ABSTRACT
Background: Prescription error and irrational prescribing are the avoidable problems imposed on health care delivery system from prescriber side which must be addressed. Periodic prescription audit helps to curtail the error and irrational prescribing.Methods: A prospective observational study was conducted on patients visiting various Outpatient Department of RIMS, Ranchi, Jharkhand on all working days at 11:00 AM to 12:00 PM from 1 August 2018 to 31 July 2019. Various aspects of collected prescriptions were analyzed by using World Health Organization (WHO) prescribing indicators.Results: In this study, out of 700 prescriptions collected, 76 were excluded. Out of total 624 patients analyzed, 382 (61.28%) were male and 242 (38.72%) were female. 48 (7.69%) patients belonged to ?18, 464 (74.36%) to 19-64 and 112 (17.95%) to ?65 years of age group. Tablet (71%) was the most common dosage form. None of prescriptions were having registration number of the doctor. 242 (38.78%) prescriptions did not have a diagnosis duly written. The total no. of drugs prescribed in 624 prescriptions was 2176. Only 32 (5.13%) prescriptions were found to have medicines prescribed in block letters. Antibiotics (29%) were the most common class of drugs prescribed. Average number of drugs per prescription was 3.47. Only 48 (2.20%) drugs were prescribed by their generic name while total of injectables prescribed were 102 (4.68%). Total number of drugs from NLEM was 848 (38.97%). 196 (9.00%) drugs were fixed-dose combination.Conclusions: In our study, we found deficiencies in various parts of prescriptions. Prescribing pattern was not in accordance with WHO recommendation for prescribing practice.
ABSTRACT
Background: Prescription audit is one of the methods to assess the drug utilization pattern and rational use of drugs. In our country the value of drugs prescribed is in crores but a significant proportion of drugs is prescribed irrationally. This is probably due to defect in prescription pattern, lack of knowledge in health care personnel, pressure from drug manufacturing companies and many more. To promote rational use of drugs, standard policies must be set and this can be achieved only after auditing current prescription practices.Methods: A prospective study was carried out in Medical college hospital, Raigarh in the month of January 2018. Around 1000 prescriptions were collected randomly from pharmacy and the prescriptions were analysed on various parameters like patient抯 demography, parts of a prescription, information related to doctor and drugs.Results: In this study, we found that percentage of generic drugs were 58.02% and 70.43% drugs were from essential drug list. Only 13.19% FDCs were used. 34 prescriptions were illegible and capital letters were used only in 26 prescriptions. We also found deficiency in parts of a prescription like inscription part (13.3%), subscription part (26.9%) and in doctor抯 identity (33.2%). The majority of drugs were antimicrobials (23.81%) followed by anti-inflammatory and analgesics (21.1%).Conclusions: This study shows that the use of generic drugs and essential drugs is on the lower side as compared to standard guidelines. The prescription pattern was defective in many prescriptions. This study shows incompleteness of prescriptions and proper steps are needed to guide the physicians to promote rational use of drugs.
ABSTRACT
Of all non-traumatic amputations 50% occur in Diabetics, mostly as a final outcome of foot ulcers. A major biomechanical factor in the causation of foot ulcers in persons with diabetes mellitus is elevated peak plantar pressure. Offloading the ulcer area in the form of equalisation of pressure across the plantar surface can accelerate healing of the ulcer. Total contact casting is one such method of offloading, and this study attempts to investigate the advantages of the above method as compared to conventional dressings in the physiatric management of the depth--ischaemia grades 1A, 1B, 2A, 2B neuropathic plantar ulcers in a diabetic patient. The outcome measure was the time taken for complete resolution of the ulcers. Of the 29 patients in Category A treated with total contact casting involving a total of 39 foot ulcers, 36 healed, which was statistically significant (p < 0.05) as compared to 25 out of the 33 ulcers healing in Category B consisting of 26 patients treated by conventional dressings alone. Total contact casting is an effective, rapid, economical, ambulatory and outpatient--based method for the treatment of diabetic foot ulcers.