World Health Organization Core Drug Research Articles

Prescribing Pattern of Antimicrobial Agents in Patients with Pelvic Inflammatory Disease in a Tertiary Care Hospital at Rural Part of Western Nepal

Introduction: Antibiotics are the most frequently prescribed drugs in patients with Pelvic Inflammatory Diseases. Appropriate antibiotic prescriptions in health care institutions are an important element in quality of care, infection management and cost control.
 Aims: To analyze prescription pattern of antimicrobial agents in patients with pelvic inflammatory diseases.
 Methods: This quantitative cross-sectional study was conducted including 300 patients' prescriptions, at Karnali Academy of Health Sciences Jumla Nepal for period of six months during August 2021 to January 2022. This study was based on medication utilization form, which was designed on basis of World Health Organization core drug use indicator format.
 Results: Females were in ages from 12 to 69 years, with mean of 30.46 ± 18.71 years. Chronic Pelvic inflammatory Disease was most prevalent in 20–29 age group (47%) while, lowest in 60–69 age group (1.67%). The total number of prescribed drugs was 796 averaging 2.65 drugs per prescription. The most commonly prescribed antimicrobials were azithromycin (30.15%), tinidazoles (25.25%) and ofloxacin (8.16%). Only 15.5% of drugs were prescribed with generic names and all were from essential list of medicines. 92.8% of prescriptions were administered orally, while 7.8% parenteral. However 76.34% of prescriptions were considered irrational.
 Conclusion: The high prevalence of irrational prescriptions suggests need for interventions to improve healthcare provider's adherence to established treatment guidelines. Dominance of specific drug classes underscores importance of tailoring treatments to the specific pathogens involved in Pelvic Inflammatory Disease. Suggesting potential room for improvement inadherence to evidence-based guidelines.

Evaluation of prescribing patterns using WHO core drug use indicators in a pediatric hospital of Kabul Afghanistan: A prospective cross-sectional study

BackgroundThe global issue of irrational drug use, particularly concerning pediatric patients, is a significant concern. Notably, there has been a lack of studies assessing rational drug prescribing for pediatric patients within Afghanistan's healthcare system. This investigation aimed to address this gap by examining drug prescribing patterns at the Indira Gandhi Pediatric Health Institute (IPHI) in Kabul, Afghanistan. MethodsA prospective cross-sectional analysis was conducted to evaluate the prevailing drug prescribing practices at the outpatient department of IPHI in Kabul, Afghanistan. A systematic random sampling method was employed to select 600 outpatient prescriptions from the institute, following the World Health Organization (WHO) guidelines for investigating drug utilization in healthcare facilities. ResultsThe average age of patients was 4 years, and the average number of drugs per prescription was 2.9. Notably, 84% of prescriptions included one or more antibiotics, surpassing the WHO standard of <30%. Furthermore, 67% of the prescribed drugs were listed on Afghanistan's national essential drugs list (EDL), falling below the standard value of 100%. Only 35.1% of the prescribed drugs were in generic form, also lower than the recommended 100%. Moreover, 5.7% of all prescriptions included injections, the ideal value is <20%. The most frequently prescribed drug groups were anti-microbials (25.7%), followed by non-steroidal anti-inflammatory drugs (NSAIDs), (21.4%), gastrointestinal drugs (17.3%), and vitamins (7.8%). ConclusionThe study's findings indicate that, on average, a higher number of drugs were prescribed per patient visit at IPHI compared to recommended standards. Additionally, there was a lower utilization of generic drugs and drugs from Afghanistan's national essential drugs list (EDL), with an over-prescription of antibiotics.

