PRESCRIPTION AUDITING BASED ON THE WORLD HEALTH ORGANIZATION (WHO) PRESCRIBING INDICATORS IN OUTPATIENT DEPARTMENT OF A TEACHING HOSPITAL IN KERALA
DOI:
https://doi.org/10.22159/ajpcr.2021.v14i5.41305Keywords:
Prescription auditing, Prescribing indicators, Outpatient departmentAbstract
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.
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References
Gillian P, Nathan G. Medication misuse in India: A major public health issue in India. J Public Health 2015;38:150-7.
Muhammad A, Muhammad RS, Muhammad A, Danial U, Abdul R, Arslan R, et al. Assessment of WHO/INRUD core drug use indicators in two tertiary care hospitals of Bahawalpur, Punjab, Pakistan. J Pharm Policy Pract 2016;9:1-8.
Mishra S, Sharma P. Prescription audit and drug utilization pattern in a tertiary care teaching hospital in Bhopal. Int J Basic Clin Pharmacol 2016;5:1845-9.
Igbiks T, Joseph OF. Drug prescription pattern in a Nigerian tertiary hospital. Trop J Pharm Res 2012;11:146-52.
Maryam GF, Shekar HS. Audit of prescriptions in a tertiary care hospital-a retrospective study. World J Pharm Pharm Sci 2016;5:886-94.
Sneha K, Haider S, Kashyap V, Singh SB. A study on pattern of prescription writing practices at Rajendra institute of medical sciences Ranchi. Indian J Prev Soc Med 2014;45:100-4.
Kusum K, Prakash K. Study of drug prescribing pattern in a Tertiary Care Hospital in Jharkhand. Int J Biomed Res 2017;8:85-8.
Ahsan M, Shaifali I, Mallick AK, Singh HK, Verma S, Shekhar A. Prescription auditing based on World Health Organization (WHO) prescribing indicators in a teaching hospital in North India. Int J Med Res Rev 2016;4:1847-52.
Hemangini RA, Manish JB, Narendra PP, Tripathi CB. Prescription audit in outpatient departments of a tertiary care teaching hospital: A cross-sectional study. Eur J Pharm Med Res 2017;4:372-9.
Pavan KK, Srinivasa BR, Sangeetha K, Reddy YJ, Sai KG. A study of prescription audit in outpatient department of a tertiary care teaching hospital in India: An observational study. J Drug Deliv Ther 2017;7:92-7.
Debasis B, Chandra NB, Suman C, Prasanta S. A study of prescription auditing in a tertiary care teaching hospital of Eastern India. J Drug Deliv Ther 2014;4:140-9.
Uday RS, Prabhakar S, Ambika A, Roshani S, Bhupendra R, Mishra SK. Pharmacoepidemology of prescribing drugs in Tertairy Care Hospital in Central India: Rewa, Madhya Pradesh in years 2013-14. Int J Res Pharm Biosci 2014;1:8-14.
Ofori-Asenso R. A closer look at the World Health Organization’s prescribing indicators. J Pharmacol Pharmacother 2016;7:51-4.
Promoting Rational use of Medicines: Core Components. WHO Policy Perspectives on Medicines. Geneva: World Health Organization; 2002. p. 1-6.
Patil KR, Mali RS, Dhangar BK, Bafna PS, Gagarani MB, Bari SB. Assessment of prescribing trends and quality of handwritten prescriptions from Rural India. J Pharma Sci Tech 2015;5:54-60.
Anjan A, Arijit G, Rania I, Srijita G, Santosh B, Subhajit P. Assessment of prescribing pattern with World Health Organization prescribing indicators in outpatient departments of a tertiary teaching Hospital in Eastern India: A cross sectional study. Eur J Biomed Pharm Sci 2017;4:657-61.
Naveen A, Ramesh B, Teki S. Prescription auditing in regard with the prescription patterns in a tertiary care teaching hospital. Asian J Pharm Clin Res 2018;11:176-80.
Shahid H, Zahida P, Seema G, Dinesh K, Rohini G, Shivani T. A study of prescription auditing in rural health care setting of North India. Int J Med Sci Public Health 2016;5:2461-5.
Bekele NA, Tadesse J. Prescription auditing based on World Health Organization (WHO) prescribing indicators: A case of Dilla University Referral Hospital. J Drug Deliv Ther 2018;8:21-5.
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