Optimization and impact of an evidence-based pre-audit prescription decision system in primary healthcare settings

Objective Analyze the operation mode of the prescription pre-audit intelligent decision system in a county-level hospital, evaluate its intervention effects on outpatient and emergency operations, thus providing references for similar hospitals to carry out pre-audit intelligent decision system and promote rational drug use. Methods Utilizing evidence-based approaches, system rule modifications have been refined and synergized with AI-driven decision-making analytics to examine the operational framework of pre-audit prescription decision system. Additionally, retrospectively analyze the types and levels of problems triggered by outpatient and emergency prescriptions from October 2022 to August 2023, as well as the rationality of prescriptions in the system. Results According to the clinical operation of the hospital, problems triggered by unreasonable prescriptions have been finely classified into different levels according to the severity of prescription problems. From October 2022 to August 2023, the number of prescriptions triggering issues such as indications, dosage, special populations, compatibility, administration, and contraindications showed a decreasing trend compared with October 2022 before the intervention. For example, the number of prescriptions with unreasonable routes of administration decreased from 1,745 to 20, and the number of contraindicated prescriptions decreased from 1,399 to 16. The prescriptions triggering Level 5 alerts decreased from 5.609% to 1.793% and the prescription compliance rate increased from 92.20% to 95.98%. Conclusion The prescription pre-audit intelligent decision system enhances patient safety and promotes rational drug use. However, the system requires fine-tuning and continuous improvement of the system rule library to effectively validate prescriptions and improve prescription accuracy. In the future, integrating big data, artificial intelligence and other technologies for secondary system development will be a model worthy of consideration. In addition, promoting this system to medical federation to establish a regional prescription review model will further promote the high-quality development of pharmaceutical services.