Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study

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Shetty" }, { "@type": "Person", "name": "Shreya Bera" }, { "@type": "Person", "name": "Priyanka Renita D'Souza" }, { "@type": "Person", "name": "Keshava Pai" } ], "publisher": { "@type": "Organization", "name": "F1000Research", "logo": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 480, "width": 60 } }, "image": { "@type": "ImageObject", "url": "https://f1000research.com/img/AMP/F1000Research_image.png", "height": 1200, "width": 150 }, "description": " Background Rational prescription writing is an important skill to master during internship. This Quality Improvement (QI) project aimed to understand the state of prescription writing among interns posted in the Department of Psychiatry, analyze the causes responsible for errors in prescription writing and bring about a change in the current practice. Methods The MBBS interns are posted in the Department of Psychiatry for 15 days. During day 1 to day 5 of their posting, a pre intervention phase was conducted wherein prescriptions written by interns in the Department of Psychiatry were collected. The prescriptions were scored based on 14 criteria which were selected based on World Health Organization (WHO) guidelines and Medical Council of India (MCI) ideal prescription format. During PDSA (Plan Do Study Act) Cycle 1, an educational handout was distributed to the interns containing the MCI ideal prescription format and WHO guidelines regarding prescription writing. The brochure was also verbally explained to the interns. From day 7 to day 15 of their posting, prescriptions written by the interns were collected. The prescriptions were scored using the same criteria. Results During the pre intervention phase the mean total score of prescriptions was 9.54 ± 1.003. There was a significant improvement in the mean total score to 10.26 ± 0.746. There was a 7.54% improvement. There was also a significant improvement in several individual criteria. Conclusions The first PDSA cycle was successful in improving the quality of prescription writing among interns posted in the Department of Psychiatry. There is a need to implement more PDSA cycles to improve the quality still further. " } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/13-269/v2", "name": "Prescriptions written by MBBS Interns in the Department of Psychiatry..." } } ] } Home Browse Prescriptions written by MBBS Interns in the Department of Psychiatry... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Bakshi P, Shetty SB, Bera S et al. Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.12688/f1000research.144712.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article Revised Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] Previously titled: Prescription writing quality of psychotropic agents in MBBS interns in a private medical college hospital in Mangaluru Poorva Bakshi https://orcid.org/0009-0007-0888-1614 1 , Sharanya B. Shetty https://orcid.org/0000-0001-9827-7443 2 , Shreya Bera 1 , Priyanka Renita D'Souza https://orcid.org/0000-0002-2858-0911 2 , Keshava Pai https://orcid.org/0000-0003-0753-9685 2 Poorva Bakshi https://orcid.org/0009-0007-0888-1614 1 , Sharanya B. Shetty https://orcid.org/0000-0001-9827-7443 2 , [...] Shreya Bera 1 , Priyanka Renita D'Souza https://orcid.org/0000-0002-2858-0911 2 , Keshava Pai https://orcid.org/0000-0003-0753-9685 2 PUBLISHED 20 Dec 2024 Author details Author details 1 Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 2 Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India Poorva Bakshi Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Sharanya B. Shetty Roles: Conceptualization, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Shreya Bera Roles: Data Curation, Formal Analysis, Writing – Review & Editing Priyanka Renita D'Souza Roles: Data Curation, Writing – Original Draft Preparation, Writing – Review & Editing Keshava Pai Roles: Methodology, Writing – Original Draft Preparation, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS This article is included in the Manipal Academy of Higher Education gateway. Abstract Background Rational prescription writing is an important skill to master during internship. This Quality Improvement (QI) project aimed to understand the state of prescription writing among interns posted in the Department of Psychiatry, analyze the causes responsible for errors in prescription writing and bring about a change in the current practice. Methods The MBBS interns are posted in the Department of Psychiatry for 15 days. During day 1 to day 5 of their posting, a pre intervention phase was conducted wherein prescriptions written by interns in the Department of Psychiatry were collected. The prescriptions were scored based on 14 criteria which were selected based on World Health Organization (WHO) guidelines and Medical Council of India (MCI) ideal prescription format. During PDSA (Plan Do Study Act) Cycle 1, an educational handout was distributed to the interns containing the MCI ideal prescription format and WHO guidelines regarding prescription writing. The brochure was also verbally explained to the interns. From day 7 to day 15 of their posting, prescriptions written by the interns were collected. The prescriptions were scored using the same criteria. Results During the pre intervention phase the mean total score of prescriptions was 9.54 ± 1.003. There was a significant improvement in the mean total score to 10.26 ± 0.746. There was a 7.54% improvement. There was also a significant improvement in several individual criteria. Conclusions The first PDSA cycle was successful in improving the quality of prescription writing among interns posted in the Department of Psychiatry. There is a need to implement more PDSA cycles to improve the quality still further. READ ALL READ LESS Keywords Prescription, intern, rational prescription writing, Quality Improvement Project, Audit, Psychiatry Corresponding Author(s) Sharanya B. Shetty ( [email protected] ) Close Corresponding author: Sharanya B. Shetty Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2024 Bakshi P et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Bakshi P, Shetty SB, Bera S et al. Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.12688/f1000research.144712.2 ) First published: 15 Apr 2024, 13 :269 ( https://doi.org/10.12688/f1000research.144712.1 ) Latest published: 20 Dec 2024, 13 :269 ( https://doi.org/10.12688/f1000research.144712.2 ) Revised Amendments from Version 1 In this version we have made modification to the title as per the reviewers feedback reflecting the study design. We have also added additional studies in the available knowledge section. We have combined the pre intervention and post intervention tables and added the p value in the same. We have made few modifications in the introduction and discussion section. We have added limitation based on reviewers feedback. In this version we have made modification to the title as per the reviewers feedback reflecting the study design. We have also added additional studies in the available knowledge section. We have combined the pre intervention and post intervention tables and added the p value in the same. We have made few modifications in the introduction and discussion section. We have added limitation based on reviewers feedback. See the authors' detailed response to the review by Dr Shashwath Sathyanath See the authors' detailed response to the review by Vandana Gaur See the authors' detailed response to the review by Sanjeev Badiger READ REVIEWER RESPONSES Introduction The problem of irrational drug prescription is prevalent worldwide. 