DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20213366

Assessment of prescription completeness and antibiotic consumption at a rural health and training centre, Delhi

Arvind Kumar, Arti Bahl, Sunil Gupta, Charan Singh, Sudhir Kumar Jain, Sujeet Kumar Singh

Abstract


Background: The prescription audit is a useful method to assess the doctors’ contribution to the rational use of drugs in a country. A prescription is considered complete when it covers all the parts of the prescription. The polypharmacy increased the risk of drug interaction, dispensing errors and confused the patients for dosage schedules. A prescription with the minimum number of drugs per prescription helps in rational pharmacotherapeutics. The objectives of this study were to describe the pattern and completeness of prescription at rural health and training center and to estimate antibiotic consumption at rural health and training center.

Methods: A descriptive cross-sectional study was conducted to determine the current prescribing practice at RHTC. Data were collected in the two pharmacies of the rural hospital. A total of 612 prescriptions with the last refill were considered for the assessment.

Results: The average number of drugs prescribed per prescription 3.53. The percentage of prescriptions in which an antibiotic was prescribed was 20%. The percentage of drugs prescribed by generic name and from an essential drug list was 71.5% and 98.7% respectively. The most commonly prescribed form of antibiotics was extended-spectrum penicillin.

Conclusions: All the prescriptions were complete covered parts of prescriptions. The dosing errors were present in maximum prescriptions. The WHO prescribing indicators were within the limits, an average number of drugs per prescription suggests a practice of polypharmacy. The peak of the use of antibiotics was observed in September followed by January and November. The least use of antibiotics was in December followed by June.

 


Keywords


Antibiotic consumption, ATC/DDD, Polypharmacy, Prescription audit, Prescription practice

Full Text:

PDF

References


Brunton L, Chabner BA, Knollman B. Goodman and Gilman’s the Pharmacological Basis of Therapeutic. 12th ed. New York, NY: McGraw Hill; 2011.

Indian Medical Council. Professional Conduct, Etiquette and Ethics, 2002. Available at: https://www.mciindia.org/documents/rulesAndRegulations/Ethics Regulations-2002. Accessed on 20 June 2021.

American Society of Hospital Pharmacists. ASHP Guidelines on Preventing Medication Errors in Hospitals. American J Hospital Pharm. 1993;50(2):305-14.

WHO. WHO Policy Perspectives on Medicines-Promoting Rational Use of Medicines: Core Components WHO Policy Perspectives on Medicines, 2002. Available at: http://www.msh.org/. Accessed on 20 June 2021.

Devi DP, George J. Diabetic nephropathy: prescription trends in tertiary care. Indian J Pharm Sci. 2008;70(3):374-8.

Mishra S, Sharma P. Prescription audit and drug utilization pattern in a tertiary care teaching hospital in Bhopal. Int J Basic Clin Pharmacol. 2016;5(5):1845-9.

Pathak A, Gupta VK, Maurya A, Kumar A, Singh A. Assessment of drug prescribing pattern using WHO indicators in hospitalized patients at a tertiary care teaching hospital in rural area of India. Int J Basic Clin Pharmacol. 2016;5(3):651-5.

Gupta A, Mishra S. Prescription audit study in a tertiary care hospital using the anatomical therapeutic chemical and defined daily dose classification concept. Int J Basic Clin Pharmacol. 2014;3(5):889.

Tamuno I, Fadare JO. Drug Prescription Pattern in a Nigerian Tertiary Hospital. Trop J Pharm Res. 2012;11(1):146-52.

Mittal N, Mittal R, Singh I, Shafiq N, Malhotra S. Drug utilisation study in a tertiary care center: recommendations for improving hospital drug dispensing policies. Indian J Pharm Sci. 2014;76(4):308-14.

Karande S, Sankhe P, Kulkarni M. Patterns of prescription and drug dispensing. Indian J Pediatr. 2005;72(2):117-21.

WHO. WHO Model List of Essential Medicines 19th List, 2015. Available at: http://www.who.int/medicines/publications/essentialmedicines/en/. Accessed on 20 June 2021.

