Biomedicine

Abstract

Introduction and Aim: Medical audit is a continuous systematic evaluation of clinical practices and medical care quality intended at identifying errors, improving patient care and optimizing medical resource utilization. Prescription audit, a key component of medical audit, objectively assesses prescribing patterns of clinicians against established standards. Its benefits include rational drug use, improved prescribing behavior, efficient resource allocation, and enhanced patient outcomes. However, it is not routinely done due to lack of expert dedicated manpower for this work in medical colleges in India. Material and Methods: This study explored, the involvement of medical undergraduate students to support prescription auditing in a medical college. The study involved, evaluation of outpatient prescription compliance using the National Accreditation Board for Hospitals and Healthcare Providers (NABH) checklist, audited by undergraduate medical students. A retrospective observational study was conducted using prescriptions reviewed by Phase 2 MBBS students during the 2020-2021 academic session. In accordance with the competency-based medical curriculum of the National Medical Commission (NMC), students undertook prescription appraisal (PH3.2 competency) as part of pharmacology practical training. Following structured instruction, out patient prescriptions were audited by medical students using the NABH checklist which were reassessed by faculty investigators from the Department of Pharmacology. The results were represented in percentages and used chi square tests for the comparison of the students and investigators NABH prescription audit parameters. Additionally, the faculty investigators also examined WHO prescribing indicators, prescription legibility, and polypharmacy. Results: Of the 120 prescriptions submitted, 32 were duplicates and 19 were excluded for errors such as inpatient charts or prescriptions from external institutions. Thus, 51 (42.5%) were eliminated. To preserve sample size, additional valid outpatient prescriptions audited by students were included, maintaining sample size to 120 for final analysis. Overall, students’ reporting was comparable to investigators in most parameters. Polypharmacy was evident in 73.3% of prescriptions. Sixteen percent of prescriptions were illegible. Of the 394 prescribed drugs, 56.3% were generic. Antibiotics accounted for 12.2% (48 drugs), while 61.7% of the prescriptions were from the Essential Drugs List (EDL). Conclusion: The findings demonstrate that undergraduate medical students can effectively participate in prescription auditing under appropriate faculty supervision with emphasis on observing duplication and errors in reporting.