1 According to a World Health Organization (WHO) estimate, more than 50% of drugs are prescribed, dispensed, or sold inappropriately, and 50% of patients fail to take them correctly ( https://www.who.int/activities/promoting-rational-use-of-medicines ). The prescription is the written instruction of the physician communicated to the patient. Writing rational prescriptions is an important skill for physicians. Poorly written prescriptions can negatively affect patient treatment, including worsening of the disease and making the prescriber liable to influence, which may lead to irrational prescribing. 2 Rational prescribing requires a logical approach that involves several key steps, including making the diagnosis, determining the therapeutic goals, consideration of treatment options, deciding the best treatment option, prescription and monitoring. 3 Internship is a period of one year during which newly qualified Bachelor of Medicine and Bachelor of Surgery (MBBS) graduates practice under the guidance of senior doctors in designated hospitals. Studying the pattern of their prescriptions and suggesting changes is of utmost importance in improving the quality of patient care and enhancing the undergraduate medical education of interns. Available knowledge Studies conducted in Asian countries have reported varying rates of errors when writing prescriptions. These values range from 7% to 35.4%. 4 A study conducted in Bangladesh found that 78% of drugs were prescribed by their generic names, 85% complied with the essential drug list, and 81% were dispensed according to prescription. 5 In a study conducted in private hospitals in western India, prescriptions were analyzed according to WHO prescribing indicators. It was found that out of the 250 prescriptions analyzed, patient details were not written in 100% of prescriptions. Drug dosage, instructions regarding drug administration, and the duration of the treatment were not completely written in 90%, 74%, and 80% of prescriptions studied, respectively. The prescriber’s medical registration number was not mentioned in any of the prescriptions. 6 In a study carried out in the non-governmental organization sector in West Bengal, India, it was found that the majority were signed, legible, and complete with respect to age/gender data, 95.5% used Latin abbreviations, and 7.7% mentioned neither signs, symptoms, nor diagnosis. Irrational fixed-dose combinations were used in 45.6% of the prescribed drugs. Only 45.7% of prescribed drugs conformed to the WHO model list of essential drugs. 7 In a study of selected rural pharmacies in southern India, it was found that 91.4% of prescriptions did not contain any drug prescribed by its generic name. 8 In a study in The Oxford Dental College and Hospital, Bangalore, prescriptions were analyzed for several features, such as patient details, doctor’s information, and drug information. Prescriptions written by undergraduate students were better than those written by interns and postgraduates (PGs). 9 The prescriptions written by interns were studied in a primary health centre in India, and it was found that 34.97% of drugs were prescribed by generic name and 58.7% of drugs prescribed were from the essential drug list of India. 10 A study conducted in India sought to understand the factors involved in the problem of irrational prescriptions. The prevalence of Fixed Drug Combinations in India was found to be one such factor. 11 Another study showed that interventions positively impact the ability of medical students to write prescriptions, however the type of intervention which is best suited for this purpose is still not agreed upon. 12 Rationale After studying the literature available regarding the state of prescription writing, this Quality Improvement (QI) project was conceptualized. This QI project sought to understand and bring about improvements in the quality of prescriptions written by interns posted in the Department of Psychiatry. A process map was created that outlined the process through which the interns were posted in the Department of Psychiatry to write prescriptions ( Figure 1 ). Figure 1. Process map regarding the process by which interns write prescriptions. We carefully studied the process and brainstormed possible causes of the poor quality of prescription writing among interns with the help of a fishbone diagram ( Figure 2 ). Figure 2. Fishbone diagram regarding causes of poor prescription writing. Aims The aim of our QI project was to improve the quality of prescription writing among interns posted in the Psychiatry department. Our Specific, Measurable, Applicable, Realistic and Timely (SMART) aim was to improve the mean prescription scores. Methods Study setting: This study was conducted in the outpatient Department of Psychiatry, Kasturba Medical College Hospital, Attavar, Mangaluru. Study design: Quality Improvement Project. Study participants: MBBS interns in the Department of Psychiatry, Kasturba Medical College Hospital, Attavar, Mangaluru. Inclusion criteria a) MBBS Interns posted in the Department of Psychiatry, willing to grant consent. b) Patients above the age of 18 years attending Psychiatry Outpatient department. Exclusion criteria a) Postgraduates and consultants writing prescriptions for the patients b) Interns posted in other specialties Study duration: 1 year from November 2022 till August 2023 Sample size The sample size for the study is 85 with 5% level of significance. N = Z 2 ρv / d 2 = ( 1.96 ) 2 ( 0.67 ) ( 1 − 0.67 ) / ( 0.1 ) 2 = 85 Z = 1.96 is standard normal value at 5% level of significance Ρ = Proportion = 67% d = Absolute Precision = 10% Sampling method: Convenient sampling method. Methodology: As a part of compulsory rotation during internship, the interns are posted in the Psychiatry department for 15 days. We used the Plan-Do-Study-Act (PDSA) model to conduct this Quality Improvement Project. The PDSA model is a four-step model used to improve the process or bring about a change in a system. We divided our study into two phases. The pre intervention phase and PDSA cycle 1 were repeated for each batch of interns who participated in this study. The PDSA model used for this study consisted of the following: Plan: Based on the results of the pre intervention phase, we planned to implement the intervention. Do : We implemented the intervention Study : We studied the result of the intervention Act : Using an educational handout on prescription writing during internship Pre intervention phase On the first day of the psychiatry postings, the interns were informed about the study and written informed consent was obtained from them. They were instructed to create copies of the prescriptions that they