Average Number Of Drugs Research Articles

Incidence and types of dispensing errors in the pharmacy of a tertiary care charitable hospital

IntroductionDispensing errors challenge the patient safety and may induce unwanted and noxious events. The objective of this study was to estimate the incidence and types of dispensing errors in the pharmacy of a tertiary care charitable hospital. Materials and methodsThis was a prospective observational study conducted for a period of 15 months in the patient counseling area of a 1000 bed hospital. A suitable data collection tool was developed and was approved by the research advisory committee. The required data were obtained randomly from 1852 patients visiting the hospital's pharmacy. The collected data were analyzed for incidence and types of dispensing errors using SPSS (version 20.0). ResultsA total of 5353 drugs were dispensed on 1852 prescriptions. The average number of drugs per prescription was found to be three (2.89). The maximum number of drugs prescribed in a prescription was twelve and the minimum was one. Pantoprazole was the most frequently prescribed drug (n = 633, 34.18%). A total of 26 dispensing errors were identified in 21 prescriptions, accounting for a rate of 1.40%. Out of the total errors identified, wrong dose was found to be the most common type of dispensing error accounting for (n = 8, 30.76%), followed by incorrect labeling and wrong quantity (n = 4, 15.38% each). ConclusionThe incidence of dispensing errors was 1.4% and most of the errors were related to the dose/strength of the dispensed drugs.

Prevalence of Diseases and Pattern of Medicine Used by Retired Armed Forces Personnel Attending at a Military Hospital

Introduction: Retired armed forces personnel constitute a large group of population whose treatment is ensured by the armed forces. Their disease prevalence and medicine use pattern will help the authority to take more effective decision for managing their ailments. Objectives: To observe the medicine use patterns and disease prevalence among retired armed forces personnel. Materials and Methods: This cross-sectional prescription evaluation was carried out on 546 prescriptions obtained from Others Rank (ORs) Pharmacy of Combined Military Hospital (CMH), Dhaka from mid June to mid July, 2020. According to World Health Organization’s (WHO) core prescribing indicators analysis, number of drugs/prescription, percentage of drug written in generic name, percentage of prescription with an injection, percentage of prescription with antimicrobials and percentage of prescription containing local purchase drugs were calculated. Results: All the patients were male and their age ranges from 38 to 84 years with mean age of 58.6 years. Half of the patients were in 55 to 64 years age groups. About 43% patients had two chronic diseases. The average number of drugs per prescription was 5.3 drugs. Patients with single disease required less number of drugs/prescription (3.7) compared to patients having two (5.6) and multiple diseases (8.2). Hypertension was the most frequent diagnosis (n=330) and diabetes was the 2nd frequent diseases (n=307). Conclusion: The average number of drug per prescription corresponds to the number of diseases. The retired armed forces personnel with active adult life (55-64 years) suffer more than the elderly (more than 65). Hypertension and diabetes mellitus are the most prevalent diseases. JAFMC Bangladesh. Vol 18, No 1 (June) 2022: 12-15

Assessment of Drug Use in a Tertiary Hospital in Southeast Nigeria Based on Who Core Drug Use Indicators

Background: Irrational use of medicines is a global phenomenon and an issue of concern with so many undesirable consequences. The complex nature of the pharmaceutical care process is an indication for an essential tool that investigates drug use pattern in health facilities. The WHO released the core drug use indicators to address these issues. The study assessed drug use in a tertiary hospital in southeast Nigeria based on WHO core drug use indicators. Methods: A cross-sectional descriptive study design was used and the study was conducted from October 2021 to June 2022. Retrospectively, 300 prescriptions were selected and reviewed using systematic random sampling for a year from 2020 -2021 to investigate prescribing indicators. A total of 120 randomly selected patients and pharmacy personnel were observed and interviewed to investigate the patient-care and facility-specific indicators. The WHO/INRUD core drug use indicators were used to assess the patterns of drug use in comparison to the result gotten. Results: The average number of drugs per encounter was 2.76, the Percentage of drugs prescribed by generic names was 78.02%, the Percentage of antibiotics prescribed was 33.33%, and the Percentage of injections prescribed was 1.67%. Average consulting time in minutes was 17.5 minutes, the average dispensing time in seconds was 92.1 seconds, the Percentage of drugs actually dispensed was 76.97%, Percentage of adequately labeled was 100%, and the percentage of patients’ knowledge of correct dosage was 90%. The facility did not have an Essential Drug List but had all (100%) the key drugs listed by the WHO drug list. Conclusion: All of the prescribing indicators deviated from the WHO/INRUD recommended optimal values. Patient-care and facility-specific indicators deviated from the optimal values except that of the average consultation time, average dispensing time, percentage of drugs adequately labeled, and 100% availability of key drugs. Although a few of the WHO benchmark for rational drug use were met, the outcomes were not satisfactory and required interventions to improve rational drug use in the facility.

