A Survey of Drug Audit Practices and Promotion of Quality Prescribing in Australian Hospitals with a Focus on Psychotropic Drugs

• Published in: Australian journal of hospital pharmacy Vol. 30; no. 5; pp. 196 - 201
• Main Authors: Fellows, Linda, Hughes, Jeffery D
• Format: Journal Article
• Language: English
• Published: 01-10-2000
• ISSN: 0310-6810; 0310-6810
• DOI: 10.1002/jppr2000305196

Objective: To gain an insight into current practice of drug audit/drug usage evaluation (DUE) in Australian hospitals with a particular focus on psychotropic drugs.
Method: All Australian hospitals with greater than 150 beds were surveyed by questionnaire to ascertain the level of drug audit activity and the strategies used to support quality prescribing. Twenty‐two pharmacists from 18 different hospitals in 5 States participated in a structured follow‐up interview.
Results: Pharmacists from 73 (49%) of the 150 hospitals surveyed responded. Drug audit activity varied widely across hospitals and did not necessarily relate to the size or demographics of the hospital. While there was increasing use of well‐structured DUE, simple one‐day ‘snapshots’ of drug usage were also common. Interviewees reported that the focus of DUE was primarily on cost containment, with a secondary element of quality prescribing. Pharmacists were closely involved, but little training or additional resources were provided for these activities. Successful DUE was seen to depend heavily on hospital culture and in particular on the support of key clinicians and senior managers. Psychotropic drug audit was not a high priority for DUE outside the stand‐alone psychiatric institutions. Lack of resources and incentives coupled with inadequate information technology have limited DUE progress.
Conclusion: There is recognition in Australian hospitals that DUE is a valuable tool for improving prescribing practice. To progress DUE it is critical to advance and standardise hospital computer systems and in particular to introduce electronic prescribing. In addition there is scope to improve policy agendas relating to accreditation requirements and national standards to enhance the development of DUE.