Study of the effect of pharmacotherapeutic audit meetings on prescription writing in a tertiary care center-an interventional study

Background: Rational drug prescription is a practice when an appropriate drug with correct dosage, formulation, frequency and duration is prescribed. Prescription audit with the help of regular Pharmaco-therapeutic audit meetings (PTAM) is a continuous cycle, involving observing practice, setting standards, comparing practice with standards, implementing changes and observing new practice. World health organization (WHO) and international network for rational use of drugs (INRUD) jointly provided a few prescription and drug use indicators to guide rational prescription writing practice. Aim of the study was to assess the effect of pharmaco-therapeutic audit meetings on prescription writing and its rationality. Methods: This was a single center cross-sectional, prospective study conducted over a period of 14 months (December 2018-February 2020). Prescriptions from outpatient departments of general medicine, pulmonary medicine, physical medicine and rehabilitation (PMR), community and family medicine (CFM), pediatrics and psychiatry were collected. All the collected prescriptions were screened for rationality using WHO/INRUD core indicators and the index of rational drug prescribing was calculated. Prescriptions beyond acceptable limit were discussed in PTAM and same process was repeated over next 2 months to assess change in prescribing patterns after PTAM. Chi-square and student’s t-test was used for statistical analysis. Results: Statistically significant change in proportions for antibiotic prescribing was 3.4% [95% CI (-1.7%-9.4%), p=0.20] and prescriptions with generic name drugs was 10.5% [95% CI (6.1-14.6%) p<0.0001 was seen while no significant change was seen in injectable preparation use 0.6% [95% CI (-0.6%-1.5%); p=0.26)] and prescriptions from essential drug list (EDL) 0.5% [95% CI (-4.2%-5.4%) p=0.83]. Conclusions: Our study showed that PTAM is an effective way to improve rationality of prescriptions and must be done regularly for improving prescribing practices.