ABSTRACT
Background: Epilepsy is one of the common neurological disorders diagnosed early in life. Availability of many antiepileptic drugs (AEDs) makes it difficult to choose the appropriate pharmacotherapy. Aim and Objective: Understanding the pattern of AED prescription to evaluate the rationality of AED prescriptions in epileptic patients. Materials and Methods: This was a retrospective, observational study carried out at new civil hospital, Surat for a duration of 6 months. The study involved collecting data from the case files of all the patients irrespective of age or gender diagnosed with epilepsy and undergoing treatment from any of the outpatient departments of the hospital. Demographic details, clinical diagnosis, and detailed data about the prescribed pharmacotherapy were recorded in a pre-approved data sheet. The WHO prescribing indicators were evaluated for each prescription. Descriptive statistics was used. Results: The average age of the patients was 21.64 ± 10.46 years. A total of 1565 drugs were prescribed in the 331 epilepsy patients’ prescriptions. Out of this, 551 drugs (35.21%) were antiepileptics. Most of the patients received monotherapy (75.53%). The most commonly prescribed drug was sodium valproate (46.10%) followed by phenytoin (30.13%) and carbamazepine (10%). The average AED per prescription was 1.70. Majority of the prescriptions (94.63%) used generic names. There were no injectable used and no fixed dose combinations were prescribed in any of the patients. Conclusion: The prescriptions followed the rational prescribing pattern. Treatment of epilepsy is usually by monotherapy with valproate being the most commonly used AED. Prospective studies to evaluate adverse effects and patient compliance will help in efficient policy-making decisions.
ABSTRACT
Introduction: Community pharmacy (CP) is one of the health care centers that have a key role to play in the current COVID-19 pandemic period. Prescriptions monitoring studies are essential as this helps in understanding the current prescribing pattern adopted by physicians. Furthermore, only few CP-based research studies were noted. This study was conducted with an aim to study prescribing pattern using World Health Organization (WHO) indicators from few community pharmacies in Maharashtra, India, during COVID-19 Pandemic period. Material and Methods: An observational study was conducted and sample comprised of prescriptions collected from different parts of Maharashtra (Mumbai, Pune. and Nashik). One thousand and fifty-six prescriptions were collected and data was collected for a period of 6 months (August 2020–January 2021). The variables of interest in this study were: Number of medications in each prescription, number of prescriptions with generic names, number of antibiotics and injectables in each prescription, number of prescribed drugs from essential drug list (EDL), and defined daily dose (DDD). Results: Out of 3058 drugs prescribed, it was found that average number of drugs per prescription was 2.89 (standard deviation ± 1.37). Only 23 (0.75%) were prescribed by generic name. Antibiotics and injectables were 399 (37.78%) and 29 (2.74%), respectively. Drugs that were prescribed from EDL were only 920 (30.08%). The total class of antimicrobial agents prescribed (Anatomical Therapeutic Chemical group J01) was 13. After calculating DDD, DDD of Azithromycin was found to the highest (81.6 g). Conclusion: Among five WHO indicators, only the percentage of encounters with an injection was in compliance with the WHO recommended value. Further studies are required for better understanding of this area.
ABSTRACT
Background: There are multiple protocols currently being followed worldwide for effective management of COVID-19 depending on the disease severity as a consequence, of which the prescribing patterns and therapeutic choices still remain unclear. Drug utilization studies provide insight into the current prescribing practices and help us in facilitating the rational use of drugs. Aim and Objectives: The aims of this study were to evaluate utilization pattern of medications used to treat COVID-19 in hospitalized patients with moderate disease as defined by Indian Council of Medical Research (ICMR) guidelines. Materials and Methods: Hospital-based prospective, observational, and cross-sectional study was conducted in Designated COVID Hospital, Bidar Institute of Medical Sciences, Bidar for 4 months from March 1, 2021, to June 31, 2021. Data were collected from patients, every 10th inpatient was randomly selected. Rationality of prescriptions was evaluated using the WHO core drug prescribing indicators. A total of 234 hospitalized patients aged more than 18 years with laboratory confirmed COVID-19 of moderate severity according to ICMR guidelines were included in the study. Results: In our study, we found average number of drugs per encounter as 7.29. Percentage of drugs prescribed by generic name as 89.05%. Percentage of encounters with antibiotic as 96.58%. Percentage of encounters with an injection prescribed as 100%. Percentage of drugs prescribed from essential drug list as 83.25%. Conclusion: Drug utilization in COVID-19 is diverse and is in accordance with the existing guidelines. Medications used are highly corresponding to the disease severity. Polypharmacy detected, here, is not irrational as it suppressed the COVID-related mortality. Steroids, anticoagulants and oxygen being the key determinants.
