Evaluation of Drug Utilization Pattern Using WHO Prescribing Indicators in Endodontic Department at a Tertiary Hospital in Eastern Nepal

2020 ◽  
Vol 5 (3) ◽  
pp. 1191-1195
Author(s):  
Sushmita Shrestha ◽  
Navin Agrawal ◽  
Deependra Prasad Sarraf
Keyword(s):  
Drug Utilization ◽  
Inappropriate Prescribing ◽  
Systemic Infection ◽  
Tertiary Hospital ◽  
World Health ◽  
Utilization Pattern ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Essential Drug List ◽  
Dental Practitioners

Introduction: Irrational or inappropriate prescribing practice is common in developing countries that can lead to ineffective treatment, prolonged hospitalization, harm to the patient, increased treatment cost and development of drug-resistant organisms. The prescription of antibiotics and other drugs in endodontics is limited to patients with progressive and diffuse swelling and with systemic infection. However, antibiotics continue to be over-prescribed by more than 66% dentists without a rational justification.Therefore, the periodic assessment of drug utilization pattern is important to know the existing pattern of drug use, decrease adverse effects and provide feedback to the prescribers. Objective: To evaluate the drug utilization pattern in endodontics using the World Health Organization prescribing indicators. Methodology: A cross-sectional prospective study was conducted among the patients visiting the outpatient department of Conservative Dentistry and Endodontics. After obtaining the informed consent, the relevant data were collected on a self-designed proforma by reviewing the health cards of the patients. The WHO prescribing indicators were calculated. Descriptive statistics were calculated using SPSS version 11.0. Results: Out of 187 patients, 101 (54%) were female. Mean age was 38.9±16.6 years. Majority of the patients suffered from acute apical periodontitis (30.5%). A total of 281 drugs were prescribed to 187 patients. Paracetamol+Ibuprofen (44.1%) was the most frequently prescribed drugs. Most of the patients were prescribed one drug (78.6%).  Average drug per prescription was 1.5. Majority of the drugs (89.0%) were prescribed from Essential drug list of Nepal. Conclusions: Analgesics were the most frequently prescribed drug. The prescription practice was rational. There is need to increase the number of medicine prescribed from National List of Essential medicines.Educational initiatives should be undertaken to further strengthen the rational prescription among dental practitioners.

scholarly journals Prescribing Trends in the Out Patient Department in a Tertiary Hospital in Bangladesh

2014 ◽  
Vol 40 (2) ◽  
pp. 8-12 ◽  
Author(s):  
MM Alam ◽  
F Parveen ◽  
F Ara ◽  
MJU Iqbal ◽  
RR Saha
Keyword(s):  
Generic Drugs ◽  
Inappropriate Prescribing ◽  
Healthcare Providers ◽  
Tertiary Hospital ◽  
World Health ◽  
Intervention Programme ◽  
Cross Sectional ◽  
Essential Drug List ◽  
Prescribing Trends ◽  
Injection Use

A cross-sectional descriptive study was carried out among individuals attending the OPD of Medicine, Surgery and Gynaecology & Obstetrics from February 1st 2010 to April 30th 2010 in Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh to see the patterns of prescriptions using World Health Organization core prescribing indicators and some additional indices. A total of 300 patients were included in this study. The average number of drugs per encounter was 3.6 and 1.33% drugs were prescribed by generic name. Use of antibiotic (48% of encounters) was frequent, but injection use (1.33% of encounters) was very low. Only 43.16% drugs were prescribed from EDL of Bangladesh. Percentage of encounters with an antiulcerant, a NSAID and a multivitamin & multimineral prescribed were 69%, 68.67% and 39.33% respectively. So the finding from current study shows a trend towards inappropriate prescribing, particularly the over-prescribing of antibiotics and under-prescribing of generic drugs & from essential drug list of Bangladesh. Hence, there is a need for effective intervention programme to encourage the physicians and healthcare providers in promoting more appropriate drug use. DOI: http://dx.doi.org/10.3329/bmj.v40i2.18496 Bangladesh Medical Journal 2011 Vol.40(2): 8-12