Prescription Patterns of Drugs Used in Patients with Coronary Artery Disease at Tertiary Care Hospital

Background: The Cardiovascular disease is emerging as one of the leading cause of morbidity and mortality worldwide. To determine the appropriateness of the prescriptions and various trends in treatment, so as to provide the basis for modification in the future drug usage in accordance with risk factors and clinical presentations and also assess the improvement of health-related quality of life of patients with coronary artery disease.
 Methods: A prospective, observational and cross-sectional study was conducted in Department of Pharmacology in collaboration with Department of Medicine of tertiary healthcare hospital. As per inclusion criteria, patients visiting Medicine Outpatient department (OPD) from November 2021 to January 2022 were enrolled in the study.
 Results: Total 360 prescriptions were analysed, most of them belonged to the age group of 61-75 years. The prevalence was higher in Females (54%) than males (46%). An average number of drugs per prescription was 4.5. All the drugs were prescribed by generic names. 90.63% drugs prescribed were included in World Health Organization (WHO) essential drugs list 2021. 98.40% drugs prescribed were included in National list of essential medicines (NLEM) 2015. Antiplatelets (99.44%) were the most commonly prescribed category of drugs, followed by hyperlipidaemic (96.67%).
 Conclusion: The overall analysis of prescription pattern suggests that most of the drugs were prescribed rationally according to current American College of Cardiology Federation/American Heart Association (ACC/ AHA) guidelines. The incidence of polypharmacy was in the normal limits as per WHO recommendation. Generic drugs were prescribed majorly, which promotes awareness amongst prescribers, supporting WHO policies.

“DRUG UTILIZATION STUDY IN PATIENTS VISITING GYNAECOLOGY OPD AT TERTIARY CARE HOSPITAL”

Gynaecological diseases are common in India because of socio-economic conditions, hygiene literacy problems. Women health is one of most neglected issues in developing countries like India. With the increasing awareness, the ow of patients visiting gynaecology outpatient department (OPD) has increased. Gynaecological drugs are one of the strong selling drugs in pharmaceutical market. Drug utilization research facilitate appropriate use of drugs in patient, minimize the adverse event and lead to better patient outcome. This study revisits the utilization patterns of drugs used in the gynaecology OPD. A prospective, observational and cross-sectional study was conducted in Department of Pharmacology in collaboration with Department of Obstetrics and Gynaecology of tertiary healthcare hospital. Total 360 prescriptions were analysed, most of them belonged to the age group of 31-50 years. The Average number of drugs per prescription is 3.2. 38.33% were found to be infective while 61.66% were non-infective. Total 1876 drugs were prescribed. Among all drugs, Hematopoietic agents were most commonly prescribed (46.69%) followed by antimicrobials (29.16%). 98.40% drugs were prescribed by generic name and by 1.60% brand name. 91.95% drugs prescribed were included in WHO essential drugs list 2021. 96.69% drugs prescribed were included in National list of essential medicines (NLEM) 2015. In this study it was observed that majority of patients visiting the OPD were from urban areas, as the women from rural areas depend on peripheral health services, so it is crucial to strengthen the peripheral health services, to reduce the mortality and morbidity amongst the population.

Drug Utilization and Pharmacoeconomic Evaluation of Oral Hypoglycemic Agents in the Endocrinology Department of a Tertiary Care Hospital

