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 Morbidity profile and prescription audits using WHO core prescribing indicator in government hospitals of Province 1, Nepal

2021 ◽  
Vol 3 (2) ◽  
pp. 15-22
Author(s):  
Shambhu Shah ◽  
Prasanna Dahal ◽  
Anil Kumar Sah ◽  
Surya B. Parajuli ◽  
Naveen Shrestha
Keyword(s):  
Metabolic Diseases ◽  
Healthcare Delivery ◽  
Circulatory System ◽  
Essential Medicine ◽  
Cross Sectional Study ◽  
World Health ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Essential Medicine List ◽  
Tertiary Hospitals

Background: Periodic assessment of morbidity and drug use at various levels of healthcare delivery system is important to recognize common prevalent morbidities and rationalize the use of medicines. The study was conducted to determine the common morbidities and audit prescription using WHO prescribing indicator in government operated tertiary hospitals of eastern Nepal. Methods: A cross-sectional study was carried out in government tertiary hospitals of Province 1, Nepal, from March 2019 to August 2019. For analysis, descriptive statistics were used.  Prescribing characteristics were evaluated using recommended guidelines of the World Health Organization (WHO) prescribing indicators. Results: Six hundred prescriptions were analyzed. The most prevalent morbidity was endocrine, nutrition & metabolic diseases (21.5%) followed by diseases of the respiratory system (19.8%), circulatory system (17.6%), and digestive system (12.8%). The most frequently encountered individual disease entity were hypertension (18.7%), diabetes (15.5%), acid peptic disorders (14%). A total of 2072 drugs were prescribed with an average of 3.45 (± 1.39) drugs per consultation. About 30.2% of prescriptions encountered contain at least one antibiotics, whereas injectable were prescribed in 1.8%. Only 3.9% of total medicines were prescribed in generic name and 31.7% of drug prescribed were from essential medicine list. Conclusion: Among the prescriptions evaluated, diseases of the endocrine, respiratory, cardiovascular, and gastrointestinal systems were the most common morbidities. Polypharmacy was prevalent to some extent whereas prescribing in generic and essential medicine list was poor relative to standard WHO recommendations. However, the overall prescribing of antibiotics and injection were found to be satisfactory.

scholarly journals Assessment of infrastructure of first referral unit facilities in Surguja division: a responsibility of providing emergency obstetric care

2019 ◽  
Vol 6 (12) ◽  
pp. 5168
Author(s):  
Abha Ekka ◽  
Shubra A. Gupta ◽  
Divya Sahu ◽  
Anmol Madhur Minj ◽  
G. P. Soni
Keyword(s):  
Healthcare Delivery ◽  
Essential Medicine ◽  
Emergency Obstetric Care ◽  
Obstetric Care ◽  
Cross Sectional Study ◽  
Civil Infrastructure ◽  
Healthcare Delivery System ◽  
Cross Sectional ◽  
Physical Infrastructure ◽  
Maternal And Newborn

Background: Availability of emergency obstetric care (EmOC) is one of interventions to reduce maternal and newborn deaths. The health system fails when effective and affordable health interventions do not reach the population, when Poor infrastructure, drugs and equipment are lacking, and qualified human resources are scarce. The objective of the present study was to assess the availability of EmOC infrastructure in first referral units (FRUs) of Surguja division, Chhattisgarh.Methods: A cross sectional study was designated with 13 FRUs of Surguja division. A semi structured, closed-ended questionnaires was observed on the basis of check list, reviewing record, and interview by available staff.Results: FRUs of Surguja division for physical infrastructure scored 68.5%, for essential medicine 69.2%, for equipments 50.7%, for instruments 45.3% and for availability of blood 34.6%, for health man power category of specialist score was 25.7% but for supportive staff 65.4%.Conclusions: Our study revealed three existing bottlenecks in the healthcare delivery system as inadequate civil infrastructure, short fall of specialists as well as inadequate supplies of drugs and equipment, hampering the function of facility.

scholarly journals PRESCRIPTION AUDITING BASED ON THE WORLD HEALTH ORGANIZATION (WHO) PRESCRIBING INDICATORS IN OUTPATIENT DEPARTMENT OF A TEACHING HOSPITAL IN KERALA

