Objective: The current study aims to determine the pattern of drug usage in terms of patient-care, facility care, and complementary drug use indicators among elderly people. Methods: The study was a prospective cross-sectional study that was conducted in the outpatient department. Patient-care, facility care, and complementary drug use indicators were assed as per the WHO/INRUD indicators. Patient/patient party knowledge of correct dose was analyzed by the information; time of administration (when) and quantity of drugs to be taken (how much). Results: The duration of consultation in the ophthalmology department was comparatively longer (30.33 min) than in other departments. The dispensing time of the medicine department was 126.60 s which was higher than other departments. Among the total medicines, 88.58% were dispensed, 21 (1.06%) of the total drugs had the patient’s name labeled on the envelope while 1430 (81.53%) of the drugs had drug name and 1617 (92.19%) only had the administration time labeled on the envelope. On interviewing patients/patient parties, 240 (59.55%) knew both the time of administration and the number of drugs to be taken. The average medicine cost encountered per patient was found to be Nepalese rupees (NRs.) 1353±1079 NRs. (US$ 11.57±9.23). Conclusion: It is concluded that systematic changes need to be applied to improve the patient knowledge, to deliver quality advice to the patients, and to maintain the process of adequate labeling in medications.

NSAIDs are commonly prescribed group of drugs with changing frequency of prescription pattern over a period of time and has wide range of adverse effect, mainly on alteration in GI, renal functions and CVS system, which can be life-threatening. Thus, the aim of study was to evaluate the current prescription pattern of non-steroidal anti-inflammatory drugs (NSAIDs) and the prevalence of NSAID-induced gastrointestinal (GI) risk factors in a Tertiary Care Hospital of Western Nepal. A prospective observational NSAIDs induced gastrointestinal risk related study was conducted over a period of two months by clinical pharmacist on which study cohort include 370 patients who are taking or/and prescribed with NSAIDs. A self-administered questionnaire was completed by each patient for knowledge over prescribed NSAID and simplified risk scoring scale (the Standardized Calculator of Risk for Events; SCORE) was used to evaluate patients risk for GI complications with the used of NSAIDs. Data were analyzed by using Statistical Package for Social Science (SPSS) software version 17.0. The study groups were stratified into four risk groups according to GI SCORE tool, 18.4% of the patients belonged to high risk to very high risk groups for gastrointestinal complications. Analysis of prescription pattern revealed that overall frequency of prescription pattern of plain NSAIDs was found to be 60%, among which naproxen 500mg (21.3%) was found to be the most commonly prescribed non-selective NSAIDs (92%). Out of 370 at 105 prescription FDCs were prescribed. The finding conclude that although about more than 70% of patients receiving gastroprotective agents and had knowledge over NSAIDs still patients were at high to very high risk for NSAID-induced gastrointestinal complications and still there is a need of effective education/ knowledge towards NSAIDs and their pros and cons on use to the respective healthcare workers and patients in order to promote effective drug utilization. Key words : Fixed Dose Combination (FDCs), Gastro-protective Agents (GPAs), Gastrointestinal complications, Non- Steroidal Anti-inflammatory Drugs (NSAIDs),