ABSTRACT
Background: Prescription auditing is an important tool to assess and evaluate the drug utilization pattern and rational use of medicines. A successful prescription audit is crucial for health care workers, patients, and the community to ensure that their patients receive the best possible treatment. The purpose of drug audit is to improve patients care and to avoid potential fatal errors. Aim and Objectives: This study has been conducted to evaluate and analyze existing prescription errors in tertiary care hospital of Rajasthan and their magnitude. Materials and Methods: A retrospective observational study was carried out in Jhalawar Medical College, a tertiary care hospital in Rajasthan. Around 1000 prescriptions were collected randomly from medical college pharmacies. Outpatient prescriptions from all the major clinical departments available at hospital pharmacies were analyzed using the WHO prescribing indicators. Information regarding the patient, doctor, drug, and legibility of the prescription were obtained. Results: In our study, we found that most common age group mentioning in prescriptions were 18� years (55.7%), most common gender are males (60.2%). Generic names were prescribed in all prescriptions (100%). Patient information was mentioned in 73.2% prescriptions. Warning signs were not mentioned in any prescription whereas 10.2% prescription mentioned medicines name in capital letter. Average number of medicines per prescription was 4.1. Prescription with drugs prescribed from essential drug list was 88%. Conclusions: In our study, we found many insufficiencies, lack of clarity and important instructions in different parts of prescriptions. There is immediate requirement of improvement in prescribing habits of doctors. Proper steps such as workshops, practical training, and continuing medical education should be needed to guide the physicians to promote rational prescription.
ABSTRACT
Background: High-risk pregnancy is defined as pregnancy complicated by factors that can adversely affect maternal and perinatal outcome. About 10–30% of pregnancies are high risk which accounts for 70–80% perinatal mortality and morbidity. Drug utilization data help to monitor the drugs prescribed and to assess the outcome by evaluating appropriateness and rationality of prescription. Aims and Objectives: This study aims to evaluate the pattern of drug use in high-risk pregnancy and to assess the WHO core prescribing indicator and US FDA category. Materials and Methods: A total of 250 case record forms of pregnant women admitted to high-risk ward were analyzed. Patient’s demographic data and detailed information about prescription were recorded and analyzed as per the WHO core drug prescribing indicators and US-FDA category. Descriptive statistics were used. Results: A total of 1121 drugs were prescribed among which antimicrobials (33.7%) were used more frequently followed by antihypertensive (13.9%), intravenous (609, 54.2%) route was the major route of drug administration, followed by oral (527, 47%), intramuscular (33, 2.9%), and subcutaneous (16, 1.4%). Average number of drugs per encounter was 4.48, percentage of encounters with an antimicrobials prescribed is around 70.4%, percentage of drugs prescribed by generic name was 93.5%, percentage of drugs prescribed from essential drugs list was 73.3%, and percentage of encounters with an injection prescribed was 50.4%. Majority of drugs belong to the US-FDA pregnancy Category B (45.04%), followed by Category C (39.4%), A (10.8%), and D (4.6%). Conclusion: Majority of drugs were prescribed by generic name and belonged to Category B drugs which are considered safe. Standards of prescription were in accordance with the WHO prescribing indicators. Overall prescribing behavior is rational and encouraging.
