• Meng-Jer Hsieh, Yi-Wen Huang, Ying-Huang Tsai, Jia-Yih Feng, Wei-Juin Su, and Taiwan Society of Tuberculosis and Lung Disease.
• Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Chang-Gung Medical Foundation, Chiayi, Taiwan; Department of Respiratory Therapy, School of Medicine, Chang-Gung University, Taoyuan, Taiwan.
• J Formos Med Assoc. 2020 Nov 1; 119 (11): 1658-1665.

BackgroundA nationwide program initiated by Taiwan CDC was conducted by the Taiwan Society of Tuberculosis and Lung Disease to improve the appropriateness of anti-TB prescriptions in Taiwan.MethodsAll anti-TB prescriptions from 12 hospitals across Taiwan were reviewed by experienced pulmonologists, according to the 2011 Taiwan TB treatment guidelines, between May and October 2013. The investigation period was divided into three stages: May to June, July to August, and September to October. The concordance rates between anti-TB prescriptions and the guidelines were compared among the three stages and between medical centers and regional hospitals.ResultsA total of 2574 new anti-TB prescriptions were reviewed. The appropriateness of anti-TB prescriptions was 82.0%. The most dominant error was inappropriate dosage of anti-TB medications. The appropriateness improved significantly with prescription review, and the concordance rates were 78.7%, 80.6%, and 87.6% in stages 1, 2, and 3, respectively (P < 0.001). The inappropriateness of medication dosage also improved significantly, with the rates of inappropriate dosage dropping from 10.2% in stage 1-5.4% in stage 3 (Odds ratio 0.491, P < 0.001). The appropriateness rates showed no significant difference between regional hospitals and medical centers (82.5% vs. 81.3%, Odds ratio 0.915, P = 0.393), but the improvement of prescription appropriateness was significant in regional hospitals but not in medical centers.ConclusionPrescription review by TB experts is an effective approach to improve the appropriateness of anti-TB prescriptions.Copyright © 2020 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

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