scholarly journals Drug utilization pattern and appropriateness of prescription in IPD geriatric patients in a tertiary care teaching hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 55
Author(s):  
Shuchisuta P. Pathy ◽  
Sachchidanand Pandey ◽  
Bhabagrahi Rath ◽  
Rinu Rani Dash
Keyword(s):  
Drug Use ◽  
Drug Utilization ◽  
Geriatric Patients ◽  
Tertiary Care ◽  
World Health ◽  
Potentially Inappropriate Medications ◽  
Utilization Pattern ◽  
Geriatric Population ◽  
Prescribing Indicators ◽  
Inappropriate Medications

Background: Drug utilization research provides insights into different aspects of drug use and drug prescribing such as pattern, quality, determinants and outcomes of drug use. Polypharmacy is considered to be hazardous for the elderly, because of their greater vulnerability to drugs and multiple drug use. Prescription of potentially inappropriate medications (PIMs) has been found to be a common cause of morbidity and mortality among the geriatric population and has necessitated the creation of criteria for the safe use of medicines among them. Objectives of the study were to assess the drug utilization pattern in geriatric patients and analyse their prescriptions as per the World Health Organization (WHO) core prescribing indicators and STOPP and START criteria.Methods: An observational, cross-sectional study was conducted from May 2019 to August 2019 in inpatient department of general medicine of VIMSAR, Burla. Prescriptions of ≥65 year patients were collected and documented by active surveillance from the medicine ward.Results: Majority of the patients were in age group of 65-75. Stroke is the more common comorbidities among geriatric population. Average number of medication per prescription is 5.42. About 78.74% of drugs are injectable. The percentage of antibiotics prescribed to patient is 27.75%. Based on STOPP criteria potentially inappropriate medications PIM is 7% and START criteria PIM is 29%.Conclusions: Our study suggests that prevalence of polypharmacy was high which is usually unavoidable in geriatric patients and less PIM is suggestive of adherence to WHO core prescribing indicators, and prescription of drugs as per STOPP and START guidelines are indicative of scope for improvement.

scholarly journals Evaluation of Drug Use Patterns of Out Patient Attendees in a Tertiary Care Teaching Hospital in Dermatology and Venereology Department as a Tool to Promote Rational Prescribing

2014 ◽  
Vol 4 (1) ◽  
pp. 4-9
Author(s):  
Nushrat Noor ◽  
Md Jamal Uddin ◽  
Mohammad Afsan ◽  
Hafiza Akhter ◽  
Farhana Kabir
Keyword(s):  
Tertiary Care ◽  
Inappropriate Prescribing ◽  
Healthcare Delivery ◽  
Essential Medicine ◽  
Cross Sectional Study ◽  
World Health ◽  
Carbon Paper ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Prescribing Indicators

Background: Drug utilization studies are pre requisite for the formulation of drug policies. They offer useful methods for teaching and training in drug therapy and also identify the problems that arise from drug usage in healthcare delivery system and highlight the current approaches to the rational use of medicines. Objectives: The main objective of the prescription audit or evaluation was to measures for improving the prescription practices and to generate information on the core prescribing indicators proposed by the World Health Organization (WHO). Methods: This was a descriptive type of cross sectional study. The study was conducted in the Out Patient Department (OPD) of Dermatology & Venereology in a tertiary care private hospital, Dhaka, Bangladesh in between January and March’2012. A total of 300 prescriptions were obtained with the help of a pre-inserted carbon paper in a special format using WHO core prescribing indicators. Results: The average number of drugs per encounter was 3.8 and no single drug was prescribed by generic name. Use of antibiotic (56% of encounters) was frequent, but injection use (2.67% of encounters) was within the recommendation of WHO. The use of fixed drug combinations (FDCs) was 15.28% of prescribed drugs. Only 22.08% drugs were prescribed from national essential medicine list. Conclusion: The findings from the current study showed a trend towards inappropriate prescribing. DOI: http://dx.doi.org/10.3329/updcj.v4i1.21158 Update Dent. Coll. j: 2014; 4 (1): 04-09

scholarly journals Prescription auditing based on World Health Organization (WHO) prescribing indicators: A case of Dilla University referral hospital