Assessment of prescription completeness and drug use pattern using WHO prescribing indicators in private community pharmacies in Addis Ababa: a cross-sectional study

BackgroundHealthcare systems in both developing and developed countries were not free from prescription errors. One of the effects of prescription errors is irrational prescribing. According to the estimation of the World Health Organization (WHO), greater than 50% of medicines are prescribed and dispensed irrationally. On the other hand, research on drug use patterns in the private healthcare sector is scarce. This study aimed to assess prescription Completeness and Drug use Pattern using WHO prescribing indicators in Private Community Pharmacies in Lemi-Kura sub-city.MethodsBased on the WHO prescribing indicators, a retrospective cross-sectional technique was employed to examine the completeness and drug-prescription patterns. The study was conducted from April to May 2021. Prescriptions, kept for 1 year that was prescribed from March 2020 to March 2021, by private healthcare sectors, were analyzed. A systematic random sampling technique was employed to select prescriptions obtained from private health facilities. Data were analyzed using SPSS® version 26.0 software.ResultsOf a total of 1000 prescriptions, 1770 drugs were prescribed and the average number of drugs per prescription was 1.77. Prescriptions for two drugs account for 38% of these, while prescriptions for three drugs account for 15%. Age, sex, and card number were written on 99.0%, 99.2%, and 41.8% of prescriptions, respectively. The patient's name was written on every prescription. Even though the availability of other therapeutic information on the prescription made it appear greater, only 44.2% of prescriptions included the dosage form of medications. The generic name was used for the majority of the medications (67.8%). Furthermore, assuming that each prescription was for a single patient, 71% of patients received antibiotics, and 2% received injectable medicines. The National List of Essential Medicines-Ethiopia was used in 99.6% of the prescriptions.ConclusionsOn the basis of the finding of this study, the prescribing and prescription completeness indicator showed deviation from the standard recommended by WHO. 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 prescription errors in Ethiopia. Hence, in-service training for prescribers should be provided to improve adherence to basic prescription writing.

Drug utilization evaluation of medications used in the management of neurological disorders

Background and objectThe burden of neurological disorders in India is expected to increase due to the rapid demographic and epidemiological transition, with irrational drug use, which is also a global concern. Thus, drug utilization evaluation is designed to ensure appropriate medicine use within the healthcare settings. The aim of the study was to assess the rate and pattern of drug utilization in the management of neurological disorders. Materials and methodsA hospital-based cross-sectional drug utilization evaluation study on neurological drugs was carried out at the Department of Neurology over a span of six months. All legible prescriptions consisting neurological medications irrespective of patient's gender, aged ≥ 18 years were included for the study. The World Health Organization (WHO) core drug use indicators were used to assess the drug prescribing and utilization patterns. ResultsA total of 310 prescriptions were reviewed, where male predominance was found to be 56.45%. Out of 310 prescriptions, drugs belonging to 26 neurological classes were prescribed for the management of various neurological disorders. The majority of patients were diagnosed with epilepsy and the most prescribed drugs per patient were phenytoin (14.8%) and valproic acid (6.45%). By following the WHO core drug prescribing indicators, 65.47% of drugs prescribed from the India National List of Essential Medicines, 2022, followed by 29.83% of drugs prescribed in generic name and 10.86% of prescriptions including injections. ConclusionThe study findings showed that the prescribing pattern in the Department of Neurology was in accordance with the WHO core prescribing indicators. But, the extent of polypharmacy prescriptions was very high. Therefore, interventions are very necessary to promote rational drug prescribing patterns and thus clinical pharmacists can contribute to assess and review the drug utilization pattern to optimize the drug therapy and improvement in patient safety.

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.

Evaluation of prescription completeness, rational drug-use patterns using WHO prescribing, patient-care and facility indicators in Debre Tabor Comprehensive Specialized Hospital, Ethiopia: A cross-sectional study.

