Prescription practices of physicians, quality of care, and patients' safety: A mixed methods comprehensive study

Amidst inconsistent prescribing patterns and potentially harmful medication errors in the field of medical practice, this study endeavored to explore the prescription practices of physicians in Rawalpindi metropolitan city in Pakistan.

A mixed method study was conducted based on the analysis of 1232 prescriptions gathered from 16 pharmacies, along with in-depth interviews with 13 practicing physicians. The prescriptions were assessed for legibility, polypharmacy, patient details, history, diagnosis, and other relevant information. Data were analyzed using descriptive statistics, and the prevalence of various aspects of prescription accuracy was calculated. Thematic analysis was conducted on the qualitative data.

Almost half of the prescriptions were from the private general practitioners, and the rest were from hospital-based doctors and consultants. Only a small percentage of prescriptions were fully legible, and many had incomplete or missing patient information, medical history, and diagnosis. Polypharmacy was also found to be prevalent, with significant differences in prescription accuracy across different medical specialties. The absence of continuing medical education, influence of pharmaceutical industry, and overcrowded practice settings drive the doctors to prescription practices. On the user side, perception of polypharmacy, patient-physician communication, and availability and cost of medicines emerged as major themes.

There is an obvious need to improve prescription accuracy regarding patient safety on the whole. Increased investment in health-care infrastructure, greater access to continuing medical education, and a commitment to promote evidence-based medicine could make a difference. Prescription practices must be safe, effective, and aligned with the latest advances in medical science.