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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.
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Background: Self-medication is a widely practiced trend in the general Indian population. Among the medical students, self- medication is popular because of awareness about the disease and their treatment. Analgesics are one of the most common drugs used for self-medication. Very few studies are available in Jharkhand regarding this subject. So, the present study aims to delve into the pattern of self-medication practices of analgesics among the 1st and 3rd semester medical students of RIMS, Ranchi, Jharkhand.Methods: A questionnaire based cross sectional study was done in RIMS, Ranchi, Jharkhand, India in March-April 2019 among the undergraduate medical students. The results were expressed as percentage and frequency.Results: Out of total 150 and 142 students in the 1st and 3rd semester respectively, 140 and 130 students practiced self- medication. Advice from seniors was the biggest source of information in both the groups followed by internet and books. Paracetamol was the most common drug (75%; 60%) and headache was the most common indication (55%; 68%). Quick relief of symptoms was the most common reason for self-medication in both the groups (44%; 48%).Conclusions: In both the groups, the students continued the drug even after experiencing side effects (77%; 60%). Most students were of the view that such practice is not acceptable at all times (75%; 72%).
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Background: A regular and effective prescription audit is a key tool to ensure rational use of drugs and to assess drug utilization in the health care system. This study is first of its kind, in Rajendra Institute of Medical Sciences (RIMS), Ranchi, highlighting comparative assessment of prescriptions of online booked appointments in department of medicine and dermatology via online registration system (ORS) using WHO prescribing indicators. This ORS is an integral part under Digital India Initiative.Methods: This was a comparative, observational study conducted in Department of Pharmacology of RIMS, Ranchi. The study period was 6 months from 1 March 2019 to 31 August 2019. Prescriptions details of outpatient department (OPD) patients were collected from the government authorized pharmacy facility “Dawai Dost “at RIMS. 75 prescriptions from each of the departments were analyzed.Results: 75 prescriptions from patients who attended medicine and dermatology outpatient department (OPD) during the study period, after registering appointment via ORS, was collected and comparative assessment was done. This audit highlights important correctable parameters although legibility was not the major concern. Adherence to National List of Essential Medicines (NLEM) was 45% and 49% for department of medicine and dermatology respectively.Conclusions: The prescription audit process should be done regularly to assess ORS prescription to ensure high quality rational prescribing and support Digital India initiative. Adherence to NLEM of India should be 100%. The latest NLEM of India should be provided to the concerned departments and feedback should be provided to the physicians.
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ABSTRACTBackground: The objective of the present study was to evaluate the prescribing pattern of hypolipidaemic drugs in the outpatient department of cardiology in a tertiary care hospital.Methods: A cross-sectional study was conducted in the department of cardiology for the period of 3 months. A total of 526 prescriptions were analyzed for variants such as the disease patterns, the type of hypolipidaemic drugs which are prescribed for those diseases, the prescribing daily dose of the hypolipidaemic drugs and the prescribing daily dose/daily defined dose ratio of the drugs.Results: On evaluation of the prescriptions, it was conferred that both the patients of normal lipid profile (34.77%) and abnormal lipid profile (65.18%) were prescribed hypolipidaemic drug. Diabetes with hypertension (35.74%) was the most common disease for which hypolipidaemic drugs were prescribed. Atorvastatin (30.98%) was the most common drug which was prescribed as monotherapy, whereas atorvastatin with aspirin and clopidogrel (17.49%) was the most common drug prescribed in combination.Conclusions: Use of statin has become very prevalent with increasing trends of use in both normal and abnormal lipid profile patients, suggesting consideration of rational use of statins to follow good prescribing pattern so that morbidity and mortality can be prevented.