wrote with the help of a carbon sheet which was provided with the empty prescriptions. Informed written consent was obtained from the patients whose prescriptions were used in the audit. For the first 5 days of Psychiatry posting, carbon copy of the prescriptions were collected before giving the original prescription to the patients. PDSA cycle 1 On day 6 of the posting, the interns were given an educational handout which was based on the WHO practical manual guide to good prescribing that explained the format of the prescriptions to be followed. The investigators also explained regarding the format of the prescription writing to be followed by the interns. On days 7–15, the interns again created copies of the prescriptions they were writing with the help of carbon sheets provided with the empty prescriptions, and these were collected before giving the original prescription to the patients. Tool for data collection a) Criteria for assessing the quality of prescription: To determine the quality of prescription writing, we established certain criteria. These were based on WHO guidelines. 13 The Medical Council of India (MCI) ideal prescription format was also used to create the criteria ( https://delhimedicalcouncil.org/images/Latest-News/modalprescription.pdf ). The prescriptions were evaluated using the following criteria: If the criteria are present, 1 point will be awarded, and if the criteria are absent, 0 points will be awarded. Then, the final score of that prescription was calculated by adding the points. The scores range from 0 to 14. 1. Date 2. Name of patient 3. Age of patient 4. Contact number of the patient 5. Gender of the patient 6. Generic name of the drug 7. Drug name in capital letter 8. Strength 9. Dosage form 10. Route of Administration 11. Total quantity of drugs to be given by pharmacy 12. Number of days to take the drug 13. Number of times to take the drug in a day 14. Signature or initials of the prescriber b) Educational handout: This was based on the WHO Practical Manual Guide to Good Prescribing. 13 Biological materials required - none Data analysis Statistical analysis was performed using IBM SPSS Statistics for Windows version 29 (IBM Corp., Armonk, N.Y., USA). 14 The copyright license has been obtained by the institution. An open source alternative is Jamovi version 1.x. 15 Means and standard deviations were calculated. The t-test was used for continuous variables, and the chi-square test was used for categorical variables. Statistical significance was set at p value<0.05. Pre-registered data analysis The data analysis in this study was not pre-registered. Results Pre intervention phase results In total, 91 prescriptions were analyzed. The mean score of prescriptions written by the interns was 9.54±1.003. The mean scores across the various criteria were as follows ( Table 1 ): 16 Table 1. Mean scores of participants in pre intervention phase and post intervention phase. Mean of Scores before the intervention Std. Deviation Mean of Scores after the intervention Std. Deviation P value Date 0.68 0.469 0.96 0.187 <0.001 Name of Patient 1.00 0.000 1.00 0.000 - Age of Patient 0.97 0.180 1.00 0.000 0.083 Contact Number of the Patient 0.00 0.000 0.00 0.000 - Gender of the Patient 0.93 0.250 1.00 0.000 0.13 Generic Name of the Drug 0.19 0.392 0.04 0.187 0.01 Drug Name in Capital Letter 0.96 0.206 1.00 0.000 0.045 Strength 0.86 0.352 0.90 0.295 0.336 Dosage form 1.00 0.000 0.92 0.278 0.007 Route of Administration 0.00 0.000 0.02 0.153 0.159 Total quantity of drugs to be given by pharmacy 0.08 0.268 0.49 0.503 <0.001 Number of days to take the drug 0.95 0.229 0.94 0.238 0.897 Number of times to take the drug in a day 0.98 0.147 1.00 0.000 0.174 Signature or initials of the prescriber 0.96 0.206 0.99 0.109 0.196 PDSA cycle 1 results A total of 84 prescriptions were analyzed. The mean score of prescriptions written by the interns was 10.26±0.746. The mean scores across the various criteria were as follows ( Table 1 ): There was a significant improvement in the mean total score from 9.54±1.003 to 10.26±0.746 (p<0.01). There was an improvement of 7.54% after PDSA cycle 1. There was also a significant improvement in the following criteria: date (p<0.01), gender of patient (p=0.13), generic name of the drug (p=0.01), drug name in capital letters (p=0.045), dosage form (p=0.07), and total quantity of drugs to be administered by the pharmacy (p<0.01). There was no significant improvement in the Age of Patient (p=0.083), strength (p=0.336), route of administration (p=0.159), number of days to take the drugs (p=0.897), number of times to take the drug in a day (p=0.174), or signature or initials of the prescriber (p=0.196). Discussion In this QI project, we attempted to ascertain methods to improve the quality of prescriptions written by interns posted in the Department of Psychiatry. In the first PDSA cycle, we tried to fill in the knowledge gap with the help of a brochure and a verbal explanation of the format of prescription writing as prescribed by the MCI as well as the guidelines stipulated by the WHO. After PDSA cycle 1, we found a significant improvement in the total scores of the prescriptions as well as a significant improvement across several criteria, including date, gender of patient, generic name of the drug, drug name in capital letters, dosage form, and total quantity of drugs to be given by the pharmacy. The aim of this QI project was to improve prescription writing scores. After the first cycle, a 7.54% improvement was observed. A study conducted in The Oxford Dental College and Hospital, Bangalore, found that the patient’s name (95.6%), age (91.2%), and gender (91.6%) were written by the majority of the students. The patients’ outpatient number (0%), address (0%), and contact number (0.4%) were missing in almost all prescriptions, which is in agreement with our study where the name, age, and gender were mentioned in 100% of the prescriptions collected. 9 Furthermore, a study was conducted regarding the impact of patient-based teaching in improving the prescription writing skills of II MBBS students. This study showed that patient-based teaching improves responsibility, focus, and memory. 16 In our study, our informal teaching session at the end of PDSA cycle 1 revealed a similar improvement, which may be attributed to the orientation given. In another study carried out at Nobel Medical Teaching Hospital, Biratnagar, Nepal, there was a 0% error in the patient’s name, age, and sex, which was similar to our findings. 17 However, the findings of other studies are different from ours. In a study conducted at Oxford Dental College and Hospital, Bangalore, it was found that the parameters that were most often missed were dosage instructions, strength of the drugs, and duration of the drugs, which was not the case in our study. 