2018 ◽  
Vol 8 (6-s) ◽  
pp. 21-25 ◽  
Author(s):  
Nigatu Addisu Bekele ◽  
Jarsso Tadesse
Keyword(s):  
Referral Hospital ◽  
World Health ◽  
Prescribing Practices ◽  
Essential Drug ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Rational Use ◽  
Essential Drug List ◽  
Drug List ◽  
Health Organization

Introduction: Rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time, at the lowest cost to them and their community. The issues of irrational use of medicines is global and that a global approach coordinated by WHO with more vigorous implementation of leadership and evidence based advocacy of rational use of medicine is essential Materials and Methods: Cross-sectional descriptive and quantitative study was conducted at Dilla University Referral Hospital to determine the current prescribing practices. 1440 prescription were selected using systematic random sampling and reviewed retrospectively for a 2-year period from from September 01/2016 to August 31/ 2018 using prescriptions and Prescription registry. Results: The average number of drugs prescribed per prescription was 1.813  ranging from 1 and 6. 1437(99.79%), 1287(89.38%), 1392 (96.67%), 1428 (99.17%) and 0(0%) of the analyzed prescriptions had name of the patient, date, medical record number, age and address of the patients respectively. Antibiotic and injection was prescribed in 842(58.47%) and 94(6.53%) of encounters respectively. The Percentage of drugs prescribed by generic name and from an essential drug list was 85.33% (n=2227) and 97.43% (n=2543), respectively. Of the total 2610 drugs, 2431(93.14%) drugs were actually dispensed. Conclusion: Polypharmacy, percentage of encounters with with injection and percentage of drugs from essential drug list was within acceptable range. The prescribing practice for antibiotics and generic medicines shows significant deviation from WHO. Keywords: Prescription auditing, WHO prescribing indicators,  Dilla University Referral Hospital.

Drug Utilization Pattern using World Health Organization prescribing Indicators at Otorhinolaryngology OPD of a tertiary teaching hospital of Eastern Nepal

2020 ◽  
Vol 5 (2) ◽  
pp. 1076-1081
Author(s):  
Bajarang Prasad Sah ◽  
Deepak Paudel ◽  
Deependra Prasad Sarraf
Keyword(s):  
World Health Organization ◽  
Drug Utilization ◽  
Essential Medicine ◽  
Health Sciences ◽  
Prescribing Patterns ◽  
World Health ◽  
Utilization Pattern ◽  
Prescribing Indicators ◽  
Tertiary Teaching ◽  
Health Organization

Introduction: Assessment of drug utilization pattern using the World Health Organization (WHO) prescribing indicators is important to promote rational drug therapy.It needs to be evaluated periodically to obtain information about drug utilization pattern, to detect early signals of irrational use of drugs and to provide feedback to prescribers. Objective: The objective of the present study was to assess the drug prescribing patterns in the Otorhinolaryngology OPD based on the WHO prescribing indicators. Methodology: A cross-sectional study was conducted among 148 outpatients at Otorhinolaryngology and HNS department of B.P. Koirala Institute of Health Sciences for six month duration. Patients aged 18 years and above and prescribed at least one drug were enrolled. Medical case sheets of the every fifth patients visiting the OPD were reviewed to collect the relevant data on a self-designed proforma. Descriptive statistics and WHO prescribing indicators were calculated using SPSS version 11.0. The study was approved by Institutional Review Committee, B.P. Koirala Institute of Health Sciences Results: A total of 322 drugs were prescribed to 148 patients. Most of the drugs were prescribe through oral route (69.3%). Levocetrizine (10.6%) was the commonest prescribed drug followed by Ibuprofen+Paracetamol (10.2%) and Pantoprazole (10.2%). Among systemic antibiotics, Amoxicillin+Clavulanic acid (35.9%) was the most frequently prescribed followed by Cefixime (12.8%) and Levofloxacin (12.8%). Ofloxacin + Dexamethasone (22.9%) was the most frequently prescribed topical drug followed by Mometasone (17.7%). The average number of drugs prescribed per encounter or mean was 2.2 (range 1-5). The percentage of encounters in which an antibiotic was prescribed was 33.2%. The percentage of drugs prescribed by generic name and from National List of Essential Medicine (NLEM) was 28% and 31.9% respectively. Conclusions: The drug utilization pattern did not comply with the most of the WHO prescribing indicators. The average number of drug per prescription was higher than recommended by WHO, generic prescribing was remarkably lower and prescribing from NLEM was also low.