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Background: Prescription is an important document written by a doctor which if not written properly can lead to various problems such as adverse drug reactions in patients, incompatibility to follow the instructions to take timely medications and sometimes over dosage due to improper prescription can even lead to death of the patient.Methods: This prospective observational cross-sectional study was conducted over a period of 6 months. The study was conducted in Rajendra Institute of Medical Sciences, Ranchi. Various prescriptions were collected from outpatient care facilities of a tertiary care hospital. Results were analyzed and assessed on 150 prescriptions collected.Results: Total 150 prescriptions were evaluated out of which 49.3% were males and 50.7% were females. Various parameters were assessed during the study which showed that there is still a scope of improvement in prescribing patterns in areas of writing complete prescriptions, prescribing generic medications and mentioning drug dosage forms as well as time of administration in each prescription.Conclusions: The results showed there is still a scope of improvement in writing practices of prescription. The doctor should incur the habit of writing generic names of drug in every prescription. They should adopt proper handwriting skills and no mistakes should be done in a prescription. A good prescription written by a doctor will help in legible practice and will also be very helpful in patient’s care.
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Background: Aim of the study was to study percentage price variations among different brands of the commonly prescribed H2 receptor blockers.Methods: The maximum and minimum price of each brand of the drug in INR was noted by using CIMS January to April 2018 edition, Drug Today April to June 2018 Vol-1. The price ratio and the percentage price variation for individual drug brands was calculated. The price of 10 tablets/capsules were calculated. At last the price ratio and percentage price variation of various brands were compared.Results: Percentage variation in price for H2 receptor blockers marketed in India was found to be tablet cimetidine 200mg:81.89, tablet cimetidine 400mg:91.27, tablet ranitidine 150mg:295.64, tablet ranitidine 300mg:123.19, tablet famotidine 20mg:939.62, tablet famotidine 40mg:1110.09, tablet roxatidine 75mg:38.65, tablet roxatidine 150mg:21.85.Conclusions: H2 receptor blocker is the most common drug prescribed for prolonged period in case of gastritis, Gastro-Esophageal Reflux Disease (GERD), peptic ulcer. If a costly brand is prescribed, the patients have to pay more money unnecessarily for their treatment. The doctors prescribing these drugs should be aware of these variations in price to reduce the price of drug therapy.
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Background: The aim was to study the current prescribing and drug utilization pattern in Ophthalmology Department of a tertiary care teaching hospital. Drug utilization study is a part of pharmaco-epidemiological exercise quantifying the extent, nature and determinants of drug use in a population. Periodic audit of drug usage pattern forms an essential tool to ascertain the role of drug in a society, increase therapeutic efficacy and improve cost effectiveness of the therapy. It is an introspective and critical instrument providing positive impact on health care delivery to the patient. With this background, the present study was carried out to analyze the prescription pattern and drug utilization by measuring the WHO drug use indicators in ophthalmology department of a tertiary care teaching hospital.Methods: The prescriptions of 961 outpatients were included and analyzed using a predesigned case record form OPD prescription of each patient. Patient and prescription related parameters were analyzed.Results: Prescription analysis showed that the average number of drugs per prescription was 1.85. The drugs were prescribed in the form of eye drops (67.42%), followed by ointments (14.37%), capsules (15.45%), and tablets (2.71%). The dosage form and frequency of drug administration was indicated for all of the drugs prescribed, the duration of treatment for 60.97% of the drugs prescribed. Antimicrobial agents and tear substitute together constituted above 50% of all the drugs. Percentage of drugs prescribed by generic name and from NEDL was 31.62% and 37.22%, respectively. Patient抯 knowledge of correct dosage was 70.44%.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.
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A 25-year-old girl self-administered tab fluconazole for vulvovaginal candidiasis and developed fever, myalgia and erythematous papular eruptions with itching at both upper and lower lip, mucous membrane of the mouth, vaginal region, which subsequently changed into blister and multiple ulcers. She also had difficulty in swallowing due to painful erosions of the mouth and oropharynx and severe burning pain at vulval and vaginal region. There was bilateral conjunctival hemorrhage. Investigation report revealed leukocytosis and elevated C-reactive protein, which was suggesting the diagnosis of Stevens-Johnson syndrome. She was treated mainly by corticosteroids, antihistamines and antimicrobials and improved. Time taken for resolution of the lesion was 14 days. Rechallenge with the offending drug was not done in the interest of the patient and due to ethical constraints.