Objective:Irrational medicine use results in diseases worsening, disability, death, and wastage of limited resources. This study was predominantly aimed to evaluate the rationality of medicine use patterns by assessing prescribing, patient-care, and facility indicators at Debre Tabor Comprehensive Specialized Hospital by using World Health Organization core drug use indicators.Methods:A cross-sectional design was conducted to collect prescribing indicator data from 780 prescriptions retrospectively from 1 July 2020 to 30 June 2021 at outpatient pharmacy of the hospital and exit interview was held prospectively on 150 patients to evaluate patient-care indicators. In addition, indicators for health-facility were assessed by actual observation of the presence of different guidelines. Descriptive analysis of the collected data was computed using SPSS version 25.Result:Totally, 1521 drugs were prescribed to 780 encounters. On average, 1.95 drugs were prescribed per prescription. Percentage of encounters by generic name, encounters with antibiotics and injection, and drugs from essential drug list were 99.9%, 35.4%, 15.3%, and 100%, respectively. From healthcare provider–related information, the names of prescribers and dispensers were correctly written in 93.59% and 77.69%, respectively. Frequency (97.18%) and route (86.15%) of drug administration were better stated in the reviewed encounters, whereas dosage form is poorly stated (7.44%). Labeling of dispensed medicine was obtained for only 10% of patients and patient knowledge for correct dose was 94%. Availability of facility indicators was 95%.Conclusion:From the results of this study, it is possible to conclude that the prescribing, patient-care, and facility indicators did not fulfill many World Health Organization standards. Therefore, it is important if all prescribers, dispensers, patients themselves, and the governing bodies take an action to improve the prescribing and patient-care indicators for the best of the end users.

Drug utilization pattern at the cardiac surgical outpatient clinic in a tertiary care hospital at Goa

Background: Drug utilization research encourages rational drug prescribing practices and thus contributes to the contemporary use of drugs in the society. This study assesses the drug utilization pattern (DUP) at the cardiac surgical outpatient department of Goa Medical College hospital. We used the World Health Organization (WHO)-prescribing indicators to analyze the National List of Essential Medicines (NLEM) implementation as recommended in the National Drug Policy. Methods: We used a cross-sectional study design to analyze the DUP. We randomly selected 103 prescriptions dispensed to patients at the cardiac surgical outpatient during the study period. We critically examined these prescriptions for their consistency with WHO core drug use indicators. Results: The average number of drugs prescribed per person was 4.95. The most commonly prescribed top three drugs were antiplatelets (21.46%), beta-blockers (14.76%), and statins (13.78%). Most drugs were prescribed as single drugs (90.98%), whereas 9.02% were fixed-dose drug combinations (FDC). The combination of aspirin and clopidogrel was the most common prescribed FDC. The majority (72.44%) of the drugs prescribed were as per the NLEM 2015 list, whereas the generic name was low (2.8%). We measured Patient-Care Indicators and Facility-Specific Indicators also. The average consultation time and dispensing time were 7.76 and 3.23 min, respectively. The in-house pharmacy dispensed 82% of drugs. 93.75% of the key drugs were available in the facility. A copy of the essential drugs list was readily available in the facility. 96.67% of the patients knew the correct dosage of drugs. Conclusions: Anti-platelets and statins were the most commonly prescribed drugs. There was a high prescribing trend from the NLEM; however, the inclination to prescribe generic names was less. Patient-care and facility-specific indicators were also far from the optimal values except that of the average dispensing time.

PRESCRIPTION AUDIT USING THE WORLD HEALTH ORGANIZATION PRESCRIBING INDICATORS FOR INDOOR PATIENTS TREATED UNDER CMAAY/PMJAY INSURANCE SCHEMES IN A TERTIARY CARE TEACHING HOSPITAL