The objective of the study was to assess the drug utilization pattern and pharmacoeconomic evaluation of oral hypoglycemic agents in a tertiary care hospital. A prospective observational study was conducted among 153 diabetic patients above 18 years who visited the endocrinology outpatient department for 6 months, and who were prescribed at least one oral hypoglycemic agent. Cost-effectiveness was calculated using the Average Cost-Effectiveness Ratio. Drug utilization pattern of Oral Hypoglycemic Agents monotherapy showed that Metformin was utilized more in that hospital (n=35). Among combination therapy, Glimepiride + Metformin combination was prescribed the most (n=66). The average number of drugs per encounter was 5.88. 18.2% of drugs were prescribed by generic name. 17.64 of drugs encounter with an antibiotic. 13.07% of drug encounters with injections. 55.82% of drugs were prescribed from the Essential Drug List. Among the diabetes population, Metformin was the most utilized drug, followed by Vildagliptin, and Glimepiride + Metformin combination was utilized most. Overall, the prescribing trend of drugs was found to be irrational. Cost-effectiveness analysis found that Glimepiride 1 mg was the cost-effective drug, and also found that the combination of Glimepiride 0.5mg+ Metformin 500 mg was the cost-effective hypoglycemic agent.

DRUG UTILIZATION PATTERNS USING WHO CORE PRESCRIBING INDICATORS IN DIFFERENT OUT PATIENT DEPARTMENTS AT SECONDARY CARE HOSPITAL, KARIMNAGAR

Aim:The aim of this study is to assess the prescribing patterns of medicines, apply the World Health Organization (WHO) core indicators and to assess the appropriateness of prescribed medicines in a pediatric unit. Materials and Methods:A prospective observational drug utilization study of outpatients was carried out in secondary care hospital for a period of 2 months. Patients who attended different units were included in the study and patients who were not willing to participate in the study were excluded and the data collected from the hospital were analyzed. Results:Out of 150 patients, the average number of drugs per patient was 4.56. The percentage of drugs prescribed with the generic name was found to be 19.16%. Among 150 prescriptions 49.78% of the drugs were prescribed from essential drug list. Among the antibiotics 33.33% were prescribed, cephalosporin group were the most commonly prescribed followed by amino glycoside and penicillin. Nearly, 21.80% of the medicines were given as intravenous and the prescriptions without drugs were 1.43%. Only 75.6% of patients have knowledge about their dosage schedule and almost all the prescriptions were appropriate. Conclusion:The assessment of WHO core indicators helped to improvise the prescribing pattern, identify significant problems involved in the knowledge gap of patients or caretakers understanding of instructions provided by consultants and even to minimize the cost burden on patient.

Evaluation of prescribing pattern based on World Health Organization indicators in Maharashtra during COVID-19 pandemic

Introduction: Community pharmacy (CP) is one of the health care centers that have a key role to play in the current COVID-19 pandemic period. Prescriptions monitoring studies are essential as this helps in understanding the current prescribing pattern adopted by physicians. Furthermore, only few CP-based research studies were noted. This study was conducted with an aim to study prescribing pattern using World Health Organization (WHO) indicators from few community pharmacies in Maharashtra, India, during COVID-19 Pandemic period. Material and Methods: An observational study was conducted and sample comprised of prescriptions collected from different parts of Maharashtra (Mumbai, Pune. and Nashik). One thousand and fifty-six prescriptions were collected and data was collected for a period of 6 months (August 2020–January 2021). The variables of interest in this study were: Number of medications in each prescription, number of prescriptions with generic names, number of antibiotics and injectables in each prescription, number of prescribed drugs from essential drug list (EDL), and defined daily dose (DDD). Results: Out of 3058 drugs prescribed, it was found that average number of drugs per prescription was 2.89 (standard deviation ± 1.37). Only 23 (0.75%) were prescribed by generic name. Antibiotics and injectables were 399 (37.78%) and 29 (2.74%), respectively. Drugs that were prescribed from EDL were only 920 (30.08%). The total class of antimicrobial agents prescribed (Anatomical Therapeutic Chemical group J01) was 13. After calculating DDD, DDD of Azithromycin was found to the highest (81.6 g). Conclusion: Among five WHO indicators, only the percentage of encounters with an injection was in compliance with the WHO recommended value. Further studies are required for better understanding of this area.

PHARMACOEPIDEMIOLOGY OF DRUGS UTILIZED IN SKIN OUTPATIENT DEPARTMENT OF A TERTIARY CARE HOSPITAL

Periodical auditing of drug utilization is vital for the purpose of promoting rational use of drugs. So, for pharmacoepidemiological analysis of the drugs, used in skin OPD, a study was held prospectively for 3 months, in the department of Skin and Pharmacology. Data were collected from prescription form of the patients in OPD. Various parameters of utilization pattern was evaluated. The maximum number of patients belonged to age group of ---------years and lower middle class of socioeconomic status but there was no sex preponderance. Dosage, duration and frequency of therapy was recorded in more than 89% of prescriptions. the average number of drugs per prescription were 2.69 ; drugs prescribed with their generic names were 26.04% ; xed dose combinations prescribed were 36.98% and polypharmacy found were 23.3% of prescription in the OPD. The commonest dosage form were -----------. More than 80% of drugs were prescribed from hospital pharmacy. Average total cost per prescription was ---------INR in OPD; but was free of cost from hospital pharmacy.

