The impact of irrational practices: A wake up call

Garg, Meena; Vishwakarma, Pinki; Sharma, Monica; Nehra, Rajiv; Saxena, K. K.

doi:10.4103/0976-500x.142434

Cited by 15 publications

(11 citation statements)

References 3 publications

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“…However, the best approach toward such patients is to educate them rather than giving in to their false ideations. [ 3 ]…”

Section: Discussionmentioning

confidence: 99%

“…[ 2 ] Such irrational prescribing is unethical and greatly decrease the standard of drug therapy in addition to resulting in widespread health hazards such as increased incidence of adverse effects, drug interactions, and emergence of drug resistance, especially with antimicrobial therapy. [ 3 ] The World Health Organization (WHO) has reported that more than half of all medicines are prescribed, dispensed, or sold inappropriately. [ 4 ]…”

Section: Introductionmentioning

confidence: 99%

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Drug prescription pattern of outpatients in a tertiary care teaching hospital in Tamil Nadu

et al. 2018

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Purpose:Drug use prescribing indicators advocated by the World Health Organization (WHO) are important tools for assessing the degree of polypharmacy, use of generic medicines, and to evaluate if there is inappropriate use of antibiotics or parenteral medications besides estimating the adherence to the essential drugs list. This study aimed to assess the WHO prescribing indicators in prescriptions given at the medical outpatient department (OPD) in a private medical college hospital in South India.Materials and Methods:The study was done prospectively from patients when they presented for consultation at the medical OPD at our tertiary care center. Prescriptions were randomly chosen to be analyzed for the WHO prescribing indicators from September 2016 to April 2017.Results:A total of 700 prescriptions were analyzed and the average number of drugs per prescription was 2.955 ± 1.32. 32.57% of prescriptions had fixed drug combinations and a similar value of 36% was obtained for prescriptions containing more than one drug for the same indication. Amongst the prescribing indicators, generic prescribing was appallingly low (6.42%). In contrast, antibiotic prescribing and prescription of injections showed an appreciably rational trend with 15.42% and 8.14%, respectively. Furthermore, the prescription of the drugs enlisted in the essential drugs list was determined to be 90.67%.Discussion:The need for increase in generic prescribing and augmenting the adherence of prescriptions to the essential drugs list has been identified. This can be accomplished by multimodal approach that includes regulatory changes, conducting educational programs directed at attitudinal change among current doctors and imparting modifications in medical curriculum so as to inculcate the culture of abiding by the best prescription practices among budding doctors.Conclusion:This study has delineated the requisite for pertinent changes in current prescribing trends in a tertiary care teaching private colleges.

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“…However, the best approach toward such patients is to educate them rather than giving in to their false ideations. [ 3 ]…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Drug prescription pattern of outpatients in a tertiary care teaching hospital in Tamil Nadu

et al. 2018

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“…The common types including polypharmacy, inappropriate use of anti-microbials and prescribing medicines without adhering to clinical guidelines [9]. Irrational use is associated with an increased incidence of adverse effects, medication interactions and the emergence of antimicrobial resistance [10]. Furthermore, it also contributes to a substantial increase in cost to health care around the world [11].…”

Section: Introductionmentioning

confidence: 99%

WHO/INRUD Core drug use indicators and commonly prescribed medicines: a National Survey from Sri Lanka

