Effect of providing feedback and prescribing education on prescription writing: An intervention study

Accurate medication prescribing important to avoid errors and ensure best possible outcomes. This is a report of assessment of the impact of providing feedback and educational intervention on prescribing error types and rates in routine practice.

Doctors' prescriptions from selected wards in two tertiary hospitals in central Nigeria were prospectively reviewed for a 6-month period and assessed for errors; grouped into six categories. Intervention was by providing feedback and educational outreach on the specialty/departmental level at one hospital while the other acted as the control. Chi-squared statistics was used to compare prescribing characteristics pre- and post-intervention.

At baseline, error rate was higher at the control site. At the intervention site, statistically significant reductions were obtained for errors involving omission of route of administration (P < 0.001), under dose (P = 0.012), dose adjustment in renal impairment (P = 0.019), ambiguous orders (P < 0.001) and drug/drug interaction (P < 0.001) post intervention though there was no change in mean error rate post intervention (P = 0.984). Though House Officers and Registrars wrote most prescriptions, highest reduction in prescribing error rates post intervention was by the registrars (0.93% to 0.29%, P < 0.001).

Writing prescriptions that lacked essential details was common. Intervention resulted in modest changes. Routinely providing feedback and continuing prescriber education will likely sustain error reduction.