9 In our study, the total quantity of drugs to be given by the pharmacist, dosage form, and generic names were deficient in several prescriptions. The lack of generic names written in our study could be because interns have very little time to write prescriptions or because psychiatric medications are not as common as analgesics or gastritis medicines; hence, additional work and reading is required to become aware of them, and either the interns did not have an incentive to learn this or did not have enough time to cover this aspect of prescription writing. In our study, the criteria for which there was no significant improvement were criteria that already had high scores in the pre intervention phase. Furthermore, another study in Patna, where prescriptions from different OPDs in different departments were audited, showed that only 10% of the prescriptions contained drugs prescribed in their generic name. Frequency, route, and duration of drug administration were mentioned in 86.7%, 79.3%, and 69.6% of the prescriptions, respectively. Among the prescriptions, 42.5% were easily legible. 18 Legibility was not a criterion for this study. If we had to look at it subjectively, none of the prescriptions were difficult to read by the people undertaking the study. An important criterion that was judged in the study conducted in Nobel Medical Teaching Hospital, Biratnagar, were 2 same drugs or the same category mentioned in the same prescription, which accounted for 0.5% of their total errors. 17 This category was not judged in our study because it was not a criterion mentioned in the MCI ideal prescription and it is an indicator of skills and not methodology, which was what our study mostly focused on. Limitations Instructing interns to make copies of their prescriptions may have led them to pay closer attention to their prescription writing, leading to a biased result. To further understand the factors affecting the prescriptions written by interns, a qualitative component like Focussed Group Discussion would add valuable insights. Conclusion This Quality Improvement project enabled us to understand that educational handout regarding prescription writing and verbal explanations are useful tools for improving the quality of prescriptions written by interns in the department of Psychiatry. Therefore, there is a need to find more innovative methods to improve the quality of prescriptions. There is a need to improve interns’ training by emphasizing rational prescription writing during internships. Further studies are required to determine whether this method is universally applicable. Ethics and consent The protocol was approved by the Institutional Ethics Committee Kasturba Medical College, Mangalore (Reg. No. ECR/541/Inst/KA/2014/RR-20) before commencement of the Quality Improvement Project and Ethical Approval was obtained. The protocol number of the study was IECKMCMLR-10/2022/423. The date of approval was 19/10/2022. Written informed consent for the study was obtained from the interns and the patients/relatives of the patients, respectively. Participants had the right to withdraw from the study at any time. Data availability Open Science Framework: Prescription writing quality of psychotropic agents in MBBS interns at a private medical college hospital in Mangaluru. https://doi.org/10.17605/OSF.IO/HZGFC . 19 This project contains the following data: • Intern prescription writing scores xlsx (scores of prescriptions written by interns during the preintervention phase and PDSA Cycle 1). • Educational Handout.docx (the educational handout given to interns during PDSA Cycle 1). • Intern Consent Form.docx • Patient Consent Form.docx • Checklist for Prescription writing quality of psychotropic agents in MBBS interns in a private medical college hospital in Mangaluru.docx Reporting guidelines This study was based on the SQUIRE (Standards for Quality Improvement Reporting Excellence) guidelines. 20 Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0). Acknowledgements The postgraduate students of the Department of Psychiatry, Kasturba Medical College Mangaluru, Manipal Academy of Higher Education, India. References 1. Hogerzeil H: Promoting rational prescribing: An international perspective. Br. J. Clin. Pharmacol. 1995 Jan; 39 (1): 1–6. PubMed Abstract | Publisher Full Text | Free Full Text 2. Imran M, Doshi C, Kharadi D: Time to teach basic and regulatory aspects of art of prescription writing for better doctor-patient safety and keeping communication accessible and straight. Daru. 2019; 28 (1): 25–32. PubMed Abstract | Publisher Full Text 3. Rissmann R, Dubois EA, Franson KL, et al. : Concept-based learning of Personalized Prescribing. Br. J. Clin. Pharmacol. 2012 Sept 5; 74 (4): 589–596. PubMed Abstract | Publisher Full Text | Free Full Text 4. Salmasi S, Khan TM, Hong YH, et al. : Medication Errors in the Southeast Asian Countries: A Systematic Review. PLoS One. 2015 Sep 4; 10 (9): e0136545. 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Geneva: World Health Organization; 1995. 14. IBM Corp: IBM SPSS Statistics for Windows, Version 29. 0. Armonk, NY: IBM Corp. 15. The Jamovi Project: Jamovi. (Version 1.x) [Computer Software]. 16. Thenrajan P, Murugan PR: Impact of patient-based teaching in improving prescription writing skills of II MBBS students. Int. J. Appl. Basic Med. Res. 2016 Jul; 6 (3): 174–177. PubMed Abstract | Publisher Full Text | Free Full Text 17. Ansari M, Neupane D: Study on determination of errors in prescription writing: A semi-electronic perspective. Kathmandu Univ. Med. J (KUMJ). 2009 Jul 1; 7 (27): 238–241. PubMed Abstract | Publisher Full Text 18. Mishra S, Pathak PK, Ahmad S, et al. : Quality of Prescription Writing Practices in a Tertiary Care Teaching Hospital of Bihar: A Cross-Sectional Study. Int. J. Health Syst. Implement. Res. 2020 Sep 1; 4 (2): 24–33. 19. Poorva: Prescription writing quality of psychotropic agents in MBBS interns in a private medical college hospital in Mangaluru (Internet). [Dataset]. OSF. 2023. Publisher Full Text 20. Ogrinc G, Davies L, Goodman D, et al. : SQUIRE 2.0 (Standards for QUality Improvement Reporting Excellence): Revised publication guidelines from a detailed consensus process. BMJ Qual. Saf. 2016; 25 : 986–992. PubMed Abstract | Publisher Full Text | Free Full Text Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 15 Apr 2024 ADD YOUR COMMENT Comment Author details Author details 1 Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 2 Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India Poorva Bakshi Roles: Conceptualization, Data Curation, Formal Analysis, Investigation, Methodology, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Sharanya B. Shetty Roles: Conceptualization, Methodology, Project Administration, Resources, Writing – Original Draft Preparation, Writing – Review & Editing Shreya Bera Roles: Data Curation, Formal Analysis, Writing – Review & Editing Priyanka Renita D'Souza Roles: Data Curation, Writing – Original Draft Preparation, Writing – Review & Editing Keshava Pai Roles: Methodology, Writing – Original Draft Preparation, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (2) version 2 Revised Published: 20 Dec 2024, 13:269 https://doi.org/10.12688/f1000research.144712.2 version 1 Published: 15 Apr 2024, 13:269 https://doi.org/10.12688/f1000research.144712.1 Copyright © 2024 Bakshi P et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Bakshi P, Shetty SB, Bera S et al. Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.12688/f1000research.144712.2 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 2 VERSION 2 PUBLISHED 20 Dec 2024 Revised Views 0 Cite How to cite this report: Sathyanath DS. Reviewer Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.176005.r351347 ) The direct URL for this report is: https://f1000research.com/articles/13-269/v2#referee-response-351347 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 30 Jan 2025 Dr Shashwath Sathyanath , Yenepoya Medical College, Mangalore, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.176005.r351347 The article has been revised as per the earlier comments and ... Continue reading READ ALL The article has been revised as per the earlier comments and appropriate changes have been made. This article may be approved for indexing. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Deaddiction psychiatry, Consultation-liaison Psychiatry, Mood Disorders. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Sathyanath DS. Reviewer Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.176005.r351347 ) The direct URL for this report is: https://f1000research.com/articles/13-269/v2#referee-response-351347 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Gaur V. Reviewer Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.176005.r351348 ) The direct URL for this report is: https://f1000research.com/articles/13-269/v2#referee-response-351348 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 26 Dec 2024 Vandana Gaur , Department of Psychology, SDM Government PG College in Doiwala, Dehradun, Uttarakhand, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.176005.r351348 The revised version ... Continue reading READ ALL The revised version is approved for indexing. Competing Interests: No competing interests were disclosed. Reviewer Expertise: Human Psychology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Gaur V. Reviewer Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.176005.r351348 ) The direct URL for this report is: https://f1000research.com/articles/13-269/v2#referee-response-351348 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Version 1 VERSION 1 PUBLISHED 15 Apr 2024 Views 0 Cite How to cite this report: Badiger S. Reviewer Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.158550.r267459 ) The direct URL for this report is: https://f1000research.com/articles/13-269/v1#referee-response-267459 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 12 Sep 2024 Sanjeev Badiger , A J Institute of Medical Sciences and Research Centre, Mangaluru, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.158550.r267459 The topic selected by the author is relevant to the present scenario , as prescription is considered as an important Document. This article highlights the need for quality prescription writing and the need for improvement in prescription writing . Studying the ... Continue reading READ ALL The topic selected by the author is relevant to the present scenario , as prescription is considered as an important Document. This article highlights the need for quality prescription writing and the need for improvement in prescription writing . Studying the pattern of their prescriptions and suggesting changes is of utmost importance in improving the quality of patient care and enhancing the undergraduate medical education of interns. Major Points : Methodology : study sample size and study design is appropriate. But the capture other factors influencing the prescription pattern can be captured by adding qualitative component like FGD is helpful to improve the quality of the study Minor points : Topic : Relevant and well phrased Introduction: Adequate and highlighted the need for the study Data analysis ,Discussion and conclusions are adequate This research article can be accepted for indexing. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Communicable diseases and behavioral science I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Badiger S. Reviewer Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.158550.r267459 ) The direct URL for this report is: https://f1000research.com/articles/13-269/v1#referee-response-267459 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 20 Dec 2024 Sharanya Shetty , Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 20 Dec 2024 Author Response Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We ... Continue reading Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. We understand that focused group discussion would have added further insights on other qualitative aspects, which we will plan to incorporate in the next cycle. We have added the same as a limitation of our study. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. We understand that focused group discussion would have added further insights on other qualitative aspects, which we will plan to incorporate in the next cycle. We have added the same as a limitation of our study. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Competing Interests: None Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 20 Dec 2024 Sharanya Shetty , Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 20 Dec 2024 Author Response Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We ... Continue reading Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. We understand that focused group discussion would have added further insights on other qualitative aspects, which we will plan to incorporate in the next cycle. We have added the same as a limitation of our study. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. We understand that focused group discussion would have added further insights on other qualitative aspects, which we will plan to incorporate in the next cycle. We have added the same as a limitation of our study. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Competing Interests: None Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Sathyanath DS. Reviewer Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.158550.r313883 ) The direct URL for this report is: https://f1000research.com/articles/13-269/v1#referee-response-313883 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 04 Sep 2024 Dr Shashwath Sathyanath , Yenepoya Medical College, Mangalore, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.158550.r313883 Summary of the article This Quality Improvement (QI) project aimed to enhance the quality of prescription writing among MBBS interns in the Department of Psychiatry at Kasturba Medical College Hospital, Mangaluru. The study addressed the prevalent issue ... Continue reading READ ALL Summary of the article This Quality Improvement (QI) project aimed to enhance the quality of prescription writing among MBBS interns in the Department of Psychiatry at Kasturba Medical College Hospital, Mangaluru. The study addressed the prevalent issue of irrational drug prescriptions, which contributes to adverse patient outcomes and inefficiencies in healthcare. The project involved a pre-intervention assessment of prescription quality, followed by an intervention based on educational materials and feedback, and then a post-intervention assessment to measure improvements. Detailed Review 1. Work Presentation and Literature Citation Response: Yes Summary: The work is presented clearly and logically. The introduction provides a comprehensive background on the problem of irrational drug prescribing and cites relevant literature. However, there is scope of citing few newer literatures from the studies in the last 3 years 2. Study Design and Technical Soundness Response: Yes Summary: The study design is appropriate for the Quality Improvement (QI) project, utilizing the Plan-Do-Study-Act (PDSA) model. The project addresses a clear problem, implements an intervention, and evaluates its effectiveness in a systematic manner. However, the title of the article could mention the type of study design for the ease of the readers. 