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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.
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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.
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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.
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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.
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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.
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Background: Drug utilization studies are an important tool in evaluating the rationality of therapeutic practice and also it is said to improvise the therapeutic use of drugs. The present study will be undertaken to evaluate the drug utilization pattern in the department of Radiotherapy.Methods: This was a prospective, observational study that was undertaken in the department of Radiotherapy in a tertiary care teaching hospital. The study was conducted for a period of 6 months after obtaining permission from Institutional Ethical Committee. The study was conducted among cancer patients undergoing radiotherapy. The data was collected from the patient case records and was analyzed as per the WHO prescribing indicators.Results: In the present study it was observed that the average number of drugs prescribed per encounter was 7.7. The drugs prescribed by generic name were 41.4%. Percentage of encounters with an antibiotic prescribed was 100. Percentage of encounters with an injection prescribed was 20.5%. Percentage of drugs prescribed from essential drugs list was 35.8%.Conclusions: Drug utilization studies helps in modifying the prescription pattern and helps in making the drug usage more rational.
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Background: Older people are potentially at greater risk of medication error. Gaining insight into the prescribing pattern especially in eye diseases as they are a common problem in elderly, in order to identify prescribing related problems is the fundamental step in improving the quality of prescription and patient care.Methods: Prescriptions fulfilling inclusion criteria were collected from hospital Medical record department (MRD) and analyzed using the World Health Organization (WHO) core prescribing indicators for rationality of prescriptions.Results: Among 811 prescriptions analysed, 52.7% (428) were of male patients, those aged 60-70 years were 77.2% (626) and patients with only cataract constituted 77% (625). Prescriptions with oral antibiotics were 57.1% (334); topical antibiotics were 35.8% (429) and topical analgesics 46.2% (553). Out of 1182 FDCs noted, 59% (479) were found to be rational and 34.6% (281) were from Essential Medicines List 2014. Only 2% (61) drugs were prescribed using generic name while 64.06% (1606) of drugs were from the WHO Model List of Essential Medicines (April 2015). Average number of drugs per encounter was 3.7. Percentage of encounters with antibiotics was found to be 43.8% and no prescriptions with injections were noted.Conclusions: Although usage of antibiotics and topical drugs was conforming to WHO recommended standards, there is a need to improve prescription pattern by using generic names and drugs from Essential Drug List.
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Background: India is an agrarian country, where pesticides are most widely used in farming. Monsoon dependent agricultural practices are common in India. In present study socioeconomic class and prescribing pattern of commonly used drugs in organophosphate poisoning in indoor setting at tertiary care hospital is evaluated. The aim of the study was to evaluate prescribing trend of drugs and socioeconomic class of patients in organophosphate poisoning in monsoon season.Methods: Prospective observational study was conducted at Medical Intensive Care Unit (MICU) and Medicine Wards for 4 months at 540 bedded tertiary care teaching hospital.Results: Total 64 diagnosed cases were enrolled and analyzed in present study (n=64). Maximum number of cases (57.81%) were male followed by female (42.18%). Most of the cases (37.50%) were from the age group of 21-30 years. 49 (76.56%) patients were of primary intentional poisoning followed by 15 (23.43%) patients of accidental poisoning. Most common drugs prescribed were atropine, pralidoxime, cefotaxime and ranitidine. The average amount of atropine and pralidoxime used per patient/day were 37.89±63.63 mg and 10.07±26.87 gm respectively.Conclusions: Present study revealed that young male adults with low socioeconomic class from rural background were prone for intentional organophosphate poisoning in central India.
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Background: Utilization pattern of antipsychotics has undergone a major shift as the newly introduced atypical antipsychotics have heralded the market. Hence continuous studies on current prescribing trends are needed to provide most updated, effective and rational treatment of psychoses.Methods: This cross-sectional prospective study was conducted at Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India. OPD tickets of the department of psychiatry for the year 2016-2017 were evaluated for a total of 310 cases. These prescriptions were used to determine the drug utilization of antipsychotics and for their appropriateness against the WHO recommended core prescribing indicators.Results: A total of 310 patients satisfied the inclusion criteria and a male predominance was seen (male:female= 1.3:1). The most common psychotic disorder diagnosed was schizophrenia (44%). Majority of the patients (76%) received monotherapy and the prescribing trend showed a higher use of atypical antipsychotics (89%) over typical ones (11%). The most commonly prescribed anti-psychotic drugs were olanzapine (31%), followed by risperidone (26%). On analysing prescriptions according to the WHO core prescribing indicators it was observed that average number of antipsychotics prescribed per prescription was 1.32. 24% of drugs were prescribed by generic name and 5.2% were administered via injectable route. Drugs prescribed from National list of Essential Medicine, 2015 constituted 46%.Conclusions: The high inclination towards the use of atypical antipsychotics observed in our study correlates with the global changing trends in the treatment of schizophrenia. WHO prescribing indicators should be adhered to, to impart rational prescribing.
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Background: Drug utilization studies (DUS) are used as potential tool in the evaluation of healthcare system. DUS are conducted to facilitate the rational use of drugs in populations. The indicators of prescription in practice measure the performance of health care provider in several key dimensions related to appropriate use of drug. Therefore, the present study was undertaken to analyze the prescription written by doctors in a Tertiary Care Hospital in rural area.Methods: Present study is a cross sectional, prospective and observational study. The study was conducted in a rural tertiary, teaching hospital at JIIU’s Indian Institute of Medical Science and Research, Warudi, Taluka Badnapur from January 2017 to September 2017 for duration of 9 months. Data was obtained from 300 prescriptions. Data was analysed as per WHO prescribing indicators.Results: Average number of drugs in the present study was found to be 2.85. Percentage of drugs prescribed by generic name is 13.48%. Percentage of encounters with an antibiotic prescribed 60%. Percentage of encounters with an injection prescribed 4.33%. Percentage of drugs prescribed from essential drugs list 72.91%.Conclusions: These types of studies help to design policy for rational use of drugs and motivation of physician for rational use of drugs.
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Background: Irrational prescribing of medicine results in serious morbidity and mortality as well as additional economic burden and also lead to reduction in the quality of treatment; thereby causing wastage of resources, increased treatment cost, increased risk for adverse drug reaction, and emergence of resistance. WHO has generated indicators in three main drug use areas; prescribing, patient care, and facility specific factors. Methods: This study was carried out with the aim of identifying prescription pattern of antibiotics and evaluates the rationality of prescriptions in accordance with WHO prescribing indicators. 300 prescriptions were examined from the inpatient department (IPD) of a tertiary care teaching hospital from the Department of Medicine, Surgery, and Orthopedics. The IPDs were visited twice a week. Each prescription was followed for the duration of 5 days. The prescribing and dispensing details from each prescription were recorded in a tabular form as mentioned in data acquisition form. The data were analyzed as per the WHO core drug use indicators. Results: This study clearly highlights the practice of polypharmacy, low uses of generic drugs, injudicious usage of antibiotic, and injection and low usage of the drug prescribed from essential drug list. Conclusions: Multi-faceted interventions are required at many levels for the benefits of the community in the form of continued medical educational programs, consumer awareness, formation of hospital formulary, and undergraduate clinical pharmacology and therapeutics teaching.