Assessment of drug use pattern using World Health Organization prescribing indicators in a tertiary care hospital in Mangalore: A cross-sectional study

Ragam, Akshitha Sai; Acharya, Swathi; Holla, Rajendra

doi:10.5455/njppp.2017.7.0413713052017

Cited by 12 publications

(16 citation statements)

References 6 publications

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“…The injection prescribing was lower 0.7% than the WHO standard value, tertiary care hospital of India 8.33%, of western Nepal 3.1% and previous study 5% [11, 18, 25, 26]. The probable reason might be that non-parenteral medication use is easy, cost-effective and convenient in the busy outpatient department while the injection requires trained personnel.…”

Section: Discussionmentioning

confidence: 69%

“…The average number of drugs per encounter was higher (3.2) compared to the standard value 1.6–1.8 and the previous study of the Nepal 2.1 [25, 26]. The average drug per prescription was found low in a teaching hospital in Western Nepal 2.5, tertiary care hospital of India 3.03 and Nigeria tertiary hospital 3.04 [11, 18, 27]. The study showed that most of prescription that is 32.5% had three drugs and 27.5% had four drugs.…”

Section: Discussionmentioning

confidence: 79%

“…A study in a tertiary care hospital in Mangalore reported 19.44% that the antibiotics prescribed were lower than the standard range. The antibiotic policy was attributed to the low rate of antibiotic prescription [18]. The evidence-based appropriate antibiotic policy is a current need for health care facilities to reduce inappropriate antibiotic use and consequent effects.…”

Section: Discussionmentioning

confidence: 99%

“…Excessive and inappropriate prescribing results in severe consequences such as wastage of the public economy, increased risk of toxicity, increased adverse drug reaction, increased antimicrobial resistance and decreased faith in the medical profession [18]. Poor communication between patients and prescribers, self-medication and unethical medicine promotion has been reported to increase irrational prescribing [12].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of prescription pattern and prescription error in outpatient Department at Tertiary Care District Hospital, Central Nepal

Shrestha

Prajapati

2019

J of Pharm Policy and Pract

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Background The rational use of medicine improves patient’s quality of life. Excessive and inappropriate prescriptions result in severe consequences. The study of drug use patterns and prescription errors is necessary to promote rational drug use in developing countries. The aim of the study was to evaluate prescription practice and help to the quality use of medicine. Methods A retrospective, cross-sectional and quantitative study was conducted at Bharatpur District Hospital in central Nepal. The outpatient prescriptions retained at the pharmacy from November to December 2017 were used to evaluate prescription patterns and errors. The total of 770 prescriptions were reviewed. The stratified random sampling method was used. Result The total of 2448 drugs were prescribed in 770 prescriptions or patients. The average number of drugs per encounter was 3.2. The percentage of encounter with antibiotic and injection was 37.9% ( n = 292) and 0.7% ( n = 5), respectively. The percentage of drugs prescribed by generic and from an essential medicine list of Nepal was 2.9% ( n = 72) and 21.3% ( n = 521), respectively. The most common 32.5% of prescriptions contain three drugs and 24.7% of prescriptions contain four drugs. The average prescription errors per prescription were 3.4. Among total errors, omission errors related to prescriber were 1.5 ( n = 1135), omission errors related to the drug were 1.5 ( n = 1189) and commission errors were 0.3 ( n = 269). The total of 249 drug interactions were found in 19.1% ( n = 147) prescriptions. The common prescription errors were due to failure to mention prescriber name 87.5% ( n = 674), failure to mention prescriber signature 19.2% ( n = 148) and failure to mention diagnosis 39.2% ( n = 302). Conclusion The study shows low compliance with WHO prescribing indicators and high prescription errors. The prescribing practices were not confirmed to the standard recommended by WHO. Prescribing from the Essential Drug List (EDL), low rates of generic prescribing, high antibiotic prescribing and polypharmacy were a major problem. The study found major errors in prescriber and prescribed medicine details. Remarkable drug interactions were seen in prescribed medicines. The study recommended necessary practices and policy formulation and implementation by DTC and regulatory bodies to promote the rational use of medicine.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of prescription pattern and prescription error in outpatient Department at Tertiary Care District Hospital, Central Nepal

