THE RATIONALITY OF DRUG PRESCRIPTIONS AT THE GYNAECOLOGY DEPARTMENT IN A TERTIARY CARE TEACHING HOSPITAL IN KELANTAN

Sami Mustafa Alshakhshir,Mohd Pazudin,Mahmoud Sadi Alhaddad,Syed Azhar Syed Sulaiman

doi:10.21315/mjps2021.19.1.3

Abstract

The aim of this study is to assess the rational prescribing pattern of drugs for pregnant women using World Health Organization (WHO)/International Network for Rational Use of Drugs (INRUD) core drug prescribing indicators. A one-year retrospective research design from (October 2016–September 2017) was used to review pregnant women prescriptions from their medical records at Hospital Universiti Sains Malaysia (HUSM). A structured data collection form using WHO/INRUD document on prescribing indicators was used. Data was sorted and categorised according to the US Food and Drug Administration (USFDA) pregnancy classification systems and Anatomical Therapeutic Classification (ATC). Then, data was compared with the references values of WHO/INRUD. Descriptive analysis were performed using SPSS version 20. A total of 741 medical files met the study inclusion criteria. The average number of prescribed drugs per prescription and the percentage of prescribed drugs from hospital formulary list and health ministry list were within the acceptable range listed by WHO. Whereas, the percentage of pregnant women with antibiotics and injection drugs were lower than normal values 17.67% and 8.23%, respectively. Percentage of prescribed drugs from categories C and D were 13.8% and 2.8%, respectively. Whereas 24.8% of prescribed drugs were from unclassified risk category. On the other hand, multivitamins preparations were the highest category of prescriptions 17.7%. Injections and number of antibiotics per encounter were lower than the recommended range listed by WHO. However, a great caution and careful prescribing behaviour of physicians were noticed at gynaecology/obstetric departments and most of the prescribed medications were rational and safe during pregnancy.

Highlights

Using medications during pregnancy is considered as a big challenge. This is mainly due to the physiological and pharmacokinetic profile changes that occur to pregnant women which may enhance the harmful effects of drugs on both mother and unborn baby
After consulting gynaecologists in the hospital, we were told that less than 50% of patients who visited gynaecology department are prescribed with medications and some of them are prescribed with labouring medications.to exclude any repetitions in our study, we decided to screen a total of 2,600 medical file through using systematic random sampling technique by determining the sampling interval as: 8,000/2,600 = 3
Researchers reviewed a total of 2,600 medical files for pregnant women who attended the Gynaecology Department at Hospital Universiti Sains Malaysia (HUSM) within the study period

Summary

Introduction

Using medications during pregnancy is considered as a big challenge. This is mainly due to the physiological and pharmacokinetic profile changes that occur to pregnant women which may enhance the harmful effects of drugs on both mother and unborn baby. In 1985, World Health Organization (WHO) defined rationale use of drugs as “The rational use of drugs requires that patients receive medication appropriate to their clinical needs, in doses that meet their requirement for an adequate period and at the lowest cost to them and their community” (Bhartiy et al 2008; WHO 2012). All the medications are preferred to be prescribed with small doses for short periods, to avoid polypharmacy and to minimise the side effects and drugdrug interactions (Salwe, Kalyansundaram and Bahurupi 2016)

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