Study to Assess the Drug Consumption and Rationality in the Prescription of Outpatients Undergoing Periodontal Treatment

Drug utilisation research is essential in clinical practice because it serves as the foundation for implementing changes to drug dispensing rules at the local and national levels. The ultimate goal of such a study is to make drug usage more reasonable. This prospective cross-sectional study aimed to collect data on drug utilisation among dental patients from Himachal Pradesh's Department of Periodontics to identify possible targets for improving drug prescribing habits. After applying inclusion and exclusion criteria, data were collected prospectively from a total of 849 medical records of patients. The patient's information included their OPD number, age, sex, health problem description, and prescription parameters, including medicine name, route, strength, dose form, quantity, duration, investigations, provisional diagnosis, and therapy. Prescriptions were analysed using WHO core drug indicators and WHO ATC/DDD approach to calculate drug consumption. The most prescribed antibiotic was amoxicillin, separately or in combination. The number of DDD consumed and the DDD/1000 population/day was the maximum for vitamins, followed by antibacterial and non-steroidal anti-inflammatory drugs. The average number of drugs per encounter was 2.2. The percentage of encounters with an antibiotic in prescription was very high i.e., 72.3%. Only 37.6% of medications were prescribed, from NLEM 2015, and 14.60% generic names were prescribed. The dental practitioners did not adhere to WHO prescribing guidelines. The lowered number of prescriptions for generic names was a subject of worry

Patterns of prescription and adverse drug reaction profile of Non- Steroidal Anti-Inflammatory Drugs at orthopedic out-patients department

Non-steroidal Anti-inflammatory Drugs (NSAIDs) are the most prescribed drugs all over the world. These are used in the treatment of pain and inflammation. Systematic evaluation of prescription patterns and monitoring of adverse drug reactions is required to increase the therapeutic benefit and decrease the adverse effects of these drugs. An observational, cross-sectional study was conducted for 6 months from September 2021 to February 2022 in 300 patients prescribed least one NSAID to assess the prescription patterns and adverse drug reaction profile (ADR) of NSAIDs prescribed in the orthopedic outpatient department. Among enrolled patients 52% were female and 48% were male. The most common age group was 20-39. The average number of drugs per prescription was 2.89. A total of 868 drugs were prescribed, out of which 402 were NSAIDs (46.31%). Naproxen was the most prescribed agent (45.02%), followed by Diclofenac (17.17%). ADR was reported in 12% of patients. Most of the ADRs were due to Naproxen (72.18%) followed by Ibuprofen (16.66%). The gastrointestinal system was involved in maximum patients and the most common ADR was abdominal pain. Most of the drugs were prescribed by brand name 95.18%. Naproxen was the most prescribed NSAID and responsible for most ADRs. There was a higher prevalence of irrational prescribing, polypharmacy, and underreporting of ADR. A strategy must be developed and implemented for prescribing and rational use of NSAIDs and monitoring their harmful effects.

DRUG UTILIZATION STUDY IN TRAUMA INTENSIVE CARE UNIT

Objective: Trauma is defined as major public health problem worldwide and associated with significant morbidity and mortality both in developed and developing countries and to study prescription pattern in TICU among head trauma patients. Methods: The study was conducted in Trauma Intensive Care Unit of Department of Surgery in a Tertiary Care Hospital. This was a prospective, observational study done at a Tertiary Care Teaching Hospital. A total of 637 patients enrolled in the present study with fulfilling inclusion and exclusion criteria. Patient’s data recorded in case report form and analyzed to study the prescription pattern. Results: A total of 637 cases were enrolled in this study. Trauma was more common in 499 (78.34%) male followed by 138 (21.66%) female. The average duration of stay in TICU was 3.62±1.38 days. In this study, mortality rate in study was 17.27 %. In the current study, the total numbers of drugs prescribed per prescription in TICU are most commonly between 5 and 8 (55.26%) drugs followed by between 9 and 12 drugs were 37.83%. The present study states that the most common prescribed drugs used were ranitidine (100%) followed by ondansetron (89.64%). Among antimicrobials cephalosporins were most commonly used ceftriaxone (31.08%) and cefotaxime (27.63%). Conclusions: The aim of study is monitoring and evaluation of the prescribers as well as recommends necessary modifications to achieve rational medical care. Study outcomes suggesting that admission to TICU is more in middle age group with mean age of 40.2 years. Average numbers of drugs prescribed were 8.76 drugs per patients which shows the trends of polypharmacy in the prescriptions.