ABSTRACT
Background: Upper respiratory tract infections are mostly caused by viruses and are self-limiting. But it is seen that drug therapy is restored to many of them without adequate justifications. Sometimes multiple drug therapy imposes high cost burden on patients. Use of antibiotics in URTI patients have led to rise in bacterial resistance. So, this study was aimed to analyse the prescription pattern in upper respiratory tract infections and the antibiotic susceptibility of the isolated organisms.Methods: An observational cross-sectional study was conducted in a tertiary care hospital for a period of three months. Based on the inclusion and exclusion criteria sixty patients were selected. Prescriptions of these patients were collected and analysed for the various WHO prescription indicators like average number of drugs per encounter, percentage of drugs prescribed by generic names, percentage of drugs prescribed as injection, drugs form the essential drug list etc. The swabs were collected from the site of infections and were analysed for the bacterial growth. Also, the antibiotic susceptibility of these organisms was tested.Results: A total of sixty prescriptions were collected and analysed. The average number of drugs per prescription was 2.21. Antimicrobials were prescribed in 90% of cases. Approximately 50% cases the combination of amoxicillin and clavulanic acid was prescribed. The percentage of drugs prescribed by generic names was 87% and 68% drugs were form the essential drug list. The culture report of the specimen collected from the swabs showed that only 50% of cases were of some bacterial origin. And the organisms isolated were less susceptible to the antibiotics that were prescribed.Conclusions: This study of prescribing patterns in patients gives appropriate feedback and awareness among health care providers. Rationale prescribing practice will prevent antibiotic resistance and reduction in the adverse drug reactions.
ABSTRACT
Background: Evaluation of drug prescription prototype is a significant feature of patient care, which also provides as an estimate of the quality of care provided. Thus, the current study was carried out to analyze the prescriptions of patients attending outpatient department (OPD) of a tertiary care teaching hospital.Methods: Present cross-sectional study was performed in the OPD of our tertiary care teaching hospital. The study was carrying out for duration of two years. Data was obtained from 850 prescriptions. Data was analysed as per WHO prescribing indicators.Results: Total 1700 prescriptions were analysed, that includes 55.8% males and 40.1% females. The highest numbers of prescriptions were from the age group of 18-40 (53.6%) years of age. Average number of drugs in the current study was found to be (2.1). Percentage of come across with an antibiotic prescribed was 17.12%. Percentage of come across with an injection prescribed was 11.81%.Conclusions: There is necessitate of recuperating the prescribing pattern by maintaining the number of medicines as little as possible, prescribing medicines by generic names, using medicines properly after selecting and deliberately keeping the charge of treatment low.
ABSTRACT
Background: By recognizing the need to promote rational utilization of medicines, the World Health Organization (WHO) in collaboration with the International Network for Rational Use of Drugs (INRUD) developed a set of core indicators. This study aimed to investigate drug use based on it.Methods: The study was performed in Primary Health Centers (PHC) in Nashik District, Maharashtra, India. Prescriptions data for the last one year from PHCs were sampled out retrospectively. Outpatients from PHCs were selected, observed and interviewed for the patient-care indicators, prospectively. Pharmacy personnel was interviewed for the facility-specific indicators. The data were analyzed; results and conclusions were drawn.Results: The average number of drugs per prescription was 3.48 (SD=0.36). The percentages of drugs prescribed by generic name and from Essential Drug List or formulary were 83.98% and 68.97% respectively. The percentages of encounters with antibiotics and injections were 60.33% and 50.83% respectively. The average consultation and dispensing times were 3.89 minutes and 58.28 seconds respectively. 98.19% of the prescribed drugs were actually dispensed. 67.27% of the dispensed drugs were labelled. The percentage of patients’ knowledge of the correct dosage was 87.78%. The percentage availability of the EDL or formulary was 100% and of the key drugs in the stock was 85.71%.Conclusions: The need for improvement in prescribing practices can be encouraged by devising strategies such as training to physicians, rewards systems, etc. There should be plans to increase staff members for a particular working period and to educate patients with healthcare, hygiene, medicines’ compliance and common diseases.
