Computer-based prescription audit as a research, educational and management tool

Area of Science:

• Health Informatics
• Pharmacy Systems
• Clinical Pharmacy

Background:

• Existing pharmacy computer systems primarily focused on labeling and dispensing.
• There was a need for enhanced functionalities in drug use monitoring, therapeutic auditing, and research.
• Integration with patient medical records was limited.

Purpose of the Study:

• To redevelop an existing pharmacy computer system (MIDAS) with enhanced features.
• To improve drug use monitoring, therapeutic auditing, and budgetary prediction capabilities.
• To create a valuable addition to patient medical records through automatically updated prescription profiles.

Main Methods:

• Rewriting the MIDAS system for an in-house minicomputer.
• Implementing automatic sorting and retrieval techniques for patient prescription data.
• Generating automatically updated hard copy records of individual patient prescription profiles.

Main Results:

• The enhanced system facilitates budgetary predictions and drug use monitoring.
• Identification of patients on specific drug combinations (e.g., nifedipine-beta blocker) and audit of drug use (e.g., cimetidine).
• Audit revealed high polypharmacy rates (26% with ≥5 items, 3% with ≥10 items).

Conclusions:

• The upgraded system provides valuable statistical data for outpatient prescribing and budgetary forecasting.
• The system enables identification of polypharmacy and supports therapeutic audits.
• Future applications include interactive prescriber education and expanded research through database cross-linking.