Assessing the Prescription Writing Principles in Medical Students' Prescriptions during Internship

Document Type : Original Article (s)

Authors

1 Assistant Professor, Department of Pharmacology and Toxicology, School of Pharmacy and Pharmaceutical Sciences AND Isfahan Pharmaceutical Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

2 General Practitioner, Department of Research and Development, Food and Drug Deputy, Isfahan University of Medical Sciences, Isfahan, Iran

3 Pharmacist, Department of Research and Development, Food and Drug Deputy, Isfahan University of Medical Sciences, Isfahan, Iran

4 Department of Research and Development, Food and Drug Deputy, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: The acquisition of prescribing knowledge and skill is essential in medical practice. We assessed the prescribing principles and drug errors in prescriptions written by interns in Al-Zahra educational hospital of Isfahan University of Medical Sciences, Iran, in autumn 2011.Methods: In this descriptive cross-sectional study, 3800 prescriptions of outpatients issued by interns were evaluated for prescription structure (date, symbol, registration, signature, and illegibility), drug-related components (generic or brand name, dosage form, strength, and quantity), and directions for use.Findings: Mean number of drugs per prescription was 2.7 and most of the prescriptions (84%) were written illegibly. Generic names were used in 82% of prescriptions; error of omission of dosage form was found in 6% and missing or incorrect strength in 4% of prescriptions. Drug direction was correct only in 18.3% and there were different errors in other prescriptions such as missing the rout of administration (63.7%), using “as directed” (21.5%) or “as required” (18%) and missing of dosing interval (51.3%).Conclusion: The results of this study showed errors and incompleteness in prescription writing of students during internship course, especially in directions for use and dosing interval. The improvement of medical education for enhancing knowledge and skill of correct prescribing is suggested.