scholarly journals Drug utilization pattern in geriatric out patient in tertiary care hospital

2017 ◽  
Vol 6 (8) ◽  
pp. 2078
Author(s):  
Rakesh R. Jadhav ◽  
Asha D. Jadhav ◽  
Sudhir L. Padwal ◽  
Anand S. Kale ◽  
Harshal N. Pise
Keyword(s):  
Drug Utilization ◽  
Tertiary Care ◽  
General Medicine ◽  
Prescribing Patterns ◽  
World Health ◽  
Inappropriate Drug ◽  
Care Hospital ◽  
Utilization Pattern ◽  
Cross Sectional ◽  
The Mean

Background: Inappropriate drug prescribing is a global problem affecting the healthcare system. Aim and objective of the study was to study the drug utilization pattern in geriatric patient at rural tertiary care hospital.Methods: This was a cross- sectional observational study involving 600 geriatric outpatient. This study was carried out from Nov 2015 to May 2016. The data were collected using predesigned proforma specially designed for this purpose. Relevant information was obtained by analyzing prescription for World Health Organization (WHO) core drug indicators.Results: Total number 600 prescriptions analyzed at the end of six months were from general medicine department. The mean age of the patients was 63.9 years in which male (61.33%) outnumber the female. Total number 2598 drugs were prescribed to 600 patients for different diseases. The mean number of drugs per prescription were 4.33, drugs were prescribed by generic name 26.42%. drugs were prescribed from WHO essential drug list86.33. The type of formulations used were tablets and capsules in 88.5%, syrups in 5%, injections 3.5 % and inhalers 2%. Drug for Cardiovascular diseases were the most common (29.66) followed gastrointestinal (16.67), vitamins and minerals (14.66). Analgesic and NSAIDS (14.13) also prescribed commonly. Antimicrobial drugs prescribed in (7.46%) and common antibiotic prescribed were Amoxicillin ciprofloxacin and metronidazole.Conclusions: This study also effectively provides very useful baseline data also demonstrates the prescribing patterns of drugs in the geriatric patients.

scholarly journals Evaluation of Drug Utilization Pattern in Cardiovascular Diseases Using WHO/ INRUD Prescribing Indicators at Cardiology OPD of Tertiary Care Hospitals in South India: A Multicenter Cross-Sectional Study

2020 ◽  
pp. 107-120
Author(s):  
Vinoth Prabhu Veeramani
Keyword(s):  
Drug Utilization ◽  
South India ◽  
Angiotensin Receptor Blockers ◽  
Tertiary Care ◽  
Cardiovascular Drugs ◽  
Utilization Pattern ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Single Drug ◽  
Tertiary Care Hospitals