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: Drug utilization studies are useful for understanding the pattern of drug use in any particular healthcare set-up. This data gives an insight to improve the medical treatment at different layers in the health system. The oobjective of the present study was to assess drug utilization patterns by using core prescribing indicators of WHO and to assess most commonly observed skin disease in Dermatology out patients department (OPD) of tertiary care hospital.Methods: 246 prescriptions from Dermatology OPD were audited. Common skin diseases and the prescribing patterns were analysed from the prescriptions.Results: Average 2.4 drugs per prescription were seen in this study. 38.7% drugs were from National Essential Drug List of India. All the drugs were prescribed by brand names. The fixed dose combinations accounted for 20.6% drugs prescribed. Dosage, dose and duration of treatment were written for 100% of prescriptions. Around 44 different skin diseases were diagnosed amongst 246 patients predominantly cutaneous fungal infections, acne, dermatitis, eczema and psoriasis. About 591 different drugs were used mainly corticosteroids (21%), antibiotics (17%), anti-allergic (16%), antifungals (11%). Common skin conditions receiving corticosteroids were dermatitis (9.9%), eczema (9.1%). Antibiotics (17%), antifungals (11%) and antivirals (1%) were commonly used antimicrobial agents. 55.2% drugs were administered topically while 44.6% received orally.Conclusions: Prescriptions revealed a higher incidence of fungal and bacterial infections. All the medications were prescribed rationally. All prescriptions had proper dosage form, frequency of administration, duration of therapy and diagnosis. However, prescriber should be motivated for prescription of generic drugs and those from essential drug list.
ABSTRACT
Background: As medical students start their clinical training, more effort goes in the direction of proper diagnosis and appropriate methods of treatment, leading to improper training in prescription writing causing prescription errors. Physicians should also be encouraged to prescribe unbranded generic medicines which are available at a cheaper price with a comparable bioavailability of drugs and not have a misconception of being less efficacious.Methods: A cross-sectional observational study was carried out over a period of 2 months (September to October 2018). Around 256 prescriptions were randomly collected from general medicine out-patient department. Informed consent was obtained verbally, and confidentiality assured. The collected data was analyzed as per descriptive statistics and compared with the derived standard values for WHO prescribing indicators.Results: The analyzed data showed an average of 2.23±1.03 drugs per prescription. 23% of the prescriptions had at least one drug prescribed by generic name, 25% of prescriptions contained an antibiotic and 31% of prescriptions had an injection. The percentage of drugs prescribed from NLEM (National list of Essential Medicines) was only 57% as compared to the recommended 100%. Additional only 22.4% of the total number of FDCs prescribed were from NLEM.Conclusions: The average number of drugs per prescription was slightly high, indicating polypharmacy. Brand name prescribing dominates as doctors are still reluctant to use generic names being doubtful of the efficacy. Regular prescription audit with reporting might help to bring awareness among doctors to follow the recommended guidelines and minimize prescription errors.
ABSTRACT
Background: Rational use of medicines promotes good health practices and prevents inappropriate use of medicines, polypharmacy, unnecessary use of antimicrobials, injections, and also encourages use of medicines from essential medicine list and dispensing by generic names. The aim of the study was to analyze the outpatient prescriptions of a tertiary care centre by utilizing World Health Organization (WHO) core drug use prescribing indicators.Methods: A retrospective observational study was conducted in a tertiary care health setup at Puducherry, South India. Outpatient prescriptions from all the major clinical departments were analyzed using WHO prescribing indicators and they were compared with some similar studies.Results: The average number of drugs per prescription was 2.74. The percentage of prescriptions with antibiotics was 20.33% and the percentage of prescriptions with injections was 0.16%. The percentage of drugs prescribed by generic names and from essential medicine list was 83.13% and 87.9 respectively. Further antibiotic utilization was found to be higher in the department of ENT (56.67%), respiratory medicine (45%) and surgery (40%). Percentage of drugs prescribed by generic names in pediatrics and respiratory medicine were found to be 67.88% and 65.27% and percentage of drugs prescribed from essential medicine list in dermatology was 69.62%.Conclusions: Prescription pattern followed in our Institute almost adheres to the guidelines laid down by the WHO. Moreover, it is also implied that a routine audit of this type should be done in health care setups to ensure that they adhere to the WHO guidelines for better health care.