Galappatthy

Ranasinghe

Liyanage

et al. 2021

BMC Pharmacol Toxicol

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Background Identification of internationally comparable indicators of medicines use are important for a country to implement strategies and regulations to improve usage of medicines. Sri Lanka established a new National Medicines Regulatory Authority in 2015 and this survey evaluated the medication use indicators in Sri Lanka, according to the International Network on Rational Use of Drugs (INRUD), prior to its implementation. Methods This descriptive-cross-sectional study was conducted in 80 pharmacies, representing all 25 districts of the country. Three pharmacy categories were included; privately owned pharmacies, ‘Rajya Osusala’ pharmacies operated by the State Pharmaceuticals Corporation (SPC) of Sri Lanka and SPC Franchisee pharmacy outlets. Selection of pharmacies from respective districts were done proportionate to estimated population. Data were collected to identify WHO/INRUD core drug use indicators and the commonly prescribed medicines. Results Total of 2328 prescriptions were included (‘Rajya Osusala 559; SPC Franchise 711; private pharmacies 1058). Altogether 7,255 medicines were prescribed, and the 3 most commonly prescribed medicines were atorvastatin, losartan and metformin. Average number of medicines per encounter was 3.1±1.9 (Median: 3; range 1-12) Highest average number of medicines per encounter was reported in prescriptions received at ‘Rajya Osusala’ pharmacies (3.6±2.2), significantly higher than in other categories of pharmacies (p<0.001). Percentage of medicines prescribed by generic name was only 35.5%, highest at the ‘Rajya Osusala’ pharmacies (40.6%), significantly higher than other categories of pharmacies. The overall percentage of medicines prescribed from essential medicine list (EML) was 68.8%, without any significant variation between different categories of pharmacies. The percentage of medicines actually dispensed and accurately labelled were 92.4 and 98.5% respectively. Conclusions The average number of medicines per encounter was higher than the WHO recommended value but the usage of antibiotic and injectable drugs were within recommended standards. Generic prescribing, was very much lower. The EML prescribing, labelling and percentage dispensed medicines fared much better although lower than the WHO recommended 100% compliance. This island wide study has provided national wide data before the implementation of key changes in regulation of medicines in Sri Lanka and a repeat survey will be useful to identify impact of the new legislations.

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“…Inappropriate prescribing is one of the major challenges in the public health sector. It is associated with adverse consequences, including prolongation of illness, emergence of antimicrobial drug resistance, undesirable side effects, and increased cost of treatment 1,2. As defined by the WHO, rational drug use implies that patients receive medicines appropriate to their clinical needs, with adequate dose and sufficient duration, and at the lowest cost that can be afforded by patients and the community 3.…”

Section: Introductionmentioning

confidence: 99%

<p>Pattern of medication use in geriatric patients at primary healthcare facilities in Karawang, Indonesia</p>

Abdulah¹,

Insani²,

Putri³

et al. 2019

DHPS

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BackgroundRational drug use is a critical component in patient care, particularly among the elderly who often have multiple medical problems. The aim of this study was to assess the pattern of medication use among the elderly visiting primary health care facilities.MethodsA retrospective cross-sectional study was conducted at 25 primary health care facilities in Karawang District, Indonesia, and patients aged ≥60 years visiting the facilities from January to December 2014 were included. A systematic random sampling technique was used to select the study samples. Each prescription was assessed using the WHO prescribing indicators.ResultsA total of 10,118 prescriptions with 31,927 drugs were assessed. The average number of drugs prescribed was 3.15 (range: 1–7). Drugs prescribed by generic name comprised 98.09% (n=31,318) of the total number of drugs. Medical appointments wherein an antibiotic was prescribed constituted 23.45% (n=2373) of the total number of prescriptions. No injections were prescribed in this study setting. Drugs prescribed from the essential drug list comprised 83.07% (n=26,522). Paracetamol (13.44%), vitamin B complex (8.05%), and aluminum–magnesium hydroxide (7%) were the most frequently prescribed drugs, whereas amoxicillin (44.03%), chloramphenicol (13.10%), and ciprofloxacin (12.00%) were the most frequently prescribed antibiotics.ConclusionOur findings highlight that polypharmacy and prescription of essential drugs remain subjects of concern in geriatric health care. Regular medication review and promoting the use of the essential drug list among health care professionals are encouraged in primary care settings.

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The impact of irrational practices: A wake up call

Cited by 15 publications

References 3 publications

Drug prescription pattern of outpatients in a tertiary care teaching hospital in Tamil Nadu

Drug prescription pattern of outpatients in a tertiary care teaching hospital in Tamil Nadu

WHO/INRUD Core drug use indicators and commonly prescribed medicines: a National Survey from Sri Lanka

<p>Pattern of medication use in geriatric patients at primary healthcare facilities in Karawang, Indonesia</p>

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