Evaluation of a skill-based training program for interns on prescription self-audit
Keywords:
prescribing indicators, CRRI, rational prescribing, polypharmacy, drug use indicators, CBME (Competency Based Medical Education)Abstract
Context: Good prescription practices are needed to ensure rational drug use. Does training of interns on prescription self-audit improve the quality of prescriptions?
Aim: to evaluate a skill-based training program for interns on self-audit of their prescription practices.
Methods and Material: An interventional workshop on prescription self-audit was conducted for interns. In the workshop, 25 interns replicated 10 random prescriptions written by them during their Compulsory Rotatory Residential Internship (CRRI) (Cycle 1= C1). Then, the interns were trained to audit these prescriptions using WHO core prescribing indicators and interpret the results. They were asked to identify the lacunae in their prescriptions that required improvement. The same process was repeated after 2 weeks (Cycle 2= C2). C1 and C2 prescription parameters were compared to assess the effectiveness of the training. Perceptions of the interns were assessed using Likert’s scale.
Results: The mean drugs per prescription reduced from 3.19±0.9 in C1 to 2.972±0.6 in C2. The percentage of antibiotics in C1 and C2 were 42.4% and 60%, and injections were 60.4% and 48% respectively. In terms of polypharmacy, the use of injectables and antibiotics, values obtained were higher than the acceptable range set by WHO. The drugs prescribed by generic name in C1 and C2 were 37.6 % and 68.4 % and the improvement was statistically significant.
Conclusions: There was an improvement in the prescribing practices of interns with sequential self-audit. There is a perceived gap regarding rational drug use which may be bridged by further training.
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