The prevalence of polypharmacy and fall-risk-increasing drugs after hospital discharge for hip fracture: A retrospective study.

Objectives:To evaluate the incidence of polypharmacy and the use of fall-risk-increasing drugs (FRIDs) in patients >65 years of age.Methods:478 patients >65 years old, discharged from an Orthopaedic Department because of hip-fracture surgery, capable of walking before surgery, were included. The baseline characteristics of the patients and the total numbers of drugs and FRIDs were recorded from the electronic hospital registration system. Polypharmacy was defined as the average daily use of five or more drugs. The gender differences in drug prescriptions were calculated.Results:All the patients took medications except for eight (1.7%); 46% of the patients were taking <5 medications, while 386 (80.8%) were taking ≤3 FRIDs. The female patients were taking more drugs (5±2.7) and FRIDs (2.4±1.3) than the male ones (4.5±3 and 1.9±1.3) (both p<0.01). The average numbers of drugs and FRIDs prescribed at discharge were 4.9±2.8 and 2.3±1.3, respectively. The Barthel Index was higher for patients taking <5 drugs, while the length of hospital stay was greater for patients taking ≥5 medications. Increased age was associated with taking ≥5 medications (p<0.05).Conclusions:Polypharmacy and FRID use are prevalent among patients over 65 years old who have been hospitalized and surgically treated because of hip fractures.

AN ANALYSIS OF THE PREVALENCE OF POLYPHARMACY AMONG INPATIENTS OF A TERTIARY CARE HOSPITAL IN KERALA

Objectives: The aim of the study was to estimate the prevalence of polypharmacy, identify the age groups commonly associated with polypharmacy, study the correlation between duration of hospital stay and polypharmacy, and identify the diseases commonly associated with polypharmacy Methods: Record-based, prospective, and cross-sectional study among 370 inpatients of a tertiary care hospital in Kerala. Prescriptions containing ≥3 drugs were collected from inpatient medical records of patients with at least 3 days hospital stay. The number of drugs ≥5 was considered as polypharmacy in the present study. Results: The prevalence of polypharmacy was 93% and average the number of drugs per prescription was 8.81±3.097. Average number of drugs per prescription was significantly high among patients &gt;60 years. Percentage of prescriptions with polypharmacy among patients with duration of stay 3–5 days, 6–8 days, and ≥ 9 days was found to be 89.4, 98.6, and 100, respectively. There was a significant positive association between duration of hospital stay and percentage of prescriptions with polypharmacy as well as average number of drugs per prescription. Diseases or comorbidities most commonly associated with polypharmacy were hypertension, diabetes mellitus, cerebrovascular accidents, coronary artery disease, and dyslipidemia. Conclusion: The prevalence of polypharmacy was high in the present study (93%) when compared to similar studies. Age &gt;60 years was strongly associated with the prevalence of polypharmacy, but gender was not found to be factor. Duration of hospital stay was an important factor positively associated with percentage of prescriptions with polypharmacy as well as number of drugs per prescription.

CURRENT TRENDS IN PRESCRIBING PATTERN OF ANTI-MIGRAINE DRUGS IN PATIENTS OF MIGRAINE AT A TERTIARY CARE TEACHING HOSPITAL

