Outpatient prescribing trends, rational use of medicine and impact of prescription audit with feedback at a tertiary care centre in India.

Abstract

Rational use of medicines (RUM) is highly desired worldwide yet many shortcomings are found. This study aims to evaluate prescription pattern and RUM using World Health Organisation (WHO) prescribing indicators. The impact of audit and feedback has also been studied, along with comparison with published data. A cross-sectional observational study was conducted in the outpatient department setting of a tertiary care centre in central India. Data were collected from 2719 prescriptions across different departments from hospital pharmacies from 2016 to 2018 at different time periods. The data was analysed using WHO core prescribing indicators. Average number of drugs per prescription was found to be 2.53±1.23 (WHO optimal value≤2). The mean values of prescribing indicators for antibiotics (19.82% vs.≤30%) and injection prescribing (1.98% vs. ≤10%) were within optimal values. Generic prescribing (15.96% vs. 100%) and prescribing from National List of Essential Medicines (NLEM; 37.37% vs. 100%) were found to be significantly lesser. Annual audit and feedback showed improvement in generic prescribing and prescribing from NLEM, but the other trends continued to be similar. While use of antibiotics and injections among outpatients was found to be rational, there is scope of improvement in most domains that can be addressed with appropriate interventions.