Development and pilot testing of a prescription quality index for Ayurveda

Abstract

Background: Prescription quality can be a direct predictor of the net outcome of a health care delivery effort. Quality of prescription may be considered as a cumulative matrix of multiple components of a prescription on the basis of their relative importance. Prescription quality index is a recognized tool in clinical medicine for multiple purposes including the prediction of health care intervention outcome.

Objectives: Considering the importance of prescription quality among every system of medicine, an attempt was made to design a prescription quality index for Ayurveda.

Materials and methods: The Prescription Quality Index for Ayurveda was designed through item selection following a thorough literature search and was validated through multiple peer group discussions. Final draft of index containing 38 individual items carrying different scores as per their importance in the prescription was subjected to a pilot test upon 1576 indoor prescriptions generated in 2015 at State Ayurvedic College Hospital, Lucknow.

Results: The study revealed large information gaps in the components of the prescription where it was supposed to be noted by the prescribers. These gaps in the Ayurvedic prescriptions were most significant in the areas pertaining to Ayurvedic fundamentals of clinical examination, disease diagnosis and Ayurvedic drug intake methods.

Conclusion: Prescription Quality Index for Ayurveda was found useful in underlining the gaps between the ideal and generated prescriptions. This can be utilized as a useful tool to evaluate the quality of Ayurvedic prescriptions by seeing their adherence to the standard prescription template.

Keywords: Ayurveda; Index; Prescribing quality; Prescription quality.

Fig. 1

Relative weightage of various items in PQIA.

Fig. 2

Study flow chart.

Fig. 3

Summary of performance of PQIA for items between the floor and ceiling value.