3. Replication Details Response: Yes Summary : The methods and analysis are described in sufficient detail to allow replication. The article includes detailed descriptions of the intervention (educational handouts and verbal explanations), the assessment criteria for prescription quality, and the statistical methods used for analysis. The process maps and fishbone diagrams are provided, facilitating replication of the study. 4. Statistical Analysis Response: Partly Summary: The statistical analysis is mostly appropriate but could benefit from some improvements. The use of means, standard deviations, t-tests, and chi-square tests is generally suitable. However, it may be beneficial to include additional analyses or sensitivity checks to confirm the robustness of the findings. In addition, the tables mentioned are not complete as it lacks the p values mentioned in the writings. 5. Availability of Source Data Response: Yes Summary: The source data underlying the results are available for full reproducibility. The data, including prescription writing scores and the educational handout, are accessible via the Open Science Framework link provided. This transparency supports reproducibility and verification of the study’s findings. 6. Support for Conclusions Response: Yes Summary: The conclusions are adequately supported by the results. The study demonstrates a significant improvement in prescription quality post-intervention, with specific criteria showing notable enhancements. The discussion contextualizes these findings within existing literature, reinforcing the study’s conclusions. Recommendations This study can be considered for indexed after a few minor corrections. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Deaddiction psychiatry, Consultation-liaison Psychiatry, Mood Disorders. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Sathyanath DS. Reviewer Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.158550.r313883 ) The direct URL for this report is: https://f1000research.com/articles/13-269/v1#referee-response-313883 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 20 Dec 2024 Sharanya Shetty , Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 20 Dec 2024 Author Response Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We ... Continue reading Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. Taking your feedback into consideration, we have included newer studies in the introduction section. We have also changed the title of the study to accurately reflect the study design. We have merged our tables and also included p value in the table as per your suggestion. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. Taking your feedback into consideration, we have included newer studies in the introduction section. We have also changed the title of the study to accurately reflect the study design. We have merged our tables and also included p value in the table as per your suggestion. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Competing Interests: None Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 20 Dec 2024 Sharanya Shetty , Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 20 Dec 2024 Author Response Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We ... Continue reading Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. Taking your feedback into consideration, we have included newer studies in the introduction section. We have also changed the title of the study to accurately reflect the study design. We have merged our tables and also included p value in the table as per your suggestion. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. Taking your feedback into consideration, we have included newer studies in the introduction section. We have also changed the title of the study to accurately reflect the study design. We have merged our tables and also included p value in the table as per your suggestion. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Competing Interests: None Close Report a concern COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Gaur V. Reviewer Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.158550.r313887 ) The direct URL for this report is: https://f1000research.com/articles/13-269/v1#referee-response-313887 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 16 Aug 2024 Vandana Gaur , Department of Psychology, SDM Government PG College in Doiwala, Dehradun, Uttarakhand, India Approved VIEWS 0 https://doi.org/10.5256/f1000research.158550.r313887 The introduction provides a clear rationale for the study, emphasizing the importance of accurate prescription writing in clinical practice, particularly for psychotropic agents, which are associated with complex dosing and potential side effects. The study's objectives are well-defined, focusing on evaluating ... Continue reading READ ALL The introduction provides a clear rationale for the study, emphasizing the importance of accurate prescription writing in clinical practice, particularly for psychotropic agents, which are associated with complex dosing and potential side effects. The study's objectives are well-defined, focusing on evaluating the prescription writing quality of psychotropic agents among MBBS interns. The results section (assuming it is well-presented) likely provides valuable insights into the quality of prescription writing among interns. It is essential that this section includes data on common errors and areas where interns perform well, as this information could inform future training programs. The discussion should ideally interpret the results in the context of existing literature, highlighting both strengths and weaknesses in the prescription writing practices of the interns. It should discuss the implications for patient safety and medical education. The study addresses an important issue in medical education and patient safety. The focus on psychotropic agents is particularly relevant, given the complexities involved in prescribing these medications. The methodology appears sound, and the study has the potential to provide valuable insights. