[Evaluation of pharmacotherapy in general-internal ambulatory care as a possibility of quality control]

The therapeutic process at a medical outpatient clinic is evaluated. 1800 drug prescriptions for 839 patients issued by 9 medical residents from February to March 1980 were collected prospectively and analyzed by retrospective chart review. Although a rather high frequency of drug prescription (0.83 per consultation) was found, the average of 2 drugs per patient treated was considered to be low. Gastrointestinal drugs were prescribed most frequently (17% of all prescriptions), whereas antimicrobial agents (7%), psychotropic drugs (10%) and cerebrovascular vasodilators (0.8%) were used rarely in comparison with the results of other investigations. Evaluation of choice of drugs and frequency of their use was based on criteria from the literature. Analysis of prescribing patterns of the individual residents provided information about their pharmacotherapeutic peculiarities. Drug use of the group was judged to be satisfactory. The accuracy of the diagnostic workup preceding drug therapy was examined, and for 17% of all prescriptions no diagnosis could be found in the medical record. Furthermore, the chart review revealed unsatisfactory documentation of the drug therapy prescribed, i.e. 20% of prescriptions were not recorded. Educational feedback to the group was given to the residents. It was accepted as valuable information about medical behaviour and performance of the individual.