Analysis of Out Door Patients’ Prescriptions According to World Health Organization (WHO) Prescribing Indicators Among Private Hospitals in Western India

Shelat, Prakash R; Kumbar, Shivaprasad Kalakappa

doi:10.7860/jcdr/2015/12724.5632

Cited by 22 publications

(39 citation statements)

References 19 publications

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“…An earlier study in Uganda also found that of the patients who sought treatment at private clinics within 1 week of onset of symptoms, only 7% of them were properly managed. [16][17][18][19][20][21][22] Similar findings have been documented in Ghana where a high proportion, 70% of the respondents, practiced self-medication, and the most common antibiotic used was amoxicillin. 23 It is noted that the majority of drug shops (53.3%), were injecting patients probably with gentamicin and penicillin, to treat other bacterial infections like skin infections and urethritis or urinary tract infections.…”

Section: Discussionsupporting

confidence: 75%

Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

et al. 2016

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ObjectivesThe main objective of this study was to assess practices of antibiotic prescription at registered drug shops with a focus on upper respiratory tract infections among children in order to provide data for policy discussions aimed at improving quality of care and patient safety in the private health sector in Uganda.MethodsA survey was conducted within 57 parishes from August to October 2014 in Mukono District, Uganda. Data was captured on the following variables: drug shop characteristics, training of staff in management of pneumonia, availability of guidelines and basic equipment, available antibiotics, knowledge on treatment of pneumonia in children aged <5 years. The main study outcome was the proportion of private health facilities prescribing an antibiotic.ResultsA total of 170 registered drug shops were surveyed between August and October 2014. The majority of drug shops, 93.5% were prescribing antibiotics, especially amoxicillin and trimethoprim-sulfamethoxazole (septrin). The professional qualification of a provider was significantly associated with this practice, p=0.04; where lower cadre staff (nursing assistants and enrolled nurses) overprescribed antibiotics. A third, 29.4% of drug shop providers reported that antibiotics were the first-line treatment for children with diarrhoea; yet the standard guideline is to give oral rehydration salts and zinc tablets. Only few providers, 8.2%, had training on antibiotics, with 10.6% on pneumonia case management. Further to this, 7.1% drug shops had WHO-Integrated Management of Childhood Illness guidelines, and a negligible proportion (<1%) had respiratory timers and baby weighing scales. Although the majority of providers, 82.4%, knew severe signs and symptoms of pneumonia, few, 17.6%, knew that amoxicillin was the first-line drug for treatment of pneumonia in children according to the guidelines.ConclusionsThere is urgent need to regulate drug shop practices of prescribing and selling antibiotics, for the safety of patients seeking care at these outlets.

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Section: Discussionsupporting

confidence: 75%

Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

et al. 2016

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“…The results indicated that the average number of drugs per prescription was 2.4 which is higher than the WHO recommended range of 1.6 to 1.8. However, this is low compared to similar studies done in Nigeria, Kenya and India where a higher rate of 2.6; 2.7 and 3.4 respectively were found (3,5,9), But this value is high compared to studies done in three rural district hospitals in Rwanda where a mean of 1.8 per prescription was found (6). The minimum number of drugs per prescription was 1 whereas the highest number was found to be 5 and concerned only one prescription.…”

Section: Discussionmentioning

confidence: 63%

Evaluating drug prescription patterns in children according to World Health Organisation's indicators, Kigali, Rwanda: A cross-sectional study

Habimana

Nyandwi

Kabayiza

et al. 2020

Preprint

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Background Irrational drug use is a worldwide problem at all levels of health care, especially in hospitals. Prescribers in community tend to omit hospital prescribing practices, thus this problem is present at all levels of health care. Use of medicines can be greatly improved and wastage reduced if simple principles of drug management are followed. To help in solving this problem, World Health Organization (WHO) has designed prescribing core indicators that were used to evaluate drug prescription patterns in Rwanda Social Security Board (RSSB) affiliated patients.Material and Methods A retrospective cross-sectional study with quantitative analysis was carried out for a period of six months. Among the 1000 prescriptions collected, 18 of them were rejected for not fulfilling the inclusion criteria, the remaining 982 prescriptions were almost distributed equally from either private and public hospital or clinics. The study analyzed prescriptions from health facilities located in Kigali City, Rwanda. The results were presented in table with comparisons with the WHO prescription indicators.Results The average number of drugs per prescription is 2.4 which is higher than 1.8 recommended by WHO. The percentages of drugs prescribed with a generic name and those from National Essential drug List are 28.5% and 61.1% respectively, which are very low compared to WHO target of 100% for both core prescribing indicators. The percentage of encounters with an antibiotic prescribed is 42.5% and the encounters who received an injections account 1.2%.Conclusion This study revealed that there is a big gap in implementing WHO core indicators of prescription and concerned stakeholders should take measures to address this issue.

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“…However, generic name prescription was mostly higher in this state as compared to that reported in the study of Western (6.67%) and Southern (9.7%) India respectively. 12,13 However, studies in Sri Lanka and Nigeria revealed generic name were used in 78% and 48.39% of the prescriptions, respectively. 14,15 Medicines prescribed from EML were less as compared to that specified by WHO.…”

Section: Discussionmentioning

confidence: 99%

“…Similar results were obtained from another national study where 70% drugs were prescribed from EML. 12 A study from Pakistan revealed 98.8% drugs were prescribed from EML. 16 Average number of drugs per prescription was found to be higher than that recommended by WHO.…”

Section: Discussionmentioning

confidence: 99%

A comparative study of drug prescribing indicators in various hospitals of West Bengal, India

et al. 2018

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Background: Rational use of drugs is essential to ensure safety and welfare of patients. Thus, prescription audits are conducted to monitor the practice of writing prescriptions. Various standard parameters have been rationalized by World Health Organization (WHO) in order to regulate drug utilization, globally. Present study aimed to compare the pattern of prescriptions generated in different healthcare centres of West Bengal.Methods: A cross-sectional study was conducted in the inpatient and outpatient departments of RG Kar Medical College, Kolkata, in order to evaluate the prescriptions. Literature was also surveyed with the keywords “prescription audit”, “West Bengal”, to extract data on prescription audits conducted in various other hospitals of West Bengal. The WHO prescribing indicators of all these health facilities were then compared to estimate the rationality of drug prescribed by different physicians.Results: Seven published reports of prescription audits were published from the period of 2013 to 2017, the distribution being- 2 health facilities from Kolkata, 2 from Burdwan, 1 each from Bankura, Murshidabad and North Bengal. WHO standards were not strictly followed by any of the hospitals. Polypharmacy level were higher in all the hospitals. Drugs were mostly prescribed from the essential medicine list (EML).Conclusions: Present study clearly indicated that it is essential to improve these parameters for most of the healthcare centres in order to prevent irrational use of drugs. Prescription audits should also be implemented regularly so that the patients can receive better treatment at minimum cost with suitable rational therapy.

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Analysis of Out Door Patients’ Prescriptions According to World Health Organization (WHO) Prescribing Indicators Among Private Hospitals in Western India

Cited by 22 publications

References 19 publications

Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

Prescription for antibiotics at drug shops and strategies to improve quality of care and patient safety: a cross-sectional survey in the private sector in Uganda

Evaluating drug prescription patterns in children according to World Health Organisation's indicators, Kigali, Rwanda: A cross-sectional study

A comparative study of drug prescribing indicators in various hospitals of West Bengal, India

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