Study of prescribing practices of injections in outpatients of a rural tertiary care teaching hospital

Suvarna S. Rathod, Vijay M. Motghare, S. L. Padwal, V. S. Deshmukh, Rakesh R. Pore, Rushikesh Deshpande, Chetanraj G. Bhamare

Abstract


Background: Injections are probably the most common of all medical procedures. The combination of injection overuse and unsafe practices creates a major route of transmission of blood borne pathogenic infections. Unnecessary use of injections can also lead to unnecessary burden on the institution in terms of efficiency, infrastructure, staff requirement and poor utilization of resources. Monitoring and analysis of prescribing practices can help to achieve rational use of injections. The present study was carried out to study the injection prescription patterns in outpatients of a rural tertiary care teaching hospital, Ambajogai, Maharashtra, India.

Methods: A cross sectional descriptive study was conducted for duration of two months and 744 prescriptions were randomly collected and analyzed.

Results: The total number of injections prescribed in 744 prescriptions was 205. Most (71.70%) of the patients receiving them were above 35 years of age. The most common complaint for which the injections were prescribed was musculoskeletal pain (45.36%) followed by fever. About 155 (75.60%) prescriptions contained injection diclofenac which was the most commonly used drug followed by injection paracetamol (11.21%). There was a high tendency of using brand names in prescriptions (89.30%).

Conclusion: The study revealed high proportion of use of injectable drugs. There was overuse of analgesic injections like diclofenac, most of which were unnecessary and irrational. This leads to unnecessary burden on the institution in terms of efficiency, infrastructure, staff requirement and poor utilization of resources. There is a need to develop local guidelines for injection usage along with educational sessions for prescribing doctors.


Keywords


Drug utilization research, Injection practices, Irrational use

Full Text:

PDF

References


World Health Organization. Introduction to Drug Utilization Research. Oslo: World Health Organization; 2003.

Hauri AM, Armstrong GL, Hutin YJF. Contaminated injections in health care settings. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, editors. Comparative quantification of health risks: global and regional burden of disease attributable to selected major

risk factors. Geneva: World Health Organization; 2003.

World Health organization (WHO). Guiding principles to ensure injectable device security. Safe Injection Global Network (SIGN) Secretariat, Department of essential Health Technology; WHO: 2003. www.who.int/injection_safety/ WHOGuidPrinciplesInjEquipFinal.pdf. Accessed on 23 August 2013.

World Health Organisation. Injection safety. Geneva: World Health Organisation; revised 2002 Apr. WHO fact sheet no: 231. Available at: www.who.int/mediacentre/factsheets/fs231/en/. Accessed 23 August 2013.

Arora NK, Bhave S, Kamath SS, and Nair MKC, Shah R. IAP workshop on safe injection practices: recommendations and IAP plan of action: Indian Pediatrics 2005; 42: 155-61.

Reeler AV. Anthropological perspectives on injections: a review. Bull World Health Organ 2000;78: 135-43.

Mahfouz AA, Abdelmoneim I, Khan MY, Daffalla AA, Diab MM, Shaban H et al. Injection safety at primary health care level in south-western Saudi Arabia. East Mediterr Health J. 2009;15(2):443-50.

Thawani VR, Motghare VM, Purwar MB, Pagare A. Drug utilization in indoor ANC patients of Govt. college hospital, Nagpur. Journal of Academy of Hospital Administration 1997;9(2):49-51.

M. Rajasekaran, G. Sivagnanam, P. Thirumalaikolundusubramainan, K. Namasivayam, C. Ravindranath. Injection practices in Southern part of India Public Health 2003: 208–13.

Logez S, Soyolgerel G, Fields R, Luby S, Hutin Y, Baatar U et al. Rapid assessment of injection practices in Mongolia. Am J Infect Control. 2004; 32(1):31-7.

Haile D, Berhane Y. Injection practice in North Western Ethiopia. Ethiopian Medical Journal 1997;35:117-25.