ABSTRACT
Objective: The study aimed to describe the prescription pattern of cardiovascular and/or anti-diabetic drugs and adherence to the World Health Organization (WHO) prescribing indicators in Abuja District Hospitals. Methods: This descriptive retrospective study was carried out in Asokoro and Maitama District Hospitals Abuja. One thousand and nine prescriptions that contained a cardiovascular drug (CVD) and/or anti-diabetic drug issued between June 2017 and May 2018 from the Medical Outpatient Department were analyzed. Data were collected from the pharmacy electronic database, prescription pattern and adherence to WHO prescribing indicators were assessed. The analysis was done using descriptive statistics. Results were presented as percentages, means, and standard deviations. Results: The frequency of treatment was higher among women (58.8%) and the age group of 41–60 (54.8%). The average number of drugs prescribed was 3.3±1.6: the percentage of drugs prescribed in generic was (64%) and (78.8%) were from the Essential Drug List (EDL). Calcium Channel Blockers (CCB, 71.7%) and Biguanides (B, 92.4%) were the most prescribed CVD and anti-diabetic drug. The majority of the CVD (74.5%) and diabetes (63.6%) patients were on combination therapy. The most frequent CVD combination was CCB plus Angiotensin-Converting Enzyme Inhibitors/Angiotensin Receptor Blockers (29.7%). Compared to men, the proportion of females taking one or more CVD (61.3%) or antidiabetic (56.4%) was higher. Conclusion: The prescribing indicators are not optimal in Abuja district hospitals. Women received more treatment for cardiovascular and diabetes diseases than men while the age range of 41-60 was more treated than other age groups.
ABSTRACT
Background: Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’s expertise. World Health Organization has defined certain parameters to promote rational drug use in all countries. This study was designed to assess the prescription writing practices in a government tertiary care hospital in Haryana by using WHO prescribing indicators.Methods: A total of 2155 prescriptions were evaluated. Each prescription was evaluated for average number of drugs prescribed per patient per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed and percentage of medicines from Essential drug list prescribed. These indicators help us to check polypharmacy, practice of prescribing drugs by brand names, antibiotic overuse, preference of injectables and non-adherence to Essential drug list.Results: The average number of drugs prescribed per patient per encounter was calculated to be 3.25±0.24. The percentage of medicines prescribed by generic names was 35.89%. Percentage of encounters with an antibiotic prescribed was 48.21 % and with an injection prescribed was 1.85%. The percentage of medicines form NLEM was 76.36%.Conclusions: The values of WHO prescribing indicators obtained from this study show that there are some areas where the prescribers need to improve their prescribing practices.
ABSTRACT
Background: Geriatrics tend to be the largest consumers of prescribed drugs exposing them to various drug interactions and adverse drug reactions. Present study is an attempt to assess the drug utilization pattern of psychotropic drugs among the geriatrics in psychiatry out-patient department (OPD) of a tertiary care hospital in Kerala.Methods: Prescriptions of patients diagnosed with psychiatric illness and being prescribed at least one psychotropic drug were collected. Prescriptions of male and female patients of age more than 60 years were sorted and analysed separately according to WHO core prescribing indicators.Results: 18% prescriptions were of geriatric population. Depressive disorders (38.89%) were the most common psychiatric disorder encountered. Out of 291 drugs prescribed in geriatrics, 237(81.44%) drugs were psychotropic drugs. Among the total psychotropic drugs prescribed, antipsychotics (39.24%) were the most commonly prescribed class of drugs. Average number of psychotropic drugs per prescription was 2.19, drugs prescribed by generic name were 2.06% and the drugs prescribed from NLEM (2015) were 41.77%. 86.11% of prescriptions contained more than one drug and 33.33% of prescriptions contained FDCs.Conclusions: Prescription analysis using WHO prescribing indicators showed some deviations from the standard which can be improved. A trend of polypharmacy was noted in this study. Prescribing using generic name and prescribing from NLEM was low as compared to the other reference studies. Proper strategies taken to overcome the inadequacies pointed out by this study can ensure the rational use of medicines.
