Evaluation of the quality and appropriateness of medical prescriptions in the hospital discharge report

Abstract

Objectives: The aim of this research has been to evaluate: (a) the frequency of the use of non-standard terms in medical prescriptions; (b) the proportion of “new drugs of irrelevant therapeutic value” or medication of low therapeutic utility (LTU); and (c) the use of Generic Pharmaceutical Specialties (GPS).

Materials and methods: Descriptive transversal observational study with analytical components over the hospital discharge reports issued in a year. The main variables of the results were: a) the proportion of prescriptions with abbreviations, symbols or expressions of non-recommended doses in the discharge report, b) the frequency of prescriptions of pharmaceutical specialties without the relevant contribution (NRPS), c) the proportion of LTU medication in the hospital discharge reports, d) the frequency of GPS or, if they are not available, the Common International Denomination (CID) of the active ingredient in the discharge reports, and e) the mean cost per prescribed medication in the hospital discharge report.

Results: A total of 854 discharge reports have been studied containing 4,055 medical prescriptions. A considerable number (38.8%) of the medical prescriptions in the discharge report have used abbreviations and non-recommended symbols for dose expression. The prescription of new drugs of irrelevant therapeutic value reached 2.8% while the prescription of pharmaceutical products of LTU was 2.1%. Only 13.8% of the prescriptions were carried out as an active ingredient. The mean cost per prescription was 17.3 euros (SD = 31.34).

Conclusions: Appropriateness in the prescription of medication at hospital discharge is considered to be not satisfactory and our results are consistent with other previously published reports. However, there are frequent errors in the prescription of medication and given the demonstrated relationship between errors and possible adverse effects, it is necessary to introduce programs to raise awareness about the importance of the introduction of safe practices in the medical prescriptions of the hospital discharge report.