Drug prescribing and dispensing pattern in pediatrics outpatient clinic of a rural tertiary-care teaching hospital

Abstract

Background: Children constitute 40% of India’s population. They tend to suffer more frequently from illnesses, when compared with adults and elderly. Most of these illnesses are self-limiting. There are reports that these illnesses are treated inappropriately leading to polypharmacy. Children are more vulnerable to the various adverse events related to the use of drugs. Evaluation of drug utilization in adults and elderly people is a highly visible topic, but similar studies in children are limited. Aims and Objective: To evaluate the pattern of drug prescribing and dispensing in pediatric outpatient clinic in a rural tertiary-care teaching hospital using WHO Core drug use indicators. Materials and Methods: A cross-sectional study was carried out in the pediatric outpatient clinic of Swami Ramanand Teerth Rural (SRTR) Medical College, Ambajogai, Maharashtra, India. Data were collected by scrutinizing the prescriptions written by the treating physician in pediatric outpatient clinic, using WHO core drug use indicators and by interviewing parents of 300 children attending outpatient clinic. Result: The average number of drugs per prescription was 3.4 and actually dispensed was 2.5. There was a high trend of using brand names (49.6% of prescriptions) while prescribing than generic names. Use of antibiotics (60.6% of prescriptions) was frequent, but injection use (0.8% of prescriptions) was very low. A high number of drugs prescribed (77.5%) conformed to WHO list of essential medicines for children and were dispensed (69%) by the hospital pharmacy. The parents’ understanding of the correct usage of drugs was low (59%), and only 10.5% of drugs were adequately labeled. The copy of an essential drugs list was available. The availability of essential drugs was 75%. Conclusion: This study highlights the problem of overprescribing of antibiotics, inadequate labeling, and a trend toward polypharmacy. The prescribing from WHO list of essential medicines for children was fair; the use of injections was low. Interventions to rectify overprescription of antibiotics, use of brand names, and inadequate labeling of drugs is necessary to improve rational drug use.