Objective: Aim of this study is to assess the drug utilization pattern of cardiovascular drugs in cardiology outpatient department (OPD). Methodology: This prospective, multicenter, cross-sectional observational study was conducted at three selected tertiary care hospitals from different regions in South India. A total of 1026 prescriptions of the patients attending cardiology OPD of these selected hospitals 342 each over a period of 12 months was randomly identified and included in this study then critically analysed for WHO/INRUD core prescribing indicators. Results: Medicines prescribed from NLEM were 89.27%, average drugs prescribed was 5, medicines prescribed by its generic name were 2.33% and encounters with an injection prescribed were 14.52%. Commonly prescribed different class of drugs for CVDs patients were Anti-platelets (67.73%) followed by Statins (62.57%), Beta blockers (49.51%), ACE-inhibitors (40.93%), Angiotensin receptor blockers (30.40%), Calcium channel blockers (30.11%), Nitrates (25.34%), Diuretics (20.56%), Anticoagulants (20.27%), Vasodilators (9.94%) rest of the cardiovascular drugs were prescribed within 0.5-5% only, other class of drugs also prescribed for patients with different comorbidities are Anti-ulcers (69.10%), Opioid analgesics (4.09%), Antacids (3.80%), Anti-emetics and Pro-kinetics (1.85%), a pattern of poly-pharmacy was clearly evident, majority of drugs were prescribed as single drug (86.78%) whereas 13.21% as FDCs. The most commonly prescribed single drug was Aspirin (59.93%) and FDCs were Aspirin + Clopidogrel (40.24%). Anti-thrombotic agents’ particularly antiplatelet drugs expected to overtake anti-cholesterol drugs as the sales leader in the market. Maximum drugs were prescribed from the recent NLEM of India by most of practitioners its shows its acceptance and implementation by the prescribers. Conclusion: Deprescribing PPIs for the non-required patients is suggested to lower the risk of adverse drug interactions and economic burden to patients, also pharmacists needs to encourage the prescriptions with drugs in generic name if it’s deviated from the standards recommended by WHO/INRUD.

scholarly journals Drug Utilization Pattern by Using WHO Core Prescribing Indicators in Orthopedics and Obstetrics / Gynecology Departments of a Tertiary Care Hospital

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Naresh Karki ◽  
Ruban Raj Joshi ◽  
Buddhi Kumar Shrestha ◽  
Pravin Prasad
Keyword(s):  
Drug Utilization ◽  
Low Income ◽  
Tertiary Care ◽  
Care Hospital ◽  
Utilization Pattern ◽  
Essential Drug ◽  
Prescribing Indicators ◽  
Essential Drug List ◽  
Drug List ◽  
Prescription Form

Introduction: Drug utilization research is an important tool to facilitate rational use of drugs. In low income countries irrational use of drugs is a common problem like overuse of drugs and inappropriate use of antibiotics, leading to poor treatment outcome and increased burden of treatment. This study was conducted to provide understanding of drug utilization pattern by using WHO Core Prescribing Indicator. Methods: This study was conducted in Orthopedics and Obstetrics / Gynecology departments. Patients visiting these Out Patient Departments with at least one drug on prescription form were included in the study. Further, information related to WHO Core Prescribing Indicators were collected in pre-designed proforma. Results: Average number of drugs prescribed per prescription was 2.6. Means of number of drugs prescribed in Orthopedics and Obstetrics / Gynecology departments were 2.9 and 2.3 respectively (p < 0.001). Drugs prescribed in generic name and from essential drug list was 41.4% and 34.3% respectively. Prescription forms with generic name in Orthopedics department were significantly more compared to Obstetrics / Gynecology department (p = 0.00002). However, there was an increased tendency to prescribe drugs from essential drug list in Obstetrics / Gynecology department compared to Orthopedics department (p < 0.001). Conclusion: Drugs were prescribed by generic name and from essential drug list, but this was not sufficient to meet the ideal values of WHO Core Prescribing Indicator. Therefore, prioritization on prescribing drugs by generic name and from essential drug list by respective departments to achieve the standards of WHO needs to be encouraged.

scholarly journals Prevalence and Mortality of Cryptococcal Disease in Adults with Advanced HIV in an Urban Tertiary Hospital in Sierra Leone: A Prospective Study

2019 ◽  
Author(s):  
Sulaiman Lakoh ◽  
Hannah Rickman ◽  
Momodu Sesay ◽  
Sartie Kenneh ◽  
Rachael M. Burke ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Cd4 Count ◽  
Sub Saharan Africa ◽  
World Health ◽  
Categorical Variables ◽  
Hiv Patients ◽  
Cross Sectional ◽  
Cryptococcal Disease