Keywords

References

  1. Akoria OA, Isah AO. Prescription writing in public and private hospitals in Benin City, Nigeria: the effects of an educational intervention. Can J Clin Pharmacol 2008; 15(2): e295-e305.
  2. Akram A, Zamzam R, Mohamad NB, Abdullah D, Meerah SM. An assessment of the prescribing skills of undergraduate dental students in Malaysia. J Dent Educ 2012; 76(11): 1527-31.
  3. Shivhare SC, Kunjwani HK, Manikrao AM, Bondre AV. Drugs hazards and rational use of drugs: a review. J Chem Pharm Res 2010; 2(1): 106-12.
  4. Hogerzeil HV. Promoting rational prescribing: an international perspective. Br J Clin Pharmacol 1995; 39(1): 1-6.
  5. Lisby M, Nielsen LP, Mainz J. Errors in the medication process: frequency, type, and potential clinical consequences. Int J Qual Health Care 2005; 17(1): 15-22.
  6. Shah N, Aslam M, Avery A. A survey of prescription errors in general practice. Pharmaceutical Journal 2001; 267(1): 860-2.
  7. Calligaris L, Panzera A, Arnoldo L, Londero C, Quattrin R, Troncon MG, et al. Errors and omissions in hospital prescriptions: a survey of prescription writing in a hospital. BMC Clin Pharmacol 2009; 9: 9.
  8. Shankar RP, Dubey AK, Palaian S, Pranaya M, Saha A, Deshpande VY. Favorable student attitudes towards pharmacology in a medical school in Western Nepal. JIAMSE 2005; 15(1): 31-8.
  9. Alsulami Z, Conroy S, Choonara I. Medication errors in the Middle East countries: a systematic review of the literature. Eur J Clin Pharmacol 2013; 69(4): 995-1008.
  10. Al Khaja KA, Handu SS, James H, Mathur VS, Sequeira RP. Assessing prescription writing skills of pre-clerkship medical students in a problem-based learning curriculum. Int J Clin Pharmacol Ther 2005; 43(9): 429-35.
  11. Oshikoya KA, Chukwura HA, Ojo OI. Evaluation of outpatient paediatric drug prescriptions in a teaching hospital in Nigeria for rational prescribing. Paediatr Perinat Drug Ther2006; 7(4): 183-8.
  12. Menon L, Taylor Z, Tuthill DP. Can paediatric junior hospital doctors prescribe competently? Paediatr Perinat Drug Ther2006; 7:118-20.
  13. Al-Dhawailie AA. Inpatient prescribing errors and pharmacist intervention at a teaching hospital in Saudi Arabia. Saudi Pharm J 2011; 19(3): 193-6.
  14. Heaton A, Webb DJ, Maxwell SR. Undergraduate preparation for prescribing: the views of 2413 UK medical students and recent graduates. Br J Clin Pharmacol 2008; 66(1): 128-34.
  15. Han WH, Maxwell SR. Are medical students adequately trained to prescribe at the point of graduation? Views of first year foundation doctors. Scott Med J 2006; 51(4): 27-32.
  16. Odunsanya OO. Drug use indicators at secondary health care facility in Lagos, Nigeria. J Commun Med Health Care 2004; 16(1): 21-4.
  17. Hogerzeil HV, Walker GJ, Sallami AO, Fernando G. Impact of an essential drugs programme on availability and rational use of drugs. Lancet 1989; 1(8630): 141-2.
  18. Safaeian L, Mahdanian AR, Hashemi-Fesharaki M, Salami S, Kebriaee-Zadeh J, Sadeghian GH. General physicians and prescribing pattern in Isfahan, Iran. Oman Med J 2011; 26(3): 205-6.
  19. Sadeghian GH, Safaeian L, Mahdanian AR, Salami S, Kebriaee-Zadeh J. Prescribing quality in medical specialists in isfahan, iran. Iran J Pharm Res 2013; 12(1): 235-41.
  20. Aronson JK, Henderson G, Webb DJ, Rawlins MD. A prescription for better prescribing. BMJ 2006; 333(7566): 459-60.
  21. Perwitasari DA, Abror J, Wahyuningsih I. Medication errors in outpatients of a government hospital in Yogyakarta Indonesia. Int J Pharm Sci Rev Res 2010; 1(1): 8-10.
  22. Mastura I, Teng CL. The effect of "group detailing" on drug prescribing in primary care. Med J Malaysia 2008; 63(4): 315-8.
  23. Shaw J, Harris P, Keogh G, Graudins L, Perks E, Thomas PS. Error reduction: academic detailing as a method to reduce incorrect prescriptions. Eur J Clin Pharmacol 2003; 59(8-9): 697-9.
  24. Motamed N, Kashani Z, Safar MJ, Alian SH, Khademloo M, Eslamiyan R. Prescription writing ability of interns for common illnesses-Sari Medical School-summer 2004. J Mazandaran Univ Med Sci 2006, 16(51): 102-11. [In Persian].
  25. Heaton A, Webb DJ, Maxwell SR. Undergraduate preparation for prescribing: the views of 2413 UK medical students and recent graduates. Br J Clin Pharmacol 2008; 66(1): 128-34.
  26. Dean B, Schachter M, Vincent C, Barber N. Causes of prescribing errors in hospital inpatients: a prospective study. Lancet 2002; 359(9315): 1373-8.
  27. Bobb A, Gleason K, Husch M, Feinglass J, Yarnold PR, Noskin GA. The epidemiology of prescribing errors: the potential impact of computerized prescriber order entry. Arch Intern Med 2004; 164(7): 785-92.
  28. Jackson SH, Mangoni AA, Batty GM. Optimization of drug prescribing. Br J Clin Pharmacol 2004; 57(3): 231-6.
Journal of Isfahan Medical School
Volume 32, Issue 277 - Serial Number 277
January and February 2014
Pages 282-291

Files

History

  • Receive Date: 06 January 2014
  • Revise Date: 01 November 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics