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Aims Methods Results Conclusions Recording the indication for a medicine in the prescription supports communication. In May 2023, our district hospitals made the free‐text indication field in prescriptions compulsory for all medicines in the inpatient prescribing system. This study aimed to evaluate the effect of introducing a compulsory indication field in an inpatient prescribing system.Text in the indication field was manually classified as an indication, ‘other text’, ‘rubbish text’, ‘to be determined’ and ‘blank’. Prescribing data were extracted from the district data warehouse. The change in proportion of prescriptions with an indication was compared for 8 weeks after introduction of a compulsory indication field to an equivalent 8 weeks in 2022. Secondary outcomes included medication cessation and indication recording before discharge.We analysed 81 634 prescriptions before and 82 726 after indications were made compulsory. The proportion of prescriptions with an indication increased from 29.2% to 75.6%. ‘Rubbish text’ increased from 0% to 2.3%, ‘other text’ from 2.5% to 14.7%, and ‘to be determined’ from 0.0% to 6.6%. Of 5557 prescriptions with ‘to be determined’ initially, 18.1% were ceased and 2.7% had an indication before discharge.After making the prescription indication field compulsory, the proportion of medicines with an indication increased from 29% to 76%, with only a small increase in ‘rubbish text’. Following the system change, the quality of information recording improved but there was no change in medicine use. Compulsory fields should be combined with improvements in other components of care to improve medicine use. [ABSTRACT FROM AUTHOR]

We analysed data from the electronic medication chart at tertiary healthcare facilities during Nov 2020-Nov 2023 following a reconfiguration of prescribing permissions allowing medical student inpatient prescribing. A total of 262 students prescribed for 2205 patients. The 17,769 prescriptions were spread throughout the 7-day week and were mainly created in the evening (1600-2100) and within 4 hours of patient entry into hospital. The supervising doctors approved 11,434 (64%) prescriptions, which are inferred to have saved 203 hours of doctor time. Allowing medical students to prescribe facilitates clinical workflow. The impact on student education and prescribing errors requires further work. [ABSTRACT FROM AUTHOR]

The aim was to assess how making the indication field compulsory in our electronic prescribing system influenced free text documentation and to visualise prescriber behaviour. The indication field was made compulsory for seven antibacterial medicines. Text recorded in the indication field was manually classified as 'indication present', 'other text', 'rubbish text', or 'blank'. The proportion of prescriptions with an indication was compared for four weeks before and after the intervention. Indication provision increased from 10.6% to 72.4% (p<0.01) post-intervention. 'Other text' increased from 7.6% to 25.1% (p<0.01), and 'rubbish text' from 0.0% to 0.6% (p<0.01). Introducing the compulsory indication field increased indication documentation substantially with only a small increase in 'rubbish text'. An interactive report was developed using a live data extract to illustrate indication provision for all medicines prescribed at our tertiary hospital. The interactive report was validated and locally published to support audit and quality improvement projects., (©2024 AMIA - All rights reserved.)