ABSTRACT
Background: Pharmacotherapy is the mainstay of treatment in schizophrenia. The economic impact of this illness is wide ranging, long lasting and huge. The emergence of newer antipsychotics has changed the prescribing pattern. Purpose of this study is to determine the prescription pattern of antipsychotic drugs and to analyse the drug utilization in patients with schizophrenia based on WHO prescribing indicators.Methods: A descriptive study was conducted for a period of 1-year duration at inpatient Department of Psychiatry of a Government Medical College in Kerala, India among 230 schizophrenic patients. The case sheets of patients meeting inclusion criteria were scrutinised to find out the antipsychotic prescription pattern and drug utilization was analysed using WHO prescribing indicators. Analysis was done using descriptive statistics.Results: Newer antipsychotics (55.2%) were prescribed slightly more in preference to older antipsychotic (44.8%) drugs. Out of the newer drugs prescribed olanzapine (20.9%) was prescribed the most followed by risperidone (18%). Haloperidol (22.9%) was the most frequently prescribed older antipsychotic. Majority (71.3%) of the patients were given more than one antipsychotics during the hospital stay. Trihexyphenidyl (27.9%) was the most frequently co-prescribed drug with antipsychotics. Average number of drugs per encounter was 4.19, 73.4% of the drugs were prescribed in their generic name, 50.4% of the encounters were with an injection prescribed. 44.4%of the drugs were prescribed from the EDL (WHO-19th edition). Average drug cost per encounter was Rs.45.43. Percentage of drug cost spent on injections was 8.44%.Conclusions: Newer antipsychotics were more prescribed for schizophrenia of which olanzapine was the commonest. Newer antipsychotics are preferred because of their propensity to cause less side effects and more efficacy. Study of pattern of drug utilization is useful for measuring the economic impact of drug use among patients thereby facilitating rational prescribing.
ABSTRACT
Background: Kolkata, one of the major metropolitan cities of India, is also the capital of the state West Bengal, contributes largest number of malaria cases reported from West Bengal. The present study was undertaken to assess the anti-malarial prescribing pattern in a tertiary care teaching hospital in Kolkata.Methods: This was an observational, prospective, cross-sectional study for a period of one year (from March 2017 to February 2018) in which prescriptions of diagnosed pediatric and adult malaria patients were scanned and reviewed for anti-malarial use pattern. Core drug use indicators were also analyzed to assess the rational prescribing pattern.Results: During one-year study period, 122 adult and 24 child malaria patient encounters were screened. Among adult patients, 48(39.3%) patients had P. falciparum and 74(60.7%) patients had P. vivax malaria; in children, 9(37.5%) patients had P. falciparum and 15(62.5%) patients had P. vivax malaria. All adult and pediatric P. vivax malaria patients were treated with chloroquine. Artemisinin derivatives were prescribed to 91.67% of adult and 88.88% of pediatric falciparum malaria patients, 77.09% of adults and 66.67% of children received ACT. Artemether- lumefantrine was the most commonly prescribed ACT (33.34% in adults and 55.56% in children). Prescriptions were usually in generic name and from National EDL. Percentage of encounters with antibiotics was high in both age group but percentage of encounters with injections was low in adults and children. Conclusion: Chloroquine was used rationally for treatment of P. vivax malaria patients. Artemether-lumefantrine was the most common ACT used for treatment of P.falciparum malaria cases though the National guideline for treatment of malaria does not recommend Artemether-lumefantrine for this state and region for treatment of falciprum cases.