Shrestha

Prajapati

2019

J of Pharm Policy and Pract

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“…Ethical codes were laid down in Ayurveda, which morally abides the physician to maintain conduct that is beneficial for himself, patient and society. Even Vagbhata"s Ashtanga samagraha advocates good conduct, friendly gesture, compassion as distinguishing qualities for physician 18,19 .…”

Section: Ethics In Medical Treatment As Core Of Rationalitymentioning

confidence: 99%

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2020

IJPSR

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Medicine has been a noble profession since time immemorial. Many cultures have the view that it is linked with the supernatural deity. The persons were priests in many civilizations. They had high status in Society. They were considered as a medium of communication between the supernatural and were assumed to have powers. In those times, those priests used rituals and follow some religious code of conduct for treatment. This was the primitive stage of ethics as a part of religious ritual. Latter with observations, many folk traditional medicine ethics were created in a teacher-student relationship. Further traditional medicine like Ayurveda, TCM, Korean developed, which had mutual interactions in ideology and philosophy. It was evident with the review of these studies and also had a diverse set of rules entertaining behavioral and professional codes for prescriber health care worker and patient for providing rational and safe delivery of health services. However, with the separation of medical science from religion, the positive philosophical background and the behavioral element lost its ground. Thus rationality becomes behavioral In addition, previously, all elements of treatment were done by viadys or healers, but with development, different professions arrived, which incensed scope of error, which is a hurdle to the objective of rational drug use in of drug. Hence, a universal approach of PDAA CYCLE and DRIOP methodology concept to optimize teamwork and ensure rational drug use is conceptualized. This approach has taken into consideration of all elements in the drug use process and has been devised to bridge the gaps leading to irrational use in the modern scenario. This would be helpful in the rational use of widely used drugs like antibiotics, low therapeutic index drugs, chronic illness drugs and also help to improve antibiotic resistance and lead to optimum utilization of resources, which is vital for every country but especially for underdeveloped countries and developing countries like India with high load of infections and other diseases.

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Assessment of drug use in primary health centers in Lagos State, Nigeria

Adeosun¹,

Joda²,

Aderemi-Williams³

et al. 2022

Pan Afr Med J

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Introduction rational drug use prevents wastage of resources, loss of confidence in healthcare system and drug-related morbidity and mortality. This study aims to assess drug use in Primary Health Centers (PHCs) in Lagos State, Nigeria using the World Health Organization in collaboration with the International Network of Rational Use of Drugs core drug use indicators. Methods the study was conducted between February to October 2021 as a comparative observational survey of selected PHCs. It included a retrospective and prospective cross-sectional design for prescribing and patient care indicators assessing 2640 prescriptions and clients respectively. Data were analyzed and presented as frequency with percentage or mean with standard deviation, as applicable. The performances of the types of PHCs were compared using two-sample t-test. A 2-tailed p-value < 0.05 was considered statistically significant. Results average number of drugs per prescription, drugs prescribed by the generic name, percentage of encounters with prescribed antibiotics and injections were 3.6 ± 0.9%, 76.5 ± 18.5%, 63.3 ± 19.1% and 21.1 ± 24.1% respectively with no significance difference between the comprehensive and basic PHCs. For all the facilities, the average consultation and dispensing times were 10.5 ± 6.0 minutes, 244.9 ± 179.2 seconds respectively. In this study, the percentage of patients’ knowledge of the correct dosage was 72.4 ± 38.3%. There is statistically significant difference in availability of key drugs in stock between the comprehensive and basic PHCs (p-value 0.0001). Conclusion irrational drug use practices exist in comprehensive and basic PHCs. There is a need to implement interventions aimed at strengthening good prescribing and patient-care practices across the PHCs in Lagos State.

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Assessment of drug use pattern using World Health Organization prescribing indicators in a tertiary care hospital in Mangalore: A cross-sectional study

Cited by 12 publications

References 6 publications

Assessment of prescription pattern and prescription error in outpatient Department at Tertiary Care District Hospital, Central Nepal

Assessment of prescription pattern and prescription error in outpatient Department at Tertiary Care District Hospital, Central Nepal

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Assessment of drug use in primary health centers in Lagos State, Nigeria

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