Abstract Background The global annual estimate for cryptococcal disease related deaths exceeds 180,000, with three fourth occurring in sub-Saharan Africa. The World Health Organization (WHO) recommends cryptococcal antigen (CrAg) screening in all HIV patients with CD4 count <100/µl. As there is no previous published study on the burden and impact of cryptococcal disease in Sierra Leone, research is needed to inform public health policies. We aimed to establish the seroprevalence and mortality of cryptococcal disease in adults with advanced HIV attending an urban tertiary hospital in Sierra Leone. MethodsA cross-sectional study design was used to screen consecutive adult (18 years or older) HIV patients at Connaught Hospital in Freetown, Sierra Leone with CD4 count below 100 cells/mm3 from January to April, 2018. Participants received a blood CrAg lateral flow assay (IMMY, Oklahoma, USA). All participants with a positive serum CrAg had lumbar puncture and cerebrospinal fluid (CSF) CrAg assay, and those with cryptococcal diseases had fluconazole monotherapy with eight weeks followed up. Data were entered into Excel and analysed in Stata version 13.0. Proportions, median and interquartile ranges were used to summarise the data. Fisher’s exact test was used to compare categorical variables. Results A total of 170 patients, with median age of 36 (IQR 30-43) and median CD4 count of 45 cells/mm3 (IQR 23-63) were screened. At the time of enrolment, 54% were inpatients, 51% were newly diagnosed with HIV, and 56% were either ART-naïve or newly initiated (≤ 30 days). Eight participants had a positive blood CrAg, giving a prevalence of 4.7% (95% CI: 2.4-9.2%). Of those with a positive CrAg, CSF CrAg was positive in five (62.5%). Five (62.5%) CrAg-positive participants died within the first month, while the remaining three were alive and established on ART at eight weeks. ConclusionA substantial prevalence of cryptococcal antigenaemia and poor outcome of cryptococcal disease were demonstrated in our study. The high mortality suggests a need for the HIV programme to formulate and implement policies on screening and pre-emptive fluconazole therapy for all adults with advanced HIV in Sierra Leone, and advocate for affordable access to effective antifungal therapies.

scholarly journals Drug utilization pattern in outdoor patients of pediatric tertiary care hospital: a cross sectional study

2020 ◽  
Vol 9 (11) ◽  
pp. 1725
Author(s):  
Sonal M. Parekar ◽  
Girish K. Maindarkar ◽  
Vishal V. Maindarkar
Keyword(s):  
Drug Utilization ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Drug Formulation ◽  
Oral Drug ◽  
Care Hospital ◽  
Pediatric Hospital ◽  
Sectional Study ◽  
Utilization Pattern ◽  
Cross Sectional

Background: Drug utilization study is essential, as safe and effective therapeutic regimen in paediatric population is challenging. Pattern of use of drugs in pediatrics vary as compared to adults, also there is limited data available. The objective of this study was to study drug utilization pattern in pediatric patients attending pediatric outpatient department of Maindarkar pediatric hospital, Latur.Methods: A cross sectional study was carried out for a period of six months from September 2019 to February 2020, by analysing a total 1000 prescriptions of patients who had visited the OPD of Maindarkar pediatric hospital. Prescriptions were selected by simple random sampling method.Results: In our study, out of the total of 1000 prescriptions, 244 (24.4%) were of neonates, 556 (55.6%) were of infants (1 month to 1 year) and 200 (20%) were of children above 1 year. 547 (54.7%) prescriptions were of male patients and 453 (45.3%) were of female patients. The most frequent classes of drugs prescribed were nonsteroidal anti-inflammatory drugs 704 (70.4%), followed by drugs used for respiratory disorders 655 (65.5%) and supplements (60%). Antimicrobials were prescribed in 498 (49.8%) prescriptions. The average number of drugs per prescription was 2.45. About two third of all the prescribed drugs (74.41%) were from national essential medicine list. Most of the prescriptions had oral drug formulation 825 (82.5%) followed by inhalational 208 (20.8%) followed by injectables 150 (15%). All the drugs were prescribed by brand names.Conclusions: Our study helps health-care system to understand, interpret and improve prescribing, administration, to minimize adverse events and promote rational use of medicines.

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