Background. An inappropriate prescribing pattern of antimigraine drugs by doctors may often encourage inappropriate self-medication by patients because of the asymmetry of medical information. Objective. The study is aimed to assess the current trends in prescribing patterns of anti-migraine drugs, rationality of prescription, and pattern of migraine severity in patients of migraine. Methods. A cross sectional study was conducted at a tertiary care teaching hospital. All the prescribing details including patient’s demographic details, diagnosis, details of drug therapy (drug name, dose, duration, and frequency) were recorded. Rationality of prescription was assessed using the WHO core drug prescribing indicators and the pattern of severity of migraine was assessed using MIDAS scoring system. Results. Out of 85 patients, 71 were female (83.5%), mostly around 21-30 years of age, and 27 (31.7%) patients had other comorbidities. Naproxen was the most commonly used NSAID for termination of acute migraine attack (15.3 %). The most common drugs prescribed for prophylaxis included beta adrenergic blockers (Propranolol, 14.66%), antidepressants (Amitriptyline, 9.33% and Fluoxetine 3.33%), and antipsychotics (Prochlorperazine, 4.66%). Domperidone (17.30%) was the most commonly prescribed antiemetic. Prescription of triptans was low (2.66%) with Rizatriptan as the most commonly prescribed triptan. Conclusions. The current study revealed that further improvements are required in prescribing practices especially in average number of drugs per prescription, prescription of drugs with generic names, and prescription of drugs of the essential drugs list.

Prescription Audit among Geriatric Patients Admitted in a Tertiary Care Hospital

This study aims to evaluate the drug utilization pattern in terms of defined daily dose (DDD) among geriatric patients admitted in medical intensive care unit (MICU) of a tertiary care hospital. Retrospective medical record analysis was performed for the geriatric patients (age ≥65 years) admitted in MICU from 1st June 2021 and 31st December 2021. The relevant data were collected in a proforma. The drugs were categorized by anatomical therapeutic classification and their DDD was calculated. Diabetes mellitus was the most common cause for admission. Parenteral preparations (51.12%) constituted the largest share among all the drugs prescribed. Pantoprazole - A02BC02 with DDD 25.3 was the most commonly prescribed parenteral drug (23.5%). Amlodipine - C08CA01 with DDD 29.0 was the most commonly prescribed oral drug (27.6%). Average number of drugs per patient was 10.37±0.27. Average number of antimicrobials prescribed per patient was 1.26±0.09. Ceftriaxone was the commonly prescribed antimicrobial drug. This study shows the most common causes of admission among geriatric patients in MICU setup and the pattern of drugs used. Drug utilization studies of this type may ultimately help in improving the quality of healthcare given to the geriatric patients. Keywords: Geriatric patients, Anatomical therapeutic chemical classification, Drug utilization pattern, Defined daily dose system

Evaluation of Drug Prescribing Patterns in Dermatology Outpatient Department of Two Teaching Hospitals in Bangladesh

Background: Skin diseases are common and cause a huge burden globally. Bangladesh is known to have a high prevalence of skin diseases. Considering the economic burden of the skin diseases treatment and its high prevalence, it is important to study the drug prescribing patterns in skin diseases.&#x0D; Objective: To evaluate the prescribing pattern of drug according to World Health Organization (WHO) prescribing indicators among the patients attending Dermatology outpatient department in two teaching hospitals.&#x0D; Materials and method: A cross sectional descriptive study was conducted in outpatient department of Dermatology in Dhaka Medical College Hospital (DMCH) and Sir Salimullah Medical College &amp; Mitford Hospital (SSMC &amp; MH) from July 2015 to June 2016. A total number of 600 prescriptions (300 from each hospital) were enrolled in the study. The general information and data were collected in the questionnaire and subjected to evaluation using WHO prescribing indicators.&#x0D; Results: The average number of drugs per prescription was 2.41 in DMCH and 2.38 in SSMC &amp; MH. Only 23.72% drugs in DMCH and 27.79% drugs in SSMC &amp; MH were prescribed by generic name. The percentage of prescriptions with antibiotics was 46% in DMCH and 45.66% in SSMC &amp; MH. The percentage of prescriptions with an injection encountered was 0.67% and 0.33% in DMCH and SSMC &amp; MH respectively. This study also revealed that, the percentage of drugs prescribed from the Essential Drug List (EDL) of Bangladesh was 56% in DMCH and 57.68% in SSMC &amp; MH.&#x0D; Conclusion: There is need to emphasize to keep the average number of drugs as low as possible and encourage prescribing by generic name and from Essential Drug List (EDL).&#x0D; Delta Med Col J. Jul 2020 8(1): 9-14

