Introducing a structured prescription form improves the quality of handwritten prescriptions in limited resource setting of developing countries

Abstract

Introduction: Incomplete or illegible prescriptions can lead to serious errors in administration of the prescribed medication, which can become hazardous.

Objective: Our aim is to determine if a structured prescription form can improve the quality of handwritten prescription in terms of completeness and legibility.

Methods: We conducted a prospective, non-randomized, time series study of quality of written prescriptions of general practitioners at a tertiary teaching hospital in Peshawar, Pakistan. The study involved an intervention, composed of the introduction of a pre-printed structured prescription form. The data were collected within 4 weeks including a 2-week pre-intervention phase and 2-week post-intervention phase. Completeness, quality of prescriptions and legibility were compared before and after the intervention of the pre-printed structured prescription form.

Results: A total of 463 prescriptions were obtained (260 in the pre-intervention phase and 203 in the post-intervention phase). Between pre-intervention phase and post-intervention phase, the Pakistan Medical and Dental Council registration number presence in prescriptions improved from 73.1% to 100% (P < 0.0005). The presence of prescriber's signature improved from 92.7% to 99% (P = 0.001). Drug duration was not missing in 99.5% in post-intervention phase as compared with 90.4% in pre-intervention phase (P < 0.0005). Prescriptions with no legibility problems improved from 76.2% to 94.1% (P < 0.0005). Although not statistically significant, prescriptions in which drug dosage was not missing improved from 85% to 90.6% (P = 0.07).

Limitations: We have a limited single-center study. A larger study in multiple settings is needed to develop adequate evidence for such interventions. Subjective nature of prescription legibility can also be considered as a limitation.

Conclusion: Structuring a prescription form alone may improve certain aspects of quality of written prescription in terms of completeness and legibility.

Keywords: clinical guidelines; clinical safety; patient-centred care.