ABSTRACT
Objective: Examining and comparing the primary and supplementary prescribing indicators in pediatric outpatients under six years old. Methods: We performed a comparative cross-sectional study, over nine months, from September 2015. 800 prescriptions for peadiatric patients under 6 y old were collected at 8 district hospitals in Can Tho city to evaluate the primary and supplementary prescribing indicators. The sample was collected prospectively by the systematic selection, with the interval between the patients is 5. The data was analysed and compared to the standard drug use indicators in developing countries recommended by WHO. Results: Average number of drugs per encounter: 4.1, percentage of drugs prescribed by generic name: 94.2%, percentage of encounters with an antibiotic prescribed: 85.8%, percentage of drugs prescribed from essential drugs list by Ministry of Health: 78.7%, percentage of encounters with a corticoid prescribed: 41.7%, percentage of encounters with a vitamin prescribed: 13.1%, average drug cost per encounter: 37.5 thousands VND, percentage of drug costs spent on antibiotics: 55.2%, percentage of drug costs spent on essential drugs: 75.7%, percentage of drug costs spent on corticoid: 1.9%, percentage of drug costs spent on vitamin: 1.4%. Conclusion: The results of this research have identified some issues in outpatient prescribing, which may lead to intervention studies for evaluating changes in these issues in the outpatient clinic.
ABSTRACT
Background: Corticosteroids are widely prescribed drugs in dermatology. Rational prescribing of steroids is important for best therapeutic outcome at lowest possible dose. A study was carried out at a tertiary care teaching hospital in order to evaluate the use of corticosteroids which provided a picture of trends in the usage of corticosteroids in dermatology at that set-up. Materials and Methods: This prospective, observational study was carried out in department of dermatology for 1 year after ethical approval. Data was analysed for parameters related to corticosteroids, their potency, WHO drug prescribing indicators, effectiveness as well as effects of corticosteroids on quality of life of patients. Statistical analysis was done using Microsoft Excel Office 365. Results: In the 223 patients, 44.84% patients belonged to 21-40 years age group. Mostcommon indication was eczema in 29.15% cases. Topical betamethasone (25.11%) and oral prednisolone (20.17%) were most frequently prescribed. 95/140 topical steroids prescribed were super highly potent. Among concomitant drugs, a majority of 38% were antihistaminics. Degree of polypharmacy showed 04 drugs in a majority (43.15%) of prescriptions. Only 6.27% drugs were prescribed by generic name. Conclusion: Corticosteroids were beneficial to a large no. of patients. Initial usage of low potency steroids topically wherever possible can be emphasized. WHO drug prescribing indicators analysis indicated the need to adhere to WHO guidelines as well as prescribing drugs by generic name. To maintain a balance between judicious use and frequent abuse with corticosteroid is important along with physician’s vigilance and patient education.
ABSTRACT
Background: Indian markets are flooded with more than 100,000 formulations, compared to approximately 350 formulations listed in the World Health Organization (WHO) essential drug list. To promote rational drug use in developing countries, assessment of drug use patterns with the WHO drug use indicators is becoming increasingly necessary. This study was conducted to study the prescribing patterns using WHO prescribing indicators in government healthcare facilities in a district of Assam. Methods: This was a cross sectional study carried out from July to September 2017. Out of total 4 blocks in Tinsukia district one (Ketetong) was randomly selected. All the primary and secondary level government health facilities were included and visited one by one. All the prescriptions on that day of visit were digitally photographed at the pharmacy of the health institution after taking written informed consent from the patient. A total of 353 prescriptions were scrutinized and analyzed using appropriate statistical tests. Results: Out of total 353 prescriptions collected, 11 were illegible and excluded from the analysis. The average number of drugs per encounter was 3.8. In 62.3% of encounters antibiotics were prescribed and injections were prescribed in 30.1% encounters. 71.8% drugs were prescribed by generic name and 56.2% drugs were prescribed from the essential drug list (EDL). Conclusions: The average number of drugs, percentage of injections and antibiotics per encounter was higher than recommended whereas prescription by generic name and from EDL or formulary was lower than recommended. Training of healthcare workers on rational drug use is need of the hour.