[The editorial quality of hospital drug prescriptions in the Ile de France area. A study by the Health Insurance].
OBJECTIVE
To assess the editorial quality of drug prescriptions made by hospital for ambulatory patient (outpatients or on discharge from hospital).


METHODS
This study was based on 500 drugs prescriptions with bills which were presented to the National Health Scheme for reimbursement during July 2000, from hospital centres within the Ile de France area. In a second phase, the sub-group of prescriptions for patients on discharge from hospital were analysed and permitted comparison of the results obtained with those of a study conducted in a university hospital centre in 1997 on this type of prescription.


RESULTS
In most cases, these prescriptions were drawn up during a medical consultation at the hospital (57%), on discharge from hospital (25%), or after a visit to a department of emergency unit (10%). The principal mistakes in editorial modalities were the omission of compulsory identification elements for the patient, the practitioner and the health care facility: only 17% of the prescriptions associated all these elements. In 41% of the cases, the identification of the hospital was missing, the prescriber's name in 18% and his/her function in 64%, the patient's family name was missing in 6% of the cases, and first name in 31%. Analysis of the contents of the drug prescriptions showed that 95% bore sufficient detail for the drug to be dispensed. The non-respect of rules regarding the duration of prescriptions for anxiolitics (23%) and notably hypnotics (62%) was observed. Potentially dangerous drug interactions and contraindications concerned 8% of the prescriptions studied. Comparison with other studies on the subject in the Ile de France area showed converging results regarding errors made and the absence of any improvement in editorial quality since 1997.


CONCLUSIONS
This study underlines the poor editorial quality of hospital prescriptions. The development of a standardised prescription and promotion of a computerised system would reduce the number of errors that may result from such prescriptions.
Fourgon
Robert
R
Service médical unifié d'Ile-de-France, Centre Paris-Pleyel, 93521 Saint-Denis Cedex, France.
Vicrey
Claude
C
Blanchon
Béatrice
B
Vassort
Stéphane
S
Blum-Boisgard
Claudine
C
D004347:Drug Interactions; D011307:Drug Prescriptions / Q000592:standards*; D005602:France; D006761:Hospitals / Q000592:standards; D006801:Humans; D008485:Medical Audit; D019300:Medical Errors; D010045:Outpatients; D010351:Patient Discharge; D011786:Quality Control; D012189:Retrospective Studies