Rationale Treatment of GERD During Pregnancy: A Prescription Audit Using who Core Drug use Indicators

Abstract

Background: GERD is a common condition worldwide. It is also frequently seen during pregnancy due to hormonal changes and increasing intra-abdominal pressure. Treatment is usually focused on resolving symptoms. In this regard life style modification and pharmacological interventions are done. But prescribing during pregnancy is a risk benefit condition. Irrational prescribing is a routine practice nowadays. Prescribing during pregnancy needs more care. To avoid hazards associated with irrational prescribing WHO has developed five indicators. Aim and objective: This study was designed to find out prescription mistakes during pregnancy using WHO core drug use indicators. To provide clinicians with prescribing guidlines in order to avoid future discrepancies while prescribing. Method: It was a cross sectional study. Data was obtained from outpatient obstetric departments and analyzed. Result: Antacids, PPIs, Ranitidine and metoclopramide were frequently used drugs. All drug classes are present in essential drug list of Pakistan 2021.Only 8% of the total drugs were prescribed by generic name. Number of drugs per encounter was minimum 5%.Number of injections per encounter was also within standard range 23%. About 20% of prescription were expensive which is a high cost for an under developing country like Pakistan. Practical implication: Good prescribing puts positive impact on patient’s physical and mental health. Conclusion: There should be a shift of prescription from brand name to generic name. Control of prescription cost is another issue highlighted. WHO core drug use indicators are only limited to outpatient Departments. These are of limited value for in doors patients where drug prescriptions are more complex. Keywords: Drug use WHO Drug use, GRED, Pregnancy, Pakistani Women