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OBJECTIVE To summariz e the expe rience of the ability training of prescription-auditing pharmacists in prescription pre-audit，and introduce the typical cases of the prescription-auditing pharmacists participating in the drug intervention. METHODS From October ，2020 to October ，2021，under the audit mode of “prescription pre-audit system+prescription-auditing pharmacists ” adopted by Yuxi People ’s Hospital （hereinafter referred to as “the hospital ”），the abilities of prescription-auditing pharmacists were cultivated from the aspects of training in pharmaceutical related professional knowledge ，training in the use of Chinese and English medical retrieval tools ，databases and websites ，and clinical thinking and communication ability ；through the construction of ability evaluation form of prescription-auditing pharmacists ，their abilities were assessed. RESULTS & CONCLUSIONS After one year ’s ability training ，the rational rate of prescription （doctor’s order ），the proportion of doctors ’active revision of problem prescription （doctor’s order ）and the doctor ’s acceptance rate of intervention by prescription-auditing pharmacists showed an upward trend ，the average time of irrational prescription （doctor’s order ）by prescription-auditing pharmacists showed a shortening trend ，and the intervention rate of prescription （doctor’s order ）showed a downward trend. In addition to the publication of papers （belonging to the bonus item ），the average score of the ability evaluation form of prescription-auditing pharmacists had significantly increased ， from 45.2 in October 2020 to 97.6 in October 2021.
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Background: Chronic wounds are responsible for increase in burden to healthcare systems. The evidence concerning effectiveness of antibiotic therapy or optimal regimens is insufficient. Patients with chronic wounds receive significantly more systemic and topical antibiotics. Current guidelines for antibiotic prescribing for such wounds are often based on expert opinion rather than scientific fact. As there is increasing prevalence of antibiotic resistance, the relationships between antibiotic resistance and rationales for antibiotic therapy have to be determined. Current practice of antibiotic usage for chronic wounds and postoperative wounds in a tertiary care setting should be studied.Methods: Retrospective study was conducted from February 2017 to February 2018 using medical records of patients with wound admitted in surgical departments in HIMS, Hassan, Karnataka. The inpatient records were analysed, which includes duration of stay in the hospital, number of drugs/products per person, percentage of antibiotics prescribed, percentage of antibiotic injection prescribed, and other modalities used to treat wounds.Results: In present study, amongst 100 antimicrobial prescriptions, 26 females and 74 males. The most commonly prescribed parenteral antibiotic was ceftriaxone (58%), followed by metronidazole (56%). The average number of antibiotics per prescription was 2.8. The mean duration parenteral antibiotics given was 4.26 days during their hospital stay oral antibiotics were 5.18 days after the discharge from the hospital.Conclusions: The information generated shall be used to decide the policies to govern the prescription of antibiotics in the management of chronic wounds and post-operative wounds.
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Background: Cardiovascular disease is a common term which encompasses a range of disorders that affect the heart. Cardiovascular disease is the leading cause of death among men and women in India and across the globe. There is evidence of irrational drug use in cardiovascular disorders. Drug utilization study is used to evaluate the rationality of medication use. The objective of this study was to observe the most frequently treated emergency cardiovascular diseases and to study the prescribing pattern among inpatients admitted in CICU Unit of tertiary care teaching hospital.Methods: A retrospective, observational drug utilization study was designed to evaluate the drug prescribing pattern in cardiovascular emergency patients admitted in CICU unit of tertiary care teaching hospital. Study was carried out for a duration of 4 months. Data were collected from patient case reports after getting permission from Medical superintendent of hospital. Prescribing pattern of drugs were studied based on WHO indicators.Results: Total 150 patients were included in the study. Most common cardiovascular emergency reported was Myocardial infarction (60.66%) followed by Angina pectoris (24.66%). The most common comorbidities found along with cardiovascular emergency were hypertension (62.66%) followed by Diabetes mellitus (15.33%). Most prescribed cardiovascular drugs were from the category of hypolipidemics (94.66%) and anti-platelets (92.66%). Average number of drugs per prescription was found to be 9.42. Average hospital stay per patient was found to be 4.25 days. Percentage of drugs prescribed by generic name was 70.66%. Percentage of drugs prescribed from essential drug list and National list of essential medicines were 87.4% and 97.23% respectively.Conclusions: All the drugs prescribed were according to the current guidelines. Majority of the drugs were prescribed in generic form.