EVALUASI POLA PERESEPAN PADA PASIEN LANJUT USIA MENGGUNAKAN WHO PRESCRIBING INDICATORS

Older patients are very susceptible to drug use problems. Drug use problems are related to physiological conditions that affect the pharmacokinetics and pharmacodynamics of the drug. This study aimed to evaluate drug prescribing pattern in older patients at Pasundan Health Center Bandung. Data were retrospectively collected from prescriptions from March to June 2021. The pattern of prescribing drugs was evaluate using the WHO prescribing indicator with five indicators: the number of drugs per prescription, antibiotic use, generic drugs, the percentage of injection preparations, essential drug use. A total of 638 prescriptions met the inclusion criteria. The average number of drugs per prescription is 2.8. The prescription drugs from a total of 1.777 drugs in the form of generic drugs amounted to 83.29%, and essential drugs amounted to 74.28%. The antibiotics and injection use percentage were 11.82% and 0%, respectively. The most frequently prescribed antibiotics were amoxicillin, clindamycin, ciprofloxacin, betamethasone, and miconazole. The most frequently prescribed drugs were amlodipine, paracetamol, diclofenac sodium, chlorpheniramine maleate, and multivitamins. The use of essential and generic drugs was below WHO standard, while the average number of drugs per prescription was above WHO standard.

Assessment of private health sector prescribing patterns and adherence to prescription format using World Health Organization core drug use indicators in Addis Ababa, Ethiopia

BackgroundCurrently, the private healthcare sector's role in healthcare delivery is growing in Ethiopia. However, there are limited studies on private healthcare sector drug use patterns. This study aimed to evaluate the private healthcare sector prescribing practices and adherence to prescription format, using some of the World Health Organization (WHO) core drug use indicators in Addis Ababa, Ethiopia.MethodsA retrospective cross-sectional study design was used to collect quantitative data from prescriptions prescribed and dispensed by private healthcare sectors in the Lemi-Kura sub-city, Addis Ababa. The study was conducted from June to July 2021. The WHO criteria were used to evaluate prescribing and prescription completeness indicators. Prescriptions, kept for the last 1 year that were prescribed between January 1, 2020, to January 1, 2021, by private drug outlets, were analyzed. Simple random and systematic sampling procedures were employed in selecting drug outlets and prescriptions, respectively.ResultsOf a total of 1,200 prescriptions, 2,192 drugs were prescribed and the average number of drugs per prescription was 1.83. Generic names, antibiotics, injections, and drugs on the Ethiopian essential medicines list accounted for 77.4, 63.8, 11.5, and 80.6% of all prescriptions, respectively. Among the patient identifiers, the patient card number (54.3%), weight (2.3%), and diagnoses (31.7%) were less likely to be completed. In terms of the drug-related information, the dosage form (35.5%) was the least likely to be completed. Only 36.6 and 25.8% of prescriptions contained the names and qualifications of the prescribers, respectively. It was difficult to obtain prescription papers with the dispenser identifier.ConclusionThe study findings indicated prescribing and prescription completeness indicators all considerably deviated from WHO standards and hence unsuitable. This situation could be critical since a similar pattern is reported from public healthcare sectors, which might imply the extent of non-adherence to WHO core drug use standards. Consequently, it could play a considerable role in increasing irrational medicine use in Ethiopia.

Drug utilization study in neonatal intensive care unit at tertiary care hospital.

Neonates are more susceptible to drug interactions and adverse effects, and special care should be taken when prescribing medication to them. This study aimed to investigate drug usage in the neonatal intensive care unit of a tertiary care hospital. This prospective observational study was conducted on 98 patients at the Apollo tertiary care hospital (Bannerghatta, Bangalore, India) in a period of 6 months. The most common indications for neonatal intensive care unit admission, average number of drugs per patient, the most frequently used medication, distribution of patients based on the birth procedure, and possible drug interactions were collected from patient profiles. Among the patients, 52% were males and 48% were females. Notably, 38% of patients were preterm, 60% were term, and only 2% were post-term. Also, 80.6% were born by cesarean section and 19.4% were born by normal vaginal delivery. The highest mean of drug use was in the patient of 1,000-1,500 g (8.06 per patient). Preterm was the most frequent indication for admission in neonatal intensive care unit, followed by hyperbilirubinemia and then respiratory distress syndrome. The most frequently used medication was vitamin K (99%) and antibiotics followed by dextrose. In different types of antibiotics, amikacin (41%), cefoperazone+sulbactam (35%), cephalosporin (1%), ceftriaxone (0.7%), and amoxicillin (0.3%) were commonly administered. There were some possible interactions, such as aminoglycoside with furosemide and calcium gluconate. Premature birth and resulting low birth weight were the main reasons for drug prescription. High administration of antibiotics is probably an area of concern and should be seriously considered.