Objective: This study focused on the prescriptions audit of indoor patients treated under Pradhan Mantri Jan Arogya Yojana (PMJAY) and Chief Minister Arogya Arunachal Yojana (CMAAY) insurance schemes as per the World Health Organization (WHO) prescribing indicators. Materials and Methods: Retrospective cross-sectional study was conducted and the prescriptions of around 960 patients were analyzed who were treated from June 2020 to December 2020 under CMAAY/PMJAY insurance schemes at Tomo Riba institute of Health and Medical Sciences in Arunachal Pradesh. Study was conducted in five departments and Information was collected through the review of case sheets. The post-operative day prescription was analyzed for the patients who have undergone surgery and the patients who were managed conservatively; admission day prescription was analyzed using the WHO core drug prescribing indicators. Following data were analyzed. (1) Average no of drugs prescribed per encounter; (2) percentage of encounter having antibiotic; (3) percentage of drugs prescribed by generic name; (4) percentage of encounters with an injection; and (5) percentage of drugs prescribed from the essential drug list. Results: A total of 960 indoor patients treated under five departments, out of which 359 (37.4%) treated under general surgery, 383 (39.9%) under Obstetrics and Gynecology department, 65 (6.8%) under ENT department, 68 (7.1%) under orthopedics department, and 85 (8.9%) under General medicine department. All departments taken together, the average number of drugs used per patient was 4.91. Antibiotics were prescribed in 92.18% of the total patients when all departments were included, single antibiotic was used in 72.18%, two antibiotics in 17.29%, and three in 2.7% of the total patients. Overall, the generic names were written in 67.3% of the total drugs and the most commonly used route was parenteral route, in about 98.19% of the total prescribed drugs. From the essential drugs list, 89.33% of the total drugs were prescribed. Fixed drug combination was used in 13.59% of the total drugs prescribed. Conclusion: In our study, the percentage of prescriptions with average no of drugs per prescription, antibiotic used, injections used were much higher when compared to the WHO core prescribing indicators. The reason might be because we have analyzed the prescription of indoor patients and most of them were post-operative patients, so it is justified. While prescribing, the physicians and surgeons followed WHO essential drug list but use of generic names was in few prescriptions. The generic name use to be more emphasized, encouraged, and promoted.

Study on Prescription Audit from a Rural Tertiary Care Hospital in North India

Evidence concerning prescription audits conducted in developing countries like India is scarce, especially from the rural parts of the country. Therefore, the present prescription audit was undertaken in a rural tertiary care hospital to investigate prescriptions for their completeness, in format of prescription, legibility of writing and it was assessed against the World Health Organization (WHO) recommendation of core indicators for prescription writing in order to investigate the rational usage of drugs. A total of 200 prescriptions were randomly selected, irrespective of clinical departments, patient characteristics and diagnosis over a period of six months. All the prescriptions were prospectively analyzed and conferred to an assessment of the quality of prescribing practice, general details, medical components, WHO core drug use indicators and legibility. Amongst the 200 prescriptions precisely monitored, we found that 100% prescriptions had general details of the patients such as name, age, gender, OPD/IPD registration number, hospital name &amp; address and consulting unit/department. While evaluating the handwriting of the doctors, 83.5% (177/200) of the prescriptions had legible handwriting, wherein the degree of legibility showed 68.5% (137/200) prescriptions with easy legibility, 20% (40/200) difficult legibility while 11.5% (23/200) were illegible. Along with the different types of drugs obtained from the selected prescriptions, we found that antibiotics were prescribed in 51.5% (103/200) of the prescriptions. A prescription audit is a good tool to systemically review the day to day work, maintenance of records and assessment of accuracy of the diagnosis given by doctors and also the outcome of the treatment received.

Drug Utilization Study in Ophthalmology Outpatient Department of a Tertiary Care Teaching Hospital

Abstract: Background: World Health Organization (WHO) has defined drug utilization in 1977 as marketing, distribution, prescription and use of drugs in a society with special emphasis on the resultant medical and social consequences. It should be evaluated periodically to increase the therapeutic efficacy and decrease adverse effects. Objectives: The aim of study is obtain data on the current prescribing pattern and drug utilisation trend of ophthalmologist in a tertiary care teaching hospital with ultimate goal to promote appropriate use of drugs. Methods: This prospective interventional study was conducted in 272 patients of either sex visiting Ophthalmology outpatient department over a period of six months at NMCH and RC, Raichur, Karnataka. The data collected from data collection form was analysed with the help of WHO prescribing indicators and evaluated using descriptive statistics. Results: Prescription analysis showed that the average number of drugs per prescription was 2.45. Drugs were mostly prescribed by brand name (98.5%), Eye drops (69%) were most prescribed dosage form, Injections (0.75%) were least prescribed, drugs prescribed from Essential Drug List was 50.9%. Antibiotics were most prescribed class of drugs (49.62%). Dosage form, frequency and duration of therapy were recorded in 100%, 95.5% and 84% of prescriptions. Conclusion: Polypharmacy was slightly seen in prescriptions. Antibiotics were highly used. The most commonly prescribed dosage form was eye drops. Half of drugs were prescribed from Essential drug list (EDL). Physicians preferred branded drugs rather than generic drugs. Diagnosis of the patient was not recorded for most of the prescriptions. Key words: Drug utilization evaluation, WHO core drug prescribing indicators, Polypharmacy, Generic name, Ophthalmology.