Central Drugs Standard Control Organization. National List of Essential Medicines (NLEM), 2015. Available at: http://cdsco.nic.in/WriteReadData/NLEM2015/NLEM, 2015.pdf. Accessed on 20 June 2021.

Prasad PS, Rudra JT, Vasanthi P, Sushitha U, Sadiq MJ, Narayana G. Assessment of drug use pattern using World Health Organization core drug use indicators at Secondary Care Referral Hospital of South India. Chrismed J Heal Res. 2015;2(3):223-8.

Directorate of Census Operations. District Census Handbook, Census of India 2011; Series-08; Part XII-A, 2011. Available at: https://censusindia.gov.in/2011census/dchb/0700_PART_A_DCHB_NCT OF DELHI.pdf. Accessed on 20 June 2021.

Sharif S, Shaqra M, Hajjar H, Shamout A, Wess L. Patterns of drug prescribing in a hospital in dubai, United arab emirates. Libyan J Med. 2008;3(1):10-2.

Sharma P, Kapoor B. Study of prescribing pattern for rational drug therapy. JK Sci. 2003;5(3):5-7.

Kumari S, Haider S, Kashyap V, Singh SB. a Study on Pattern of Prescription Writing Practices At Rajendra Institute of Medical Sciences, Ranchi. Indian J Prev Soc Med. 2014;45(1):101.

Phalke VD, Phalke DB, Aarif SMM, Mishra A, Sikchi S, Kalakoti P. Prescription writing practices in a rural tertiary care hospital in Western Maharashtra, India. Australas Med J. 2011;4(1):4-8.

Kaur B, Walia R. Prescription Audit for evaluation of prescribing pattern of the doctors for rational drug therapy in a tertiary care hospital. J drug Deliv Ther. 2013;3(5):77-80.

Saghafi, F ZA. Medication error detection in two major teaching hospitals: What are the types of errors?. J Res Med Sci. 2014;19(7):617-23.

Aravamuthan A, Arputhavanan M, Subramaniam K, Udaya CJSJ. Assessment of current prescribing practices using World Health Organization core drug use and complementary indicators in selected rural community pharmacies in Southern India. J Pharm Policy Pract. 2016;10(1):1.

Kumar MS, Kumar NB, AY, Ashish S, Avinash S. Study of prescribing habits and assessment of rational use of drugs among doctors of primary health care facilities. Asian J Pharm Clin Res. 2011;4(4):102-5.

Sudarsan M, Sitikantha B, Aparajita D. Audit and Quality Assessment of Prescriptions in an Urban Health Centre of Kolkata. Int J Med Public Heal. 2016;6(3):136-9.

Potharaju H, Kabra S. Prescription audit of outpatient attendees of secondary level government hospitals in Maharashtra. Indian J Pharmacol. 2011;43(2):150-6.

Sumalatha R, Nagabushan H. Assessment of knowledge, attitude and practice of prescription writing as per Medical Council of India guidelines among interns in a Medical College. Int J Pharmacol Res. 2016;6.

Abidi A, Gupta S, Kansal S. Prescription auditing and drug utilization pattern in a tertiary care teaching hospital of western UP. Int J Basic Clin Pharmacol. 2012;1(3):184-90.

Shelat PR, Kumbar SK. Analysis of out door Patients’ prescriptions according to World Health Organization (WHO) prescribing indicators among private hospitals in Western India. J Clin Diagnostic Res. 2015;9(3):1-4.

Kotwani A, Holloway K. Trends in antibiotic use among outpatients in New Delhi, India. BMC Infect Dis. 2011;11(1):99.

Berrington A. Antimicrobial prescribing in hospitals: be careful what you measure. J Antimicrob Chemother. 2010;65(1):163-8.

Iskandar K, Hanna PA, Salameh P, Raad EB. Antibiotic consumption in non-teaching Lebanese hospitals: A cross-sectional study. J Infect Public Health. 2016;9(5):618-25.