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests: No competing interests were disclosed. Reviewer Expertise: Human Psychology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Gaur V. Reviewer Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.158550.r313887 ) The direct URL for this report is: https://f1000research.com/articles/13-269/v1#referee-response-313887 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Author Response 20 Dec 2024 Sharanya Shetty , Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 20 Dec 2024 Author Response Dear Madam, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We ... Continue reading Dear Madam, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. We have taken your feedback regarding the formatting of the results section and formatted the results section to include a table which has the common errors and areas in which the interns perform well in the form of the mean scores before and after the intervention. We have also included the implications of this study under the conclusions section. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Dear Madam, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. We have taken your feedback regarding the formatting of the results section and formatted the results section to include a table which has the common errors and areas in which the interns perform well in the form of the mean scores before and after the intervention. We have also included the implications of this study under the conclusions section. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Competing Interests: None Close Report a concern Respond or Comment COMMENTS ON THIS REPORT Author Response 20 Dec 2024 Sharanya Shetty , Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India 20 Dec 2024 Author Response Dear Madam, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We ... Continue reading Dear Madam, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. We have taken your feedback regarding the formatting of the results section and formatted the results section to include a table which has the common errors and areas in which the interns perform well in the form of the mean scores before and after the intervention. We have also included the implications of this study under the conclusions section. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Dear Madam, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. We have taken your feedback regarding the formatting of the results section and formatted the results section to include a table which has the common errors and areas in which the interns perform well in the form of the mean scores before and after the intervention. We have also included the implications of this study under the conclusions section. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty Competing Interests: None Close Report a concern COMMENT ON THIS REPORT Comments on this article Comments (0) Version 2 VERSION 2 PUBLISHED 15 Apr 2024 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 3 Version 2 (revision) 20 Dec 24 read read Version 1 15 Apr 24 read read read Vandana Gaur , SDM Government PG College in Doiwala, Dehradun, India Dr Shashwath Sathyanath , Yenepoya Medical College, Mangalore, India Sanjeev Badiger , A J Institute of Medical Sciences and Research Centre, Mangaluru, India Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2025 Sathyanath D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 30 Jan 2025 | for Version 2 Dr Shashwath Sathyanath , Yenepoya Medical College, Mangalore, India 0 Views copyright © 2025 Sathyanath D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The article has been revised as per the earlier comments and appropriate changes have been made. This article may be approved for indexing. Competing Interests No competing interests were disclosed. Reviewer Expertise Deaddiction psychiatry, Consultation-liaison Psychiatry, Mood Disorders. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Sathyanath DS. Peer Review Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.176005.r351347) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-269/v2#referee-response-351347 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Gaur V. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 26 Dec 2024 | for Version 2 Vandana Gaur , Department of Psychology, SDM Government PG College in Doiwala, Dehradun, Uttarakhand, India 0 Views copyright © 2024 Gaur V. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The revised version is approved for indexing. Competing Interests No competing interests were disclosed. Reviewer Expertise Human Psychology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Gaur V. Peer Review Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.176005.r351348) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-269/v2#referee-response-351348 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Badiger S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 12 Sep 2024 | for Version 1 Sanjeev Badiger , A J Institute of Medical Sciences and Research Centre, Mangaluru, India 0 Views copyright © 2024 Badiger S. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The topic selected by the author is relevant to the present scenario , as prescription is considered as an important Document. This article highlights the need for quality prescription writing and the need for improvement in prescription writing . Studying the pattern of their prescriptions and suggesting changes is of utmost importance in improving the quality of patient care and enhancing the undergraduate medical education of interns. Major Points : Methodology : study sample size and study design is appropriate. But the capture other factors influencing the prescription pattern can be captured by adding qualitative component like FGD is helpful to improve the quality of the study Minor points : Topic : Relevant and well phrased Introduction: Adequate and highlighted the need for the study Data analysis ,Discussion and conclusions are adequate This research article can be accepted for indexing. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Communicable diseases and behavioral science I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 20 Dec 2024 Sharanya Shetty, Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. We understand that focused group discussion would have added further insights on other qualitative aspects, which we will plan to incorporate in the next cycle. We have added the same as a limitation of our study. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty View more View less Competing Interests None reply Respond Report a concern Badiger S. Peer Review Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.158550.r267459) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-269/v1#referee-response-267459 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Sathyanath D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 04 Sep 2024 | for Version 1 Dr Shashwath Sathyanath , Yenepoya Medical College, Mangalore, India 0 Views copyright © 2024 Sathyanath D. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Summary of the article This Quality Improvement (QI) project aimed to enhance the quality of prescription writing among MBBS interns in the Department of Psychiatry at Kasturba Medical College Hospital, Mangaluru. The study addressed the prevalent issue of irrational drug prescriptions, which contributes to adverse patient outcomes and inefficiencies in healthcare. The project involved a pre-intervention assessment of prescription quality, followed by an intervention based on educational materials and feedback, and then a post-intervention assessment to measure improvements. Detailed Review 1. Work Presentation and Literature Citation Response: Yes Summary: The work is presented clearly and logically. The introduction provides a comprehensive background on the problem of irrational drug prescribing and cites relevant literature. However, there is scope of citing few newer literatures from the studies in the last 3 years 2. Study Design and Technical Soundness Response: Yes Summary: The study design is appropriate for the Quality Improvement (QI) project, utilizing the Plan-Do-Study-Act (PDSA) model. The project addresses a clear problem, implements an intervention, and evaluates its effectiveness in a systematic manner. However, the title of the article could mention the type of study design for the ease of the readers. 3. Replication Details Response: Yes Summary : The methods and analysis are described in sufficient detail to allow replication. The article includes detailed descriptions of the intervention (educational handouts and verbal explanations), the assessment criteria for prescription quality, and the statistical methods used for analysis. The process maps and fishbone diagrams are provided, facilitating replication of the study. 4. Statistical Analysis Response: Partly Summary: The statistical analysis is mostly appropriate but could benefit from some improvements. The use of means, standard deviations, t-tests, and chi-square tests is generally suitable. However, it may be beneficial to include additional analyses or sensitivity checks to confirm the robustness of the findings. In addition, the tables mentioned are not complete as it lacks the p values mentioned in the writings. 5. Availability of Source Data Response: Yes Summary: The source data underlying the results are available for full reproducibility. The data, including prescription writing scores and the educational handout, are accessible via the Open Science Framework link provided. This transparency supports reproducibility and verification of the study’s findings. 6. Support for Conclusions Response: Yes Summary: The conclusions are adequately supported by the results. The study demonstrates a significant improvement in prescription quality post-intervention, with specific criteria showing notable enhancements. The discussion contextualizes these findings within existing literature, reinforcing the study’s conclusions. Recommendations This study can be considered for indexed after a few minor corrections. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Partly Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Deaddiction psychiatry, Consultation-liaison Psychiatry, Mood Disorders. I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 20 Dec 2024 Sharanya Shetty, Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India Dear Sir, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. Taking your feedback into consideration, we have included newer studies in the introduction section. We have also changed the title of the study to accurately reflect the study design. We have merged our tables and also included p value in the table as per your suggestion. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty View more View less Competing Interests None reply Respond Report a concern Sathyanath DS. Peer Review Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.158550.r313883) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-269/v1#referee-response-313883 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2024 Gaur V. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 16 Aug 2024 | for Version 1 Vandana Gaur , Department of Psychology, SDM Government PG College in Doiwala, Dehradun, Uttarakhand, India 0 Views copyright © 2024 Gaur V. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (1) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The introduction provides a clear rationale for the study, emphasizing the importance of accurate prescription writing in clinical practice, particularly for psychotropic agents, which are associated with complex dosing and potential side effects. The study's objectives are well-defined, focusing on evaluating the prescription writing quality of psychotropic agents among MBBS interns. The results section (assuming it is well-presented) likely provides valuable insights into the quality of prescription writing among interns. It is essential that this section includes data on common errors and areas where interns perform well, as this information could inform future training programs. The discussion should ideally interpret the results in the context of existing literature, highlighting both strengths and weaknesses in the prescription writing practices of the interns. It should discuss the implications for patient safety and medical education. The study addresses an important issue in medical education and patient safety. The focus on psychotropic agents is particularly relevant, given the complexities involved in prescribing these medications. The methodology appears sound, and the study has the potential to provide valuable insights. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes Competing Interests No competing interests were disclosed. Reviewer Expertise Human Psychology I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (1) Author Response 20 Dec 2024 Sharanya Shetty, Department of Psychiatry, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India Dear Madam, Thank you for your valuable feedback on our manuscript. We appreciate your insightful comments and suggestions, which has undoubtedly contributed to improving the quality of our manuscript. We have tried our best to address your concerns in the modified manuscript. We have taken your feedback regarding the formatting of the results section and formatted the results section to include a table which has the common errors and areas in which the interns perform well in the form of the mean scores before and after the intervention. We have also included the implications of this study under the conclusions section. Thank you again for your valuable feedback. Regards Dr Sharanya B Shetty View more View less Competing Interests None reply Respond Report a concern Gaur V. Peer Review Report For: Prescriptions written by MBBS Interns in the Department of Psychiatry in a Medical College Hospital in Mangaluru: A Quality Improvement Study [version 2; peer review: 3 approved] . F1000Research 2024, 13 :269 ( https://doi.org/10.5256/f1000research.158550.r313887) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/13-269/v1#referee-response-313887 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved - fundamental flaws in the paper seriously undermine the findings and conclusions Adjust parameters to alter display View on desktop for interactive features Includes Interactive Elements View on desktop for interactive features Competing Interests Policy Provide sufficient details of any financial or non-financial competing interests to enable users to assess whether your comments might lead a reasonable person to question your impartiality. 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