Prescription Audit, Drug Utilization Pattern and Adverse Drug Reaction Monitoring in Outpatients of Orthopedics Department of Tertiary Care Teaching Hospital: A Pilot Study

Abstract

Background: The domain of orthopedic illnesses is grossly underrepresented in the current healthcare scenario especially due to overreliance on mortality rather than the morbidity or dysfunction. Continuous introduction of new drugs in the field of pharmacology requires holistic utilization, effectiveness, and side-effects studies. In addition, inappropriate use of drugs poses a risk of adverse drug reactions (ADRs). Our study aims to analyze the prescription pattern in outpatient department of orthopedics at a tertiary care hospital of Delhi. Methodology: The study was carried out in 210 patients who attended the orthopedics outpatient department for a period of 3 months. Patient demographic details, duration of illness, comorbid conditions, drugs prescribed, ADRs, and usage of complementary and alternative medicine were used to analyze the pattern of drug use. Results: In our study, we observed that vitamins and mineral preparations (20%) was the most commonly prescribed class of drugs followed by nonsteroidal antiinflammatory drugs (11.42%). Polypharmacy was seen in most of the prescriptions (60.95%), but 100% of the drugs were from Essential Medicine List of Government of National Capital Territory, Delhi. About 75% of the prescriptions were prescribed by generic names. ADRs were reported in 30 patients and majority of them were mild in nature (96%). Complementary and alternative medicine was used by 13.3% of the study patients. Conclusion: Majority of the drugs were prescribed by generic names and were essential medicines. Trend of polypharmacy was noted. Injudicious use of multivitamins and calcium was seen. Nonsteroidal antiinflammatory drugs were a significant part of therapy. ADRs reported were generally mild in severity and involved gastrointestinal tract. Need of the hour is to conduct frequent prescription audits to inculcate good prescribing practices.