Rational Drug Use Evaluation Based on World Health Organization Core Drug Use Indicators in Ethiopia: A Systematic Review.

BackgroundRational use of medicines plays a vital role in avoiding preventable adverse drug effects, maximizing therapeutic outcomes with promoting patient adherence, and minimizing the cost of drug therapy. Irrational use of drugs is often observed in countries with weak health care systems. No review has been done that systematically expresses rational drug use practice based on the three WHO core drug use indicators in Ethiopia. Thus, this study was aimed to review systematically the prescribing, health-facility, and patient-care indicators based on WHO core drug use indicators in Ethiopia.MethodsA systematic article search was conducted in different electronic databases including PubMed/ MEDLINE, the Cochrane Library, EMBASE, Web of Science, POPLINE, the Global Health, and Google scholar. Quality assessment was conducted using Newcastle-Ottawa quality assessment scale. Studies were synthesized and grouped in to prescribing, patient care and health facility indicators.ResultsFrom a total of 6239 articles, 21 studies were found suitable for the review. The highest average number of drugs per encounter was 2.5 while the lowest was 0.98. The percentage of generic drug use was ranged from 70.5% to 100%. The highest percentage of encounters with an antibiotic was 85%. The lowest percentage of drugs prescribed from essential drugs list was 81.4%. The highest percentage of drugs actually dispensed and adequately labeled was 96.16% and 96.25%, respectively.ConclusionThis study showed that the practice of rational drug use varied across region of the country. The average number of drugs per prescription, percentage of drugs encounter with antibiotics, drugs prescribed by their generic name, average consultation time, average dispensing time, percentage of drugs adequately labeled, and availability of essential drugs showed deviation from the standard recommended by WHO. Thus, provision of regular training for prescribers and pharmacists, and ensuring the availability of essential drugs should be encouraged.

Drug use pattern using WHO core drug use indicators in public health centers of Dessie, North-East Ethiopia

BackgroundRational drug use requires that patients receive and take medication appropriately. Though the process of diagnosis and pharmaceutical care is complex, World Health Organization (WHO)/international network for rational use of drugs (INRUD) core drug use indicators investigate drug use to minimize the hazardous effect of the drug and enhance the wise use of scares resources. This study assessed drug use patterns in health centers of Dessie town using WHO/INRUD indicators.MethodsA cross-sectional study was conducted in public health centers of Dessie town. Data were retrospectively collected from 1500 prescriptions dispensed from January 1, 2018, to December 31, 2018 using WHO data collection tool to assess prescribing indicators. For patient care and health facility indicators, 600 patients and 3 health centers were prospectively reviewed. Systematic random sampling was used to select samples. Data were analyzed using the Statistical Package for the Social Sciences version 20.ResultsThe average number of drugs per encounter was 2.1. The percentage of encounters with antibiotics and injection was 44% and 13.9%, respectively. The percentage of drugs prescribed by generic name and from an essential drug list was 98% and 100%, respectively. On average, patients spent 4.7 min for consultation and 105 s for dispensing. From 1305 prescribed drugs, 92% were dispensed, while only 4% were labeled adequately. More than half (54.8%) of patients had adequate knowledge of their medication. None of the health centers had an essential drug list. The availability of key essential medicines was 64.10%.ConclusionThis study demonstrated irrational drug use practices in all healthcare facilities. Polypharmacy, antibiotics over-prescribing, short consultation and dispensing times, inadequate labeling of medicines, inadequate level of patients' knowledge about prescribed medicines, and unavailability of key drugs in stock were found to be the major problems. Continuous refreshment trainings on rational use of drugs and WHO recommendations should be given for prescribers and pharmacists. Further, we recommend studies involving large number of facilities to estimate overall prescribing practices.