2021 ◽  
pp. 147-151
Author(s):  
DHANYA T H ◽  
SANALKUMAR K B ◽  
ANDREWS M A
Keyword(s):  
Tertiary Care ◽  
Essential Medicine ◽  
Outpatient Department ◽  
World Health ◽  
Fixed Dose ◽  
Care Hospital ◽  
Research Committee ◽  
Cross Sectional ◽  
Prescribing Indicators

Objectives: The objectives of the study were to study the pattern of major drug groups prescribed, assess the Rational Prescription pattern by measuring the WHO Core Prescribing Indicators and to assess the quality of the prescriptions by assessing the legibility of prescription in the outpatient department of a tertiary care hospital. Methods: It was an analytical cross-sectional study done in hospital pharmacy for a period of 6 months. Approval from Institutional Research Committee and Institutional Ethics Committee was taken before starting the study. Sample size was taken as 1020. Results: One hundred and twenty prescriptions were analyzed. About 49% prescriptions were of males and 54% of females. Mean age of the patients were 46 years. A total of 3557 medicines were prescribed in 1020 prescriptions. Due to lack of legibility, we were unable to decode 122 medicines out of 3557 medicines prescribed. The dosage forms prescribed were; oral 87.4%, injections 1.4%, inhalational agents 0.4%, and topical agents 10.8%. Average number of medicines per prescription was 3.5. Percentage of medicines prescribed by generic name was 45%. Percentage of antibiotics per prescription was 24.8%. Percentage of injections per prescription was 4.8%. Percentage of medicines prescribed as per NATIONAL essential drugs list (EDL) was 3.2% and as per the WHO EDL was 2.6%. Percentage of fixed dose combinations (FDCs) was 6.5%. Conclusion: It was evident that polypharmacy was present as indicated by the average number of medicines prescribed. Medicines prescribed by generic name and from Essential Medicine List were less in number. Antibiotics and injections prescribed was in conformity with the WHO recommended values, which means that there was no irrational use of antibiotics and unwanted use of injectables. Percentage of FDCs was 6.5%. Most commonly prescribed drug was Ranitidine as per our study. Hence, as per this study, prescribers did not follow prescribing core indicators of the WHO closely, except for two indicators. The quality of prescriptions with respect to legibility and clarity was found to be optimal.

scholarly journals A comparative study of drug prescribing indicators in various hospitals of West Bengal, India

2018 ◽  
Vol 6 (6) ◽  
pp. 2063
Author(s):  
Arijit Ghosh ◽  
Anjan Adhikari ◽  
Rania Indu ◽  
Srijita Ghosh ◽  
Santosh Banik ◽  
...  
Keyword(s):  
West Bengal ◽  
Essential Medicine ◽  
Minimum Cost ◽  
Cross Sectional Study ◽  
Health Facilities ◽  
World Health ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Rational Therapy ◽  
Health Organization

Background: Rational use of drugs is essential to ensure safety and welfare of patients. Thus, prescription audits are conducted to monitor the practice of writing prescriptions. Various standard parameters have been rationalized by World Health Organization (WHO) in order to regulate drug utilization, globally. Present study aimed to compare the pattern of prescriptions generated in different healthcare centres of West Bengal.Methods: A cross-sectional study was conducted in the inpatient and outpatient departments of RG Kar Medical College, Kolkata, in order to evaluate the prescriptions. Literature was also surveyed with the keywords “prescription audit”, “West Bengal”, to extract data on prescription audits conducted in various other hospitals of West Bengal. The WHO prescribing indicators of all these health facilities were then compared to estimate the rationality of drug prescribed by different physicians.Results: Seven published reports of prescription audits were published from the period of 2013 to 2017, the distribution being- 2 health facilities from Kolkata, 2 from Burdwan, 1 each from Bankura, Murshidabad and North Bengal. WHO standards were not strictly followed by any of the hospitals. Polypharmacy level were higher in all the hospitals. Drugs were mostly prescribed from the essential medicine list (EML).Conclusions: Present study clearly indicated that it is essential to improve these parameters for most of the healthcare centres in order to prevent irrational use of drugs. Prescription audits should also be implemented regularly so that the patients can receive better treatment at minimum cost with suitable rational therapy.

scholarly journals Core Prescribing Indicators and the Most Commonly Prescribed Medicines in a Tertiary Health Care Setting in a Developing Country

