Evaluating Regulatory Compliance and WHO Prescribing Indicators in Uttar Pradesh: A Cross-Sectional Audit of Ground-Level Prescription Practices

Background

Incomplete documentation, poor legibility, excessive drug use, and preference for brand names may increase medication-related problems and compromise rational drug use. This study examined prescription writing and prescribing practices in healthcare settings in Uttar Pradesh.

Objectives

To assess prescription writing practices and rational drug use according to WHO prescribing indicators and the prescription-related requirements of the NMC Registered Medical Practitioner (Professional Conduct) Regulations, 2023.

Materials and Methods

A retrospective, cross-sectional observational prescription audit was conducted on 100 prescriptions collected from retail, hospital, and community pharmacy settings across Uttar Pradesh between January and April 2026. First-encounter outpatient prescriptions containing at least one medicine were included. Prescriptions were assessed using a structured checklist covering patient and prescriber details, diagnosis, allergy history, legibility, drug nomenclature, dosage, route, duration, and WHO prescribing indicators.

Results

Important gaps were observed in prescription practices. Diagnosis and allergy history were documented in 34% and 12% of prescriptions, respectively. Only 42% were clearly legible, 79% included the prescriber's registration number, and 14% used capitalized drug names. The mean number of medicines was 4.1±1.2 per prescription. Generic prescribing was 11.1%, while antibiotics, injections, and NLEM/EML medicines accounted for 18.8%, 5.3%, and 10.7%, respectively.

Conclusion

The audit identified substantial gaps in prescription documentation, legibility, generic prescribing, and rational medicine use. Regular prescription audits, prescriber training, pharmacist involvement, and electronic prescribing may improve prescription quality and patient safety.