Prescription auditing and drug utilization pattern in a tertiary care teaching hospital of western UP

Abstract

Background: In India, a proper reporting of medication errors in the hospital is not available. Drugs worth crores of rupee are consumed every year but a substantial part of these drugs are irrationally prescribed. In order to promote rational drug usage standard policies on use of drugs must be set, and this can be done only after the current prescription practices have been audited. The prescriptions were analyzed based on the objectives of the study in order to promote rational use of drugs in a population. Methods: The study was carried out prospectively over a period of two months and 15 days in general medicine OPD of our tertiary care hospital. A specially designed performa was used with pre-inserted carbons. Results: Two hundred and thirty seven prescriptions were analyzed. Total no. of drugs in 237 prescriptions were 1001. Therefore average number of drugs/prescription is 4.22. Drugs were prescribed by generic names in 3.79% of cases, drugs on EDL are only 53.25% and fixed dose combinations are 26.87% of total drugs. Dosage forms used were mostly oral -93.51%. Injectables were only 6.19% and topical forms were least 0.299%. Doctors profile indicates that maximum number i.e. 93.67% were general practitioners. Basic information of patient was written in 72.57% prescriptions. Complete diagnoses were written in 70.04% prescriptions. Only 88.61% prescriptions were legible and only 76.79% prescriptions were complete in terms of dose, route, strength, frequency and dosage forms. Disease pattern seen was variable. Diseases of respiratory system were maximum 44.72 % followed by infectious and parasitic diseases - 16.03 % and diseases of digestive system - 13.92 %. The most common drug groups prescribed were NSAIDs± serratiopeptidases, antibiotics, antihistaminics, multivitamins, minerals, enzymes and expectorants & bronchodilators. The incidence of polypharmacy was also common with maximum number of drugs which were prescribed per prescription were four in 39.24% of prescriptions. The prescriptions also had other minor anomalies. Conclusions: This study showed that there is scope for improvement in prescribing patterns in areas of writing generic names of drugs, essential drugs, writing legible and complete prescriptions. Polypharmacy was also evident from our study. Establishment and implementation of appropriate clinical guidelines, use of essential medicines list, public education about medicines and regular update to the clinicians will help in implementing the principles of rational pharmacotherapeutics. [Int J Basic Clin Pharmacol 2012; 1(3.000): 184-190

Assessment of drug prescribing pattern using WHO indicators in hospitalized patients at a tertiary care teaching hospital in rural area of India

“…In our study percentage prescription of antibiotic was according to ideal value. Similar value was also present in study done by Afroj Abidi et al, 2012higher in studies done by Binu et al, 2013 (41.98%), 16 U.A. Chandelkar et al, 2014 (31.8%), 17 Harmeet et al, 1998 (42.8%).…”

“…12 This is much higher than the recommended limit of 2.0. This value is also higher in studies done by Afroz et al, 2012 (4.22), 13 P. Geetha et al, 2015 (4.38).…”

“…Although this is low as compared to standard value 100% but is higher than study done by Nitti et al, 2014 (21.55%), 15 Afroz et al, 2012 (3.79%), 13 N Meena et al, 2013 (3.64%) 12 and Binu et al, 2013 (14.83%). 16 The low values of generic drug use in the above studies shows how prescribing habits are being directly influenced by the representative of the drugs companies for undue favours but this is not applicable in our study.…”

“…Poly pharmacy is a very common practice now days as is reported by various studies (Binu et al, 2013, Afroz et al, 2012 and Niti et al, 2014). 13,15,16 It is of concern in those patients with various co-morbidities as it increases the chances of drug interactions & adverse effects.…”

Evaluation of Knowledge, Attitude and Practice of Rational use of Medicine Among Interns and Resident Doctors in a Tertiary Care Teaching Hospital

“…Various studies have revealed that prescribing medicines by brand name has become a routine practice. 13,14 Prescribing by generic name should be encouraged at an early stage of medical practice to promote RUM. It is encouraging to know that almost all the respondents were always aware of the ingredients of the drug prescribed and they inform the patient regarding disease, drug therapy, and regular follow-up and monitoring of drug therapy.…”