Construction and application efficacy of a prescription review center in compact county-level medical communities: a case study in Western China

To explore the establishment of a prescription review center within compact county-level medical communities and evaluate its clinical application and operational effectiveness.The People’s Hospital of Hotan County in Hotan Prefecture, Xinjiang Uygur Autonomous Region, a leading institution within a compact county-level medical community, was selected as the research site. Initially, professional questionnaires and empirical research methods were used to systematically investigate the current status of prescription review practices across medical institutions within the community, and baseline data were compiled. After the prescription review center commenced operation, prescription review data were continuously tracked and collected. Operational effectiveness was evaluated based on the volume of automated prescription reviews and improvements in prescription qualification rates. Statistical analyses were conducted using descriptive statistics, paired chi-square tests, and the Cochran-Armitage trend test. Data visualization and statistical validation were performed with GraphPad Prism software, and P < 0.05 was considered statistically significant. Prior to the establishment of the prescription review center, there were no full-time clinical pharmacists assigned to prescription review in the medical community. The average number of pharmacists in the 67 village health service centers was less than one, and no substantive pre-prescription review activities were conducted throughout the entire community. Within the initial 6 months following the establishment of the county-level medical community prescription review center, a total of 501,865 automated prescription reviews were completed, achieving a 100% automation rate. The qualified prescription rate after automated review reached 96.82%, representing an absolute increase of 11.92% compared to the pre-intervention period. Statistical analyses demonstrated highly significant differences between monthly artificial intelligence (AI) effective intervention rates during the study period (χ²=2715.64, df = 5, P < 0.001), and the effective AI intervention rate displayed a statistically significant upward trend over time (Cochran-Armitage trend χ²=2601.77, P < 0.001). Rational prescription rates each month post-intervention were significantly higher than baseline levels (all P < 0.001). Paired chi-square tests confirmed significant reductions in all categories of irrational prescriptions following intervention (all P < 0.001). Establishing a prescription review center within compact county-level medical communities in western China, particularly where pharmacist resources are extremely scarce, can markedly enhance both pre-prescription review coverage and prescription qualification rates. This strategy effectively safeguards patient medication safety and provides valuable practical experience and a reference model for optimizing pharmaceutical services within compact county-level medical communities in underdeveloped regions.