A prospective observational study of prescription pattern in a tertiary care teaching hospital of Jharkhand

Abha Kumari, Keshav Kumar, Manju Gari, Kumari Pallavi, Subhankar Choudhury


Background: Prescription error and irrational prescribing are the avoidable problems imposed on health care delivery system from prescriber side which must be addressed. Periodic prescription audit helps to curtail the error and irrational prescribing.

Methods: A prospective observational study was conducted on patients visiting various Outpatient Department of RIMS, Ranchi, Jharkhand on all working days at 11:00 AM to 12:00 PM from 1 August 2018 to 31 July 2019. Various aspects of collected prescriptions were analyzed by using World Health Organization (WHO) prescribing indicators.

Results: In this study, out of 700 prescriptions collected, 76 were excluded. Out of total 624 patients analyzed, 382 (61.28%) were male and 242 (38.72%) were female. 48 (7.69%) patients belonged to ≤18, 464 (74.36%) to 19-64 and 112 (17.95%) to ≥65 years of age group. Tablet (71%) was the most common dosage form. None of prescriptions were having registration number of the doctor. 242 (38.78%) prescriptions did not have a diagnosis duly written. The total no. of drugs prescribed in 624 prescriptions was 2176. Only 32 (5.13%) prescriptions were found to have medicines prescribed in block letters. Antibiotics (29%) were the most common class of drugs prescribed. Average number of drugs per prescription was 3.47. Only 48 (2.20%) drugs were prescribed by their generic name while total of injectables prescribed were 102 (4.68%). Total number of drugs from NLEM was 848 (38.97%). 196 (9.00%) drugs were fixed-dose combination.

Conclusions: In our study, we found deficiencies in various parts of prescriptions. Prescribing pattern was not in accordance with WHO recommendation for prescribing practice.


Prescription error, Irrational prescribing, Prescribing indicators, Prescription audit

Full Text:



Raj P, Choudhury S, Kundu S, Patel S, Sidar B. Study of prescription pattern in a tertiary care hospital in Chhattisgarh, India: an observational study. Int J Basic Clin Pharmacol. 2018;7:598-602.

Meyer TA. Improving the quality of the order-writing process for inpatient orders and outpatient prescriptions. Am J Health-System Pharm. 2000;57(S4):18-2.

World Health Organization. Promoting rational use of medicines: core components. Policy Perspectives on Medicines. Geneva: World Health Organization; 2002.

Kumari K, Kumar P. Study of drug prescribing pattern in a Tertiary Care Hospital in Jharkhand. IJBR. 2017;8(2):85-8.

Mishra P, Suman S, Keshri UP, Mishra PK, Kumari K. The use of ATC/DDD WHO 2016 and prescription audit study in the dermatology OPD of a tertiary care hospital in Jharkhand, India. Int J Basic Clin Pharmacol. 2018;7:2409-13.

World Health Organization. How to investigate drug use in health use indicators. WHO/DAP/93.1. Available at: s2289e/s2289e.pdf. Accessed on 27 August 2019.

Gopalakrishnan S, Ganeshkumar P, Katta A. Assessment of prescribing practices among urban and rural general practitioners in Tamil Nadu. Indian J Pharmacol. 2013;45(3):252-7.

Bhartiy SS, Shinde M, Nandeshwar S, Tiwari SC. Pattern of prescribing practices in the Madhya Pradesh, India. Kathmandu Univ Med J. 2008;6(1):55-9.

Kumari R, Idris MZ, Bhushan V, Khanna A, Agrawal M, Singh SK. Assessment of prescription pattern at the public health facilities of Lucknow District. Indian J Pharmacol. 2008;40(6):243-7.

Patil KK. Prescribing pattern among intern at the rural health centre of the medical college, Manipal. IJCM. 2004;13(3):129-9.

Mandal P, Mondal S, Das A, Rahaman M, Nandy M, Jana S. Evaluation of prescribing indicators in prescriptions of private practitioners in Kolkata, India. Int J Basic Clin Pharmacol. 2015;4:919-23.

Jun Z, Linyun L, Che Z, Yuanrong Y, Fengxai G, Heng Z. Analysis of outpatient prescription indicators and trends in Chinese Jingzhou area between September 1 and 10, 2006-2009. Afr J Pharm Pharmacol. 2011;5(2):270-5.

Guyon AB, Barman A, Ahmed JU, Ahmed AU, Alam MS. A baseline survey on use of drugs at the primary health care level in Bangladesh. Bull World Health Organ. 1994;72(2):265-71.

Tamuno I, Fadare JO. Drug prescription pattern in Nigerian tertiary hospital. Trop J Pharm Res. 2012;11(1):146-52.

Memon K. Use of drugs in Sind province, Pakistan primary health care facilities, 2001. Available at: /khalil_concentration_paper.htm. Accessed on 27 August 2019.