Prescription-writing errors and markers: the value of knowing the diagnosis.
OBJECTIVE
Duplicate prescription pads are used in many family practice residency programs to monitor prescribing patterns and detect errors in the actual prescription-writing process. This study looked at whether the review of duplicate prescriptions could be enhanced by adding the patient's diagnosis to the prescription.


METHODS
The prescription-writing errors of Shaughnessy and Nickel were revised to include prescription-writing markers. These markers were defined as either an indication of use or a duration of therapy that differed from current medical literature or manufacturers' recommendations. Duplicate prescriptions of first-year family practice residents were reviewed for prescription-writing errors and markers before and after an in-service training regarding prescription writing.


RESULTS
Following the in-service training, the number of prescriptions containing the patient's diagnosis increased significantly (20% to 61%). Nineteen percent of all prescriptions contained prescription-writing errors. Eight percent of the prescriptions with the patient's diagnosis contained prescription-writing markers.


CONCLUSIONS
The addition of the patient's diagnosis to the prescription enhanced the review of duplicate prescriptions. It permitted the evaluation of not only the prescription-writing process but also the decision-making process that led to writing the prescription. It also permitted a more thorough evaluation of appropriate drug use.
Howell
R R
RR
McLeod Family Medicine Residency Program, Florence, SC.
Jones
K W
KW
D003933:Diagnosis; D011307:Drug Prescriptions / Q000592:standards*; D004363:Drug Utilization; D005194:Family Practice; D007396:Internship and Residency; D008508:Medication Errors