Quality Evaluation of Dermatology Prescriptions: Completeness, Legibility and Rationality in a Tertiary Care Indian Hospital

Background: Illegible, incomplete and inappropriate prescriptions can lead to medication errors and adverse drug reactions. Dermatological conditions, despite their global prevalence, are often underestimated. This study assesses completeness, legibility and rationality of dermatological prescriptions in India. Materials and Methods: The cross-sectional, observational study analyzed 3290 prescriptions at dermatology outpatient department of a tertiary care hospital. Ethical clearance was obtained. Participants signed written informed consent. Prescriptions from first time visitors containing at least one drug were included. Data were collected and analyzed for completeness, legibility, prescribed medicines and rational drug using descriptive statistics. Results: All prescriptions were handwritten, with 37.33% in capital letters. Prescription legibility scored illegible in 1.5% and barely legible in 4%. While all prescriptions included patient information and date, essential drug information was lacking: dose (47.03%), route of administration (73.57%), frequency (46%), strength (60.44%) and duration (65.58%). Diagnosis and prescriber’s signature were missing in 19.67% and 8% prescriptions respectively. A total of 9607 drugs were prescribed, 81.39% individually and 18.6% as fixed dose combinations. Antifungals were prescribed the maximum (20.71%). Antibiotics were included in 37% of prescriptions. Average number of drugs per prescription was three with 40.07% prescribed from National List of Essential Medicines. Trade names were used in 88.17% prescriptions. Conclusion: Prescriptions should be complete, legible and written in capital or generated by a computer to prevent errors. Dermatology practitioners should prescribe by generic names using essential drug list, adhere to clinical guidelines and limit number of drugs per prescription to promote rational therapeutics. These findings can guide future policies and interventions.