQI) tool. Methods: A cross-sectional observational study was carried out at four PHC and two SHC facilities in Anand district of India. Patients attending these facilities for at least 3 months were included. Complete medical history and prescriptions received were noted. Total and criteria wise PQI scores were derived for each prescription. Prescriptions were categorized as poor (score of ≤31), medium (score 32-33), and high quality (score 34-43) based on PQI total score. The internal consistency of PQI was measured using item total correlation and Cronbach’s α so as to validate it in our settings. Data were analyzed using Statistical Package for Social Science 20. Results: A total of 134 prescriptions were collected and evaluated for quality of prescribing. Mean age of patients was 60.6 ± 13.5 years. Mean PQI score was 23.60 ± 9.3 with 71.6% prescriptions being of poor quality. Quality of prescribing did not differ at PHC and SHC (P>0.05). Of 22 criteria, PQI score was strongly correlated with drug indication, drug effectiveness, evidence-based prescribing, unnecessary duplication, duration of therapy, and cost (P<0.01). PQI total score was negatively correlated to the number of drugs per prescription. Cronbach’s α for the entire 22 criteria were 0.90. Conclusion: PQI was found to be a reliable tool for assessment of prescribing quality in chronic diseases.