DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20195292

Audit of prescriptions from the department of general medicine based on the WHO core prescribing indicators at Sapthagiri hospital, Bangalore

Navya Teja K., Piyali Hazra, L. Padma

Abstract


Background: As medical students start their clinical training, more effort goes in the direction of proper diagnosis and appropriate methods of treatment, leading to improper training in prescription writing causing prescription errors. Physicians should also be encouraged to prescribe unbranded generic medicines which are available at a cheaper price with a comparable bioavailability of drugs and not have a misconception of being less efficacious.

Methods: A cross-sectional observational study was carried out over a period of 2 months (September to October 2018). Around 256 prescriptions were randomly collected from general medicine out-patient department. Informed consent was obtained verbally, and confidentiality assured. The collected data was analyzed as per descriptive statistics and compared with the derived standard values for WHO prescribing indicators.

Results: The analyzed data showed an average of 2.23±1.03 drugs per prescription. 23% of the prescriptions had at least one drug prescribed by generic name, 25% of prescriptions contained an antibiotic and 31% of prescriptions had an injection. The percentage of drugs prescribed from NLEM (National list of Essential Medicines) was only 57% as compared to the recommended 100%. Additional only 22.4% of the total number of FDCs prescribed were from NLEM.

Conclusions: The average number of drugs per prescription was slightly high, indicating polypharmacy. Brand name prescribing dominates as doctors are still reluctant to use generic names being doubtful of the efficacy. Regular prescription audit with reporting might help to bring awareness among doctors to follow the recommended guidelines and minimize prescription errors.


Keywords


Polypharmacy, Rational prescribing, World health organization core prescribing indicators

Full Text:

PDF

References


WHO: The pursuit of responsible use of medicines: sharing and learning from country experiences? World Health Organization; 2012. p 2. Available at http://www.who.int/medicines/areas/rational_use/en/ Accessed 13 August 2018.

WHO: De Vries TPG, Henning RH, Hogerzeil HV, Fresle DA, Policy M, Guide to good prescribing: a practical manual. 1994; p 1. Available at http://apps.who.int/medicinedocs/en/d/Jwhozip23e/2.html Accessed 13 August 2018.

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

Aravamuthan A, Arputhavanan M, Subramaniam K. Assessment of current prescribing practices using World Health Organization core drug use and complementary indicators in selected rural community pharmacies in Southern India. J Pharma Policy Prac. 2017;10(1):1.

Mathew P. Generic drugs: Review and experiences from South India. J Family Medi Pri Care. 2015;4(3):319.

World Health Organization: How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators - EDM Research Series. Available at http://apps.who.int/medicinedocs/en/d/Js2289e/ Accessed 13 August 2018.

Isha A, Ross-Degnan D, Quick J, Laing R, Mabadeje A. The development of standard values for the WHO drug use prescribing indicators. Available at: http://archives.who.int/prduc2004/rducd/ICIUM_Posters/1a2_txt.htm. Accessed 13 August 2018.

Rambhade S, Chakarborty A, Shrivastava A, Patil UK, Rambhade A. A survey on polypharmacy and use of inappropriate medications. Toxicol Int. 2012;19(1):68.

Ahsan M, Shaifali I, Mallick AK, Singh HK, Verma S, Shekhar A. Prescription auditing based on World Health Organization (WHO) prescribing indicators in a teaching hospital in North India. Int J Med Res Rev. 2016;4(10):1847-52.

Chandelkar UK, Rataboli PV. A study of drug prescribing pattern using WHO prescribing indicators in the state of Goa, India. Int J Basic Clin Pharmacol. 2014;3(6):1057-61.

Saha A, Bhattacharjya H, Sengupta B, Debbarma R. Prescription audit in outpatient department of a teaching hospital of North East, India. Int J Res Medi Sci. 2018;6(4):1241.

Mathew P. Generic drugs: Review and experiences from South India. J Family Medi Pri Care. 2015;4(3):319.