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Priyadarshani Galappatthy ◽  
Priyanga Ranasinghe ◽  
Chiranthi K. Liyanage ◽  
Maheshi Wijayabandara ◽  
Dinuka S. Warapitiya ◽  
...  
Keyword(s):  
Clinical Medicine ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Clinical Information ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Rational Prescribing ◽  
Prescribed Medicines

Irrational prescribing is common, especially in developing countries. It is important to identify the magnitude of irrational use, to take necessary steps to promote rational prescribing. We identified core prescribing indicators and commonly prescribed medicines at ward settings (IW) and outpatients’ clinics (OPC) in a tertiary care hospital in Sri Lanka. A descriptive cross-sectional study was carried out at IW and OPC settings. Prescriptions were obtained from 5 major specialties (Clinical Medicine (CM), Gynaecology and Obstetrics (GO), Paediatrics, Psychiatry, and Surgery). The WHO core prescribing indicators were used to describe the pattern of prescribing, and the most commonly prescribed medicines were identified. A total of 1,318 prescriptions were analyzed. The five most commonly prescribed medicines were paracetamol (31.0%), omeprazole (20.6%), folic acid (18.3%), atorvastatin (16.2%), and salbutamol (15.3%). The average number of medicines per encounter was 4.8 ± 3.6 (IW: 5.7 ± 4; OPC: 3.8 ± 2.8; p < 0.001 ), with the highest IW (7.8 ± 4.2) and OPC (7.8 ± 2.7) values were from CM, being significantly higher than all other disciplines ( p < 0.05 ). Percentage encounters with an antibiotic or an injection was 26.4% and 30.1%, respectively, with IW being significantly higher than OPC ( p < 0.001 ). Percentage of medicines prescribed by generic name and from the essential medicine list (EML) was 90.1% and 91.1%, respectively, with no significant IW and OPC difference. In conclusion, a high degree of polypharmacy was noted. The use of injectable medicines, prescribing from the EML, and generic name prescribing was satisfactory; however, overall rational prescribing needs further improvement. Further investigation into the degree of rational prescribing associating it with clinical information will be important.

Assessment of Antibiotic Prescription Pattern Using who Prescribing Indicators and Aware Categorization of Antibiotics

2021 ◽  
Vol 15 (11) ◽  
pp. 2872-2875
Author(s):  
Sidra Mushtaq ◽  
Fatima Javed ◽  
Mufakhara Fatimah ◽  
Zaeem Sohail Jafar ◽  
Syeda Tahira Zaidi ◽  
...  
Keyword(s):  
Healthcare Delivery ◽  
Treatment Guideline ◽  
Cross Sectional Study ◽  
University Hospital ◽  
World Health ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Prescription Pattern ◽  
Optimal Value

Background: Medicines play a crucial role in the healthcare delivery of a hospital. The appropriate use of medicines gives us assessment of the quality of health services being provided in a particular region. Aim: To evaluate the prescribing practices and antibiotic utilization patterns so that the extent of irrational use can be assessed by comparing them with published ideal values set by WHO. Study design: Retrospective, cross-sectional study. Place and duration of study: Teaching Hospital of Faisalabad: Independent University Hospital (IUH), from Jan 2018 to June/July 2018. Methodology: 200 cases were selected through systematic random sampling from medicine/surgery wards and pharmacy registers. The standard World Health Organization prescribing indicators and AWaRe categorization of antibiotics were used to assess the prescribing practices of physicians/surgeons. Published ideal standards for each of the indicators were compared with study findings to identify extent of irrational drug use. Results: Most of the facility indicators were met with. The Drug and Therapeutic Committee (DTC) was functional. The Standard treatment guideline booklets (STGs) and Essential Drugs List (EDL) of the hospital were available. 88% of the key drugs listed in EDL were available in stock. The expenditure on antibiotics compared to total medicines was 17%. Regarding prescribing indicators: the average number of drugs prescribed per encounter was 6 (optimal value 1.6–1.8). Average no of antibiotic per prescription amounted to almost 1 (0.925). % prescriptions with an antibiotic amounted to 72% (optimal value 20-26.8%).72% antibiotics were prescribed from the EDL formulary of the hospital (optimal value 100%). Conclusion: Regarding compliance with prescribing indicators and AWaRe categorization of antibiotics by WHO, significant deviation was observed. Education and training of physicians according to WHO parameters is required to ensure rational prescribing. Keywords: Prescription pattern, WHO Prescribing Indicators, AWaRe Categorization

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.

