Table 4 Summary of the quality improvement project 'prescription audit'

Identified needs

1. Complaints from the pharmacy department on the issues of polypharmacy and inappropriate prescriptions

2. No formal prescription audit had been done before

practitioners in Eswatini trained at many different countries, each with own standards of care. Standard treatment guidelines are not readily used where available

Goals

1. ensure that prescriptions met appropriate general standards (legibility, identifiable prescriber, generic drug name use)

2. comply with Standard treatment guidelines (STGs)

3. review medications and treatment for chronic diseases

4. interaction checking

5. instructions and warnings to patients

Educational initiatives

1. sensitization of all prescribers and pharmacy about the audit and its scope

2. short interactive presentations on prescribing standards (adapted from the World Health Organisations ‘Guide to good prescribing’) [35]

3. promoting use of the STGs and some short interactive case discussions on management of common cases in the facility

Objective outcomes

1. audit findings (from the audit of prescription scripts) were presented in an open forum to prescribers

2. standard operating procedures for non-compliant prescriptions were developed

3. improvement in documentation including: legibility, use of generic drug names, documenting instructions/warnings to patients,

4. reduction in the number of drugs per prescription when comparing before and after audit