A drug utilization study of psychotropic drugs in indoor patients of psychiatry department in a tertiary care hospital

Context: The rapidly expanding field of psychopharmacology is challenging the traditional concepts of treatment and constantly seeking new drugs to treat psychiatric disorders. There is a sparse work on the utilization of psychotropic drugs in indoor patients. Hence, the present study was planned to add to the existing knowledge of the utilization of psychotropic drugs. Aims: The aims of were to study the drug utilization of psychotropic drugs in the indoor patients of psychiatry department and to evaluate it according to the World Health Organization core drug use prescribing indicators. Settings and Design: This was an observational study in indoor patients of psychiatry department in a medical college. Materials and Methods: In this study, patients of all age groups diagnosed with psychiatric disorder admitted to the psychiatry department were included. The data were collected from 300 prescriptions over 6 months. Data were analyzed using descriptive statistics. Results: In 300 prescriptions, 61.98% were psychotropic drugs and average number of drugs per prescription was five. The percentage of drugs prescribed by generic name and from the essential drug list was 52.93% and 60.9%, respectively. The most common diagnosis was schizophrenia (55.6%), followed by mood disorders (26.6%). The most commonly prescribed drugs for schizophrenia, bipolar disorders, and depression were olanzapine (71.85%), sodium valproate (71.4%), and escitalopram (51.6%), respectively. Conclusion: Most of the drugs were used in accordance with standard guidelines given by the Indian Psychiatric Society. The percentage of drugs prescribed by generic names and from the National List of Essential Medicines (NLEM) needs to be increased. Olanzapine, which is not included in NLEM, was commonly prescribed psychotropic drug

A world health organization core drug use indicator based prescription study in the dermatology outpatient department of a tertiary care teaching hospital of central South India

Background: Irrational prescribing is a universal problem that may lead to inadequate response to medication therapy, poor patient compliance and increased adverse drug reactions ultimately leading to frequent hospital admissions. Hence this study was done to assess the drug utilization pattern using WHO core drug use indicators so that the recommendation can be made towards the rational prescribing.Methods: A sample of 3650 prescriptions was analysed prospectively to assess the drug utilization patterns in the dermatology OPD of a tertiary care teaching hospital of central south India.Results: The average number of drugs per prescription was 2.74 whereas 79.26% drugs were prescribed by generic names. Percentage of encounters with an antibiotic prescribed was 18.68%. Regarding use of injections, 3.26% prescriptions contains one or more injections. Percentage of drugs prescribed from essential drugs list was 78.37%. Average consultation time was lower (2.9 minutes) than recommended.Conclusions: The data from the present study indicates that prevalence of polypharmacy, inadequate consultation and dispensing time along with poor patient’s knowledge are the areas of medication therapy to be improved. Availability of essential drugs and key drugs in stock should be improved to achieve rational therapeutic goal. Further, continued medical education regarding the rational prescribing will definitely improve the standards of health care delivery.

A prescription audit using the World Health Organization-recommended core drug use indicators in a rural hospital of Delhi.

INTRODUCTION:The inappropriate use of drugs is a global health problem, especially in developing country like India. Irrational prescriptions have an ill effect on health as well as health-care expenditure. Prescription auditing is an important tool to improve the quality of prescriptions, which in turn improves the quality of health care provided. The present study was conducted to investigate the rational use of drugs for completeness, legibility, and against the World Health Organization (WHO)-recommended core drug use indicators.MATERIALS AND METHODS:A cross-sectional, outpatient department-based study was carried out in a rural hospital of Delhi wherein 120 prescriptions were randomly sampled, irrespective of patient characteristics and diagnosis over a period of 1 month. All the prescriptions were analyzed for general details, medical components, and WHO core drug use indicators. The data obtained were summed up and presented as descriptive statistics using the Microsoft Excel and were analyzed using SPSS version 16.RESULTS:All the prescriptions had general details mentioned in it. The diagnosis was mentioned in 64.2% of prescriptions, and 85.8% of drugs were prescribed by generic name. An average of 3.02 drugs per encounter was prescribed. The average consultation time and dispensing time were 2.8 min and 1.2 min, respectively. Only half of the patients had correct knowledge of dose.CONCLUSIONS:Our study highlights the need to train our prescribing doctors on writing rational prescriptions for quality improvement.

