Drug utilization 90%: an innovative method in assessing quality of drug prescription with specific reference to non-steroidal anti-inflammatory drugs prescription

Dhananjay Kulkarni, Kokila B. N., Santosh Kumar Sahu, Ravindra Kumar G.


Background: DU90% is useful tool for assessing drug prescribing pattern. In this, drugs constituting 90% of the prescription volume are identified. Size of the DU90% segment helps us to assess rational prescribing. Large number of drugs in the DU90% segment indicates less rational prescribing, whereas small number suggests more rational prescribing.

Methods: Study was carried out in orthopaedic out-patient department (OPD) for a period of three months. Only OPD based NSAID containing prescriptions were included. Data was analyzed based on demographic parameters, prescription indices, fixed dose combinations (FDC) and co-prescription of gastro-protective agents (GPA). DU90% was calculated based on defined daily dose (DDD) with their respective value in Anatomical Therapeutic Chemical (ATC) classification code. Defined daily dose is calculated as DDD/1000/day.

Results: Diclofenac (38%) was the commonest NSAID prescribed. Diclofenac +chymotrypsin (25%) was the commonest FDC prescribed. Piroxicam (19%) was the commonest NSAID prescribed in monotherapy form.  Co-prescription of GPA was high (96%). 5 of the 7 prescribed NSAIDs constitute to DU90% segment.

Conclusions: Preferential cyclooxygenase-2 (COX-2) inhibitor NSAIDs were more preferred. Number of prescribed NSAIDs constituting to DU90% is more, thus prescription pattern needs further rationalization. Further large scale study is required to bring out more details about NSAID prescription pattern and its rational use.


DU90%, FDC, DDD, NSAID, Prescription pattern, GPA

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