PRESCRIPTION PATTERN OF PSYCHOTROPIC DRUGS IN A PSYCHIATRY OPD OF A TERTIARY CARE HOSPITAL – A CROSS SECTIONAL STUDY.

2021 ◽  
pp. 191-194
Author(s):  
Kishore M S ◽  
Narendra Kumar ◽  
S Sindhu
Keyword(s):  
Psychotropic Drugs ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
World Health ◽  
Fixed Dose ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prescription Pattern

Background: The expanding and challenging eld of psychopharmacology is constantly seeking new and improved drugs to treat psychiatric disorders. Psychotropic drugs utilization in actual clinical practice, effectiveness and safety in the real-life situation needs continuous study. Therefore, the study was undertaken to analyze the prescription pattern of psychotropic drugs. Methods: A Cross sectional study was conducted in the psychiatry out-patient department of a tertiary care hospital for 4 months. Diagnosis was made according to ICD-10 criteria. Prescription pattern was analyzed using World Health Organization (WHO) drug indicators. Results: Psychotropic drugs constituted 74.85% of the prescribed medication. Average number of the psychotropic drugs per prescription was 2.53. Percentage of prescriptions with injectable drugs accounted for 5.13%. 59.28% of the drugs were prescribed by generic names, while the rest were branded. 28% of prescriptions contained psychotropic FDCs (Fixed dose th combination). 78.65% of the drugs were from the WHO's 18 List of Essential Medicines. Among the total psychotropic drugs prescribed, antipsychotics (43.87%) were the most commonly prescribed class of drugs followed by antidepressants (23.32%), anxiolytics (22.13%) and the mood stabilizers (9.88%) were the least. Conclusions: Prescription pattern of the psychotropic drugs were in accordance to the recommendations of various treatment guidelines. Antipsychotics were the most commonly prescribed psychotropic drugs.

Assessment of antipsychotic prescribing in Belgian nursing homes

2011 ◽  
Vol 23 (8) ◽  
pp. 1240-1248 ◽  
Author(s):  
Majda Azermai ◽  
Monique Elseviers ◽  
Mirko Petrovic ◽  
Luc van Bortel ◽  
Robert Vander Stichele
Keyword(s):  
Nursing Homes ◽  
Inappropriate Prescribing ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Prescribing Indicators ◽  
Prescribing Quality ◽  
Homes For The Elderly ◽  
Combined Use ◽  
Antipsychotic Prescribing

ABSTRACTBackground: Given the potential adverse effects of antipsychotics, high use in nursing homes creates concern. Our study goal was to explore the use of antipsychotics in relation to resident characteristics, and to assess the appropriateness of antipsychotic prescribing in Belgian nursing homes.Methods: Data were used from a cross-sectional study (Prescribing in Homes for the Elderly; PHEBE) conducted in 76 nursing homes in Belgium. Antipsychotics were classified into typical and atypical, using the anatomical therapeutic and chemical classification. Ten inappropriate antipsychotic prescribing indicators were selected from the updated Beers criteria (2003), Bergen District Nursing Home Study (BEDNURS) indicators, and Screening Tool of Older People's Prescriptions criteria (STOPP).Results: The residents' mean age was 84.8 years, 78.1% of whom were female. The prevalence of antipsychotic utilization was 32.9%. Antipsychotics were mainly indicated for dementia-related agitation, and psychosis with/without dementia. Higher use of antipsychotics was found for dementia (OR: 3.27; 95% CI: 2.61–4.09), insomnia (OR: 1.38; 95% CI: 1.10–1.73), depression (OR: 1.30; 95% CI: 1.03–1.65), and age <80 years (OR: 1.79; 95% CI: 1.38–2.33). Inappropriate antipsychotic prescribing indicators scoring the highest among users were: long-term use (92.6%), use despite risk of falling (45.6%), combined use with other psychotropics (31.8%), and duplicate use (15.1%). Inappropriate prescribing was associated with depression (OR: 3.41) and insomnia (OR: 2.17).Conclusion: The indicator-driven analysis of antipsychotic prescribing quality revealed a need for improvement, with the main prescribing problems relating to duration and combination of therapies. Risks/benefits of off-label use need to be evaluated more consciously at the start of therapy, and at periodic re-evaluations.

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