The prescribing pattern for the management of dengue fever in pediatric patients of a tertiary care hospital: an observational study

Background: Dengue fever is a mosquito borne viral infection which has become a global health hazard, especially in tropical and subtropical areas. Children have higher risk of developing severe forms of dengue fever, however, studies show that paediatric complications/fatalities from dengue fever are potentially avoidable by proper management. Data about drug usage patterns for dengue are particularly lacking, especially in the paediatric age group, therefore this study will help facilitate the rational use of drugs and aid in establishing a more specific management for dengue fever. The objective of the present study was to identify the prescribing pattern of dengue fever in paediatric inpatients admitted to RajaRajeswari Medical College and Hospital and assess according to the WHO core prescribing indicatorsMethods: This prospective observational study took place from March 2017 to September 2017 in the paediatric general wards. Data was collected from case files of NS1 positive patients of both genders between 1-18years. Data was analysed using descriptive statistics and expressed as percentages, means and standard deviations. The prescription pattern was analysed using the prescribing indicators mentioned in the World Health Organization core drug use indicators.Results: Total of 300 drugs were prescribed for 110 prescriptions that were analysed excluding IV fluids and blood products. Mean number of drugs prescribed was 2.7±0.8. Drugs prescribed by a generic name was 7.33%. Patients prescribed an antibiotic was 12.73%. Patients prescribed with an injection was 62.72% Majority of drugs prescribed in this study come from essential medicines list created by regulatory bodies. Intravenous fluids were administered to all patients with majority receiving normal saline (60.9%).Conclusions: Mainstay of treatment of dengue fever for paediatric patients is symptomatic along with focus on fluid management. Majority of drugs prescribed are from essential medicines lists formed by regulatory bodies. With dengue infections being a worldwide health hazard, more studies are needed to facilitate rational use of drugs in this disease.

Assessment of Drug Use Pattern Using WHO Prescribing Indicators

Background: In order to promote rational drug use in developing countries, assessment of drug use pattern using the World Health Organization drug use indicators is important. The aim of this study was to assess the drug prescription patterns at Kathmandu Medical College Teaching Hospital, using some of the World Health Organization core drug use indicators.Methods: A prospective cross-sectional study was carried out in order to determine current prescribing trends at Kathmandu Medical College Teaching Hospital. A total of 605 prescriptions were collected and analyzed in the study.Results: The average number of drugs per prescription was 5.85 considering the total amount of prescriptions. Furthermore, assuming each prescription as an individual patient, 64.1% of patients received antibiotics, and 71% of patients received injectable form of drugs. Among antibiotics the most common antibiotics prescribed were Ceftriaxone, Amoxicillin/Cloxacillin, Azithromycin, Cefixime, and Cloxacillin. Only 16.94% of the medicines were prescribed in generic names with the rest 83.06% of the medicines being prescribed in brand names and 47.55% of medicines prescribed were from the National List of Essential Medicines-Nepal.Conclusions: The current study revealed that polypharmacy and prescription writing using brand names were common. Prescriptions writing in generic nameneeds to be promoted and encouraged. There appears to be a crucial need for the development of prescribing guidelines when it comes to antibiotics.

The Assessment of Drug Use Pattern Using WHO Prescribing Indicators

Background: In order to promote rational drug use in developing countries, assessment of drug use pattern using the World Health Organization drug use indicators is important. The aim of this study was to assess the drug prescription patterns at Kathmandu Medical College Teaching Hospital, using some of the World Health Organization core drug use indicators.Methods: A prospective cross-sectional study was carried out in order to determine current prescribing trends at Kathmandu Medical College Teaching Hospital. A total of 605 prescriptions were collected and analyzed in the study.Results: The average number of drugs per prescription was 5.85 considering the total amount of prescriptions. Furthermore, assuming each prescription as an individual patient, 64.1% of patients received antibiotics, and 71% of patients received injectable form of drugs. Among antibiotics the most common antibiotics prescribed were Ceftriaxone, Amoxicillin/Cloxacillin, Azithromycin, Cefixime, and Cloxacillin. Only 16.94% of the medicines were prescribed in generic names with the rest 83.06% of the medicines being prescribed in brand names and 47.55% of medicines prescribed were from the National List of Essential Medicines-Nepal.Conclusions: The current study revealed that polypharmacy and prescription writing using brand names were common. Prescriptions writing in generic name needs to be promoted and encouraged. There appears to be a crucial need for the development of prescribing guidelines when it comes to antibiotics. Keywords: Drug prescription; drug utilization; prescribing practices; rational drug use; WHO prescribing indicators.

Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study

BackgroundDespite the complexity of drug use, a number of indicators have been developed, standardized and evaluated by the World Health Organization (WHO). These indicators are grouped in to three categories namely: prescribing indicators, patient care indicators and facility indicators. The study was aimed to evaluate rational drug use based on WHO-core drug use indicators in Dilchora referral hospital, Dire Dawa; Hiwot Fana specialized university hospital, Harar and Karamara general hospital, Jigjiga, eastern Ethiopia.MethodsHospital based quantitative cross sectional study design was employed to evaluate rational drug use based on WHO core drug use indicators in selected hospitals. Systematic random sampling for prescribing indicators and convenient sampling for patient care indicators was employed. Taking WHO recommendations in to account, a total of 1,500 prescription papers (500 from each hospitals) were investigated. In each hospital, 200 outpatient attendants and 30 key essential drugs were also selected using the WHO recommendation. Data were collected using retrospective and prospective structured observational check list. Data were entered to EPI Data Version 3.1, exported and analyzed using SPSS version 16.0. Besides, the data were evaluated as per the WHO guidelines. Statistical significance was determined by one way analysis of variance (ANOVA) for some variables. P-value of less than 0.05 was considered statistically significant. Finally, tabular presentation was used to present the data.ResultsMean, 2.34 (±1.08) drugs were prescribed in the selected hospitals. Prescriptions containing antibiotics and that of injectables were 57.87 and 10.9% respectively. The average consultation and dispensing time were 276.5 s and 61.12 s respectively. Besides, 75.77% of the prescribed drugs were actually dispensed. Only 3.3% of prescriptions were adequately labeled and 75.7% patients know about the dosage of the prescription. Not more than, 20(66.7%) key drugs were available in stock while only 19(63.3%) of key drugs had adequate labeling. On average, selected key drugs were out of stock for 30 days per year. All of the hospitals included in the study used the national drug list, formulary and standard treatment guidelines but none of them had their own drug list or guideline.ConclusionMajority of WHO stated core drug use indicators were not met by the three hospitals included in the study.

Evaluation of Prescription Pattern and Rational Prescribing in Eastern Nepal

Background To promote rational prescribing and appropriate use of drugs, it is important to evaluate the prescription pattern using the World Health Organization (WHO) drug use indicators. The aim of this study was to evaluate the prescription patterns and rational prescribing at the private community pharmacies of Biratnagar, Eastern Nepal, using some of the WHO core drug use indicators.Material and Methods Five private community pharmacies were selected using systemic random sampling. Nine hundred patient encounters from these pharmacies were assessed prospectively for four months from September 2015–December 2015. Data was collected from each patient encounter and were recorded directly into a prescription indicator form.Results Average number of drugs prescribed per encounter was 2.14 (n=1930). Percentage of drugs prescribed by generic name and from essential drug list was 45.18% (n=872) and 76.11% (n=1469) respectively. Percentage of encounters in which antibiotic and injection was prescribed were 40.44% (n=364) and 3.44% (n=31) respectively.Conclusion Prescribing practices in Eastern Nepal are not up to the standards recommended by WHO. Drug use evaluation can help to ensure whether the antibiotics are appropriately prescribed or not. Poly-pharmacy, excessive use of antibiotics was quite common and concept of generic prescribing and National Essential Medicine List (NEML) was not appreciable. Standard guidelines should be recommended and strictly followed by the prescribers and National Formulary and NEML should be made available in every health institution. Physicians should be emphasized to prescribe medicines from NEML.Journal of Nobel Medical CollegeVolume 5, Number 1, Issue 8, January-July 2016, 32-36