Prescription writing in public and private hospitals in Benin City, Nigeria: the effects of an educational intervention.

BACKGROUND

Writing a prescription is a vital part of the process of rational therapeutics; a badly written prescription could undermine a clinical consultation.

OBJECTIVES

To determine how far prescriptions meet accepted standards, identify factors underlying poor prescription writing, intervene by educational methods, and evaluate the effects of intervention.

METHODS

Prescriptions (1,197) were collected retrospectively from 40 doctors (public and private hospitals). Handwriting was assessed using a rating scale. Intervention was by face-to-face education and group seminar in public hospitals, and face-to-face education only in private hospitals, with impact evaluation 4 to 6 weeks later. Non-parametric statistics were used to assess differences in means for pre- and post-intervention values.

RESULTS

At baseline, more prescriptions from private hospitals had hospitals' addresses (p=0.005) and patients' ages (p=0.015); more from public hospitals were signed (p=0.001) and 20% of prescriptions were clearly legible. Post-intervention, more prescriptions from public hospitals were signed (p=0.017); more from private hospitals had the doses (p=0.04) and routes (p=0.05) of administration, and the intervention group in private hospitals wrote patients ages more frequently than controls (p=0.05). Doctors who had group seminar wrote frequencies and routes of administration (p=0.03 and 0.04 respectively) more than those who had face-to-face education. Handwriting worsened (p=0.04, 0.02 in public and private hospitals respectively). Poor quality of prescriptions was blamed partly on heavy workload and non-availability of prescription order blanks.

CONCLUSIONS

Prescriptions lacked details and most were not clearly legible. Intervention resulted in modest changes, which in public hospitals were more significant among doctors who had group seminars.