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Background: Coronary artery disease (CAD) is a major cause responsible for mortality more in younger age group than in elderly. Studies have reported underuse of four evidence based medicines namely aspirin, β-blockers, angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin receptor blockers (ARB), and statins in patients with CAD, particularly in developing countries. Therefore, this study was planned to analyse the prescriptions of patients with CAD to determine the appropriateness of the prescriptions.Methods: After obtaining the Institutional ethics committee permission, a cross sectional observational study was conducted at a tertiary care hospital. Total 150 patients were enrolled from the outpatient department, wards and intensive care unit of medicine department. Total 150 patients’ prescriptions presenting with varied category of CAD were screened and analysed.Results: The most common categories of CAD encountered was ST segment elevated myocardial infarction (N=50, 33%) followed by chronic stable angina (N=29, 20%). Among the drugs prescribed, antiplatelet drugs were prescribed to 135 (90%), hypolipidemics to 134 (89%), nitrates to 114 (76%), beta blockers to 97 (65%), ACE inhibitors to 94 (64%), anticoagulants to 60 (40%) and miscellaneous drugs to 52 (35%), patients. Of 68 (45%) patients with type 2 diabetes mellitus, 15 (22%) were prescribed only metoprolol and others were given ACE-I or ARBs.Conclusions: Among four evidence based drugs, use of 3 drugs, antiplatelets, beta blockers and hypolipidemics was apparent in 90% of prescriptions. Use of ACE inhibitors and ARBs was observed in type 2 diabetic patients with CAD, reflecting rational prescribing behavior of clinicians.
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Background: Prescription audit is a tool as well as a technique by its application,all professionals will improve the quality of prescribing drugs. Standards of medical treatment can be assessed by prescription audit. It is based on documented evidences to support diagnosis, treatment and justified utilization of hospital facilities. Prescription audit is a quality improvement process that seeks to improve patient care. In this background the present study was conducted. The objectives of the study were to know the frequently prescribed drugs in OPD, number of the drugs used per prescription and to find out the rationality.Methods: Study was conducted at Sri Chamarajendra Hospital, HIMS, Hassan in OPD of General Medicine.1000 prescriptions were collected and noted down the frequently used medication, number of drugs prescribed and their type of formulations for the particular diagnosis.Results: From the study it is noted that 1910 drugs out of 1000 prescriptions were prescribed which is approximately 1.91 drugs per prescription about 55% of the prescriptions contained single drug. Very few received 4-5 drugs (7%). Almost all the drugs in prescriptions were in Generic names. Around 95% of prescriptions doses were mentioned in mg, ml etc. The most commonly prescribed drugs in order are Antibiotics, antidiabetics antihypertensives, bronchodilators, steroids antiemetics and ORS were prescribed.Conclusions: Polypharmacy was not found in our prescriptions which indicates our prescriptions improved the patient conditions. This type of study will ensure to know the 慞� drug development and select the essential medicine list for various levels of health care.
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Introduction: The World Health Organization (WHO) proposed core-prescribing indicators for prescription audit and drug utilization studies. The focus of Indian studies has mainly been on the WHO core-prescribing indicators such as the range and number of drugs per prescription. Critical evaluation of prescriptions including rational auditing of prescriptions of patients admitted at Psychiatry Ward of Jawaharlal Nehru Medical College Hospital, A.M.U., Aligarh, from the period of 31/05/2013 to 30/05/2015. Materials and Methods: Permission for retrospective study to access medical records of the past 2 years of all patients admitted in the Psychiatry ward from 31/05/2013 to 30/05/2015 was obtained from the competent authority. Prescriptions of 44 patients (26 female, 18 male) were available in the Central Record Section during this period. The following parameters were taken to analyse and audit prescriptions as per WHO prescribing indicators: 1) Patient details, 2) Mention of diagnosis, legibility & spelling mistakes, 3) Details of the consultant, 4) Use of antibiotics/antipsychotics by various routes, 5) Provision of proper instructions to patients and 6) Additional parameters - Percentage of prescriptions with nutritional supplements and antacids. Results: Only 36% of prescriptions contained the full names of patients, while age, sex and address were present in 84.09% of the prescriptions. 100% prescriptions were found written with complete diagnosis and contained the signature of the concerned doctor. None of the prescription had the doctor’s contact number. A mean number of 3.18 drugs were written per prescription. All prescriptions were legible and 2.27% contained spelling mistakes. Insufficient instructions for both oral and injectable drugs were mentioned on all prescriptions. Conclusion: As per WHO laid guidelines, study related to drug use indicators are simple as a supervisory tool to assess prescribing patterns by individual doctors. These prescription studies provide scope to improvement in prescribing patterns and promotion of rational use of drug among practitioners.
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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.