Improving quality of prescriptions with clinical audit.

Sir, Prescription writing is one of the most important and basic skills that a doctor needs. Specifi c training and supervision in prescription should be emphasized during undergraduate and postgraduate teaching to minimize related errors.[1] These prescription errors may lead to adverse drug events. The study done to assess adverse drug events by Bates et al. found 28% of adverse drug events to be preventable in their study and concluded that 56% of those preventable adverse events occurred at the stage of ordering.[2] Evidence indicates that these adverse drug events are common in long-term psychiatric care units.[3] It may be applicable to other psychiatric settings, although related study has not been reported so far. The use of clinical audit for assessing the nature of prescription errors and establishing standards may be one viable solution for this problem. Clinical audit is shown to be benefi cial in many developed countries, especially in the UK, where it is commonly utilized. Often, recommendations from the audit cycle are not effectively implemented or are not pursued completely.[4] This can undermine the utility of clinical audit. A few reports on audit cycles of prescription related to psychiatry have been published in the past few years.[5-7] Even though there is a need for improvement in prescription patterns,[8] we are not aware of such a study conducted in India. This report describes our experience with a systematically conducted audit exercise on prescription orders written by postgraduate resident doctors in psychiatry.