Prescribing pattern and drug utilization study in inpatients of department of Orthopaedics in a rural teaching hospital of Ujjain, Madhya Pradesh, India

Ruchi Baghel, Sandeep K. Adwal, Vivek Singh, Ashutosh Chourishi


Background: Drug utilization study can increase our understanding of how drugs are being used. This study was done to evaluate the current drug prescribing trend in management of indoor patient of orthopaedic department and to comment on rationality of the prescribed medicines.

Methods: This is a prospective observational study conducted for 12 months, in Chandrikaben Rashmikant Gardi Hospital, a 600 bedded tertiary care rural based, teaching hospital. Total 611 patients were included in this study.

Results: Total 5416 drugs were prescribed in 611 prescriptions. Average number of drugs per prescription was 8.86. Average duration of prescription was 10.7 days. Percentage of drugs prescribed by generic name was 28.8%. Percentage of encounter with an Antibiotic prescribed was 60.23% i.e. out of 611 prescriptions antibiotics were prescribed in 368. Percentage of encounter with an Injection prescribed was 63% which means out of 611 prescriptions, injectables were prescribed in 385. Percentage of drugs prescribed from National Essential Medicine List was 52.63%. Percentage of drugs prescribed from WHO model List was 32.46%. Diclofenac (14.25%) was most commonly prescribed drug. Incidence of polypharmacy was quite high in context of Analgesics. Almost 40% of prescriptions had 2 drugs. Orally prescribed Analgesics were 62.6%, Injectables 34.38% and Topical 3.02%.

Conclusions: This study reveals that the pattern of prescription in terms of rationality is poor. Special attention needs to be given to the irrational prescribing in terms of polypharmacy and long duration. Continuing medical education regarding appropriate use of drugs, knowledge of adverse effects and standard prescription guidelines will play pivotal role in rational prescription of drugs.


Drug utilization, Prescribing pattern, Rational use

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Birkett D, Smet PD, Adjei DO, Trolin I, Bergman U, Strom H, Harbo BT and Ronning M. Introduction to Drug Utilization Research. WHO; 2003:6-9.

Gupta M, Malhotra S, Jain S, Aggarwal A, Pandhi P. Pattern of prescription of non-steroidal antiinflammatory drugs in orthopaedic outpatient clinic of a north Indian tertiary care hospital. 2005;37(6):404-5.

Prescribing patterns in the orthopaedics outpatient department in a teaching hospital in Pokhara, western Nepal. Shankar PR, Pai R, Dubey AK, Upadhyay DK. Kathmandu University Med J. 2007;5(1,17):16-21.

Sarkar C, Das B. Prescribing trends in a teaching hospital in western Nepal. JNGMC. 2002;2:4-7.

Hede SS, Diniz RS, Agshikar NV, Dhume VG.Pattern of prescribed and OTC drugs in North Goa. Indian J Pharmacol. 1987;19:145-8.

Rishi RK, Sangeeta S, Surendra K, Tailang M. Prescription audit: experience in Garhwal (Uttaranchal), India. Trop Doct. 2003;33:76-9.

Guyon AB, Barman A, Ahmed JU, Ahmed AU, Alam MS. A baseline survey at the primary health care level in Bangladesh. Bull World Health Organ. 1994;72:265-71. [PMC free article] [PubMed]

Massele AY, Mwaluko GM. A study of prescribing patterns at different health facilities in Dar es Salaam, Tanzania. East Afr Med J. 1994;71:314-6. [PubMed]

Bosu WK, Ofori-Adjei D. An audit of prescribing practices in health care facilities of the Wassa West district of Ghana. West Afr J Med. 2000;19:298-303. [PubMed]

Moghadamnia AA, Mirbolooki MR, Aghili MB. General practitioner prescribing patterns in Babol city, Islamic Republic of Iran. East Mediterr Health J. 2002;8:550-5. [PubMed]

Mallet HP, Njikam A, Scouflaire SM. Evaluation of prescription practices and of the rational use of medicines in Niger. Sante. 2001;11:185-93. [PubMed]

Bapna JS, Tekur U, Gitanjali B, Shashindran CH, Pradhan SC, Thulasimani M, et al. Drug utilization at primary health care level in southern India. Eur J Clin Pharmacol. 1992;43:413-5. [PubMed]

Kshirsagar MJ, Langade D, Patil S, Patki PS. Prescribing patterns among medical practitioners in Pune, India. Bull World Health Organ. 1998;76:271-5. [PMC free article] [PubMed]

Hazra A, Tripathi SK, Alam MS. Prescribing and dispensing activities at the health facilities of a non-governmental organization. Natl Med J India. 2000;13:177-82. [PubMed]

Ravi Shankar P, Partha P, Nagesh S. Prescribing patterns in medical outpatients. Int J Clin Pract. 2002;56:549-51. [PubMed]

Shankar R, Kumar P, Rana M, Dubey A, Shenoy N. A comparative study of drug utilisation at different levels of the primary healthcare system in Kaski district, Western Nepal. N Z Med J. 2003;116:U602.[PubMed]

Nwolisa CE, Erinaugha EU, Ofoleta SI. Prescribing practices of doctors attending to under fives in a children's outpatient clinic in Owerri, Nigeria. J Trop Pediatr. 2006;52:197-200. [PubMed]

Dawadi S, Rao BS, Khan GM. Kathmandu University Journal of Science, Engineering and Technology. Pattern of antimicrobial prescription and its cost analysis in respiratory tract infection; 2005:1.

Shankar PR, Partha P, Nagesh S. Prescribing patterns in medical outpatients. Int J Clin Pract. 2002;56:549-51. [PubMed]

Chukwuani CM, Onifade M, Sumonu K. Survey of drug use practices and antibiotic prescribing pattern at a general hospital in Nigeria. Pharm World Sci. 2002;24:188-95. [PubMed]

Rehan HS, Lal P. Drug prescribing pattern of interns at a government healthcare centre in northern India. Trop Doct. 2002;32:4-7. [PubMed]

Shankar R, Kumar P, Rana M, Dubey A, Shenoy N. A comparative study of drug utilization at different levels of the primary health care system in Kaski district, Western Nepal. N Z Med J. 2003:116. [PubMed]

Srishyla MV, Krishnamurthy M, Naga Rani MA, Clare M, Andrade C, Venkataraman BV. Prescription audit in an Indian Hospital setting using the DDD (Defined Daily Dose) concept. Indian J Pharmacol 1994;26:23-8.

Sharif SI, Al-Shaqra M, Hajjar H, Shamout A, Wess L. Patterns of drug prescribing in a Hospital in Dubai, United Arab Emirates. Libyan J Med, AOP. 2005;070928:10-2.

Rehana HR, Nagarani MA, Rehan M. A study on the drug prescribing pattern and use of antimicrobial agents at tertiary careteaching hospital in eastern Nepal. Indian J Pharmacol. 1998;30:175-80.

Sharma T, Dutta S, Dhasmana DC. Prescription pattern of NSAIDs in Orthopaedic OPD of a tertiary care teaching Hospital in Uttaranchal. JK Science. July-sep 2006;8(3):160-2.