A cross-sectional study on prescription pattern, essential medicines adherence and drug-drug interactions in patients attending ENT outpatient department of a tertiary care hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20260346Keywords:
Drug utilization, Otorhinolaryngology, Essential medicines, Drug-drug interactions, Medscape drug interaction checkerAbstract
Background: Ear, nose, and throat (ENT) disorders are common across all age groups and pose a significant socioeconomic burden. Effective management depends on rational drug prescribing. This study aimed to evaluate prescribing patterns in the ENT outpatient department of a tertiary care hospital, assess adherence to the National List of Essential Medicines (NLEM) 2022, and identify potential drug-drug interactions.
Methods: A cross-sectional observational study was conducted in the ENT outpatient department, involving 326 patients who received at least one drug. Data on demographics, diagnoses, comorbidities, and prescriptions were collected. Drug interactions were assessed using the Medscape drug interaction checker. Descriptive statistics were applied.
Results: Chronic suppurative otitis media (26.1%) was the most common diagnosis, followed by pharyngitis (11%). A total of 1204 drugs were prescribed, with an average of 3.7±1.3 drugs per prescription. Antimicrobials were the most frequently prescribed class, with Amoxicillin + Clavulanic acid being the most common oral agent (52.5%). Oral administration (74.4%), mainly in tablet form, was predominant, along with topical formulations like ear and nasal drops. Generic prescribing was observed in 66.4% of cases. Of the 56 drugs prescribed, 34% were from the hospital formulary and 41% from NLEM 2022. Potential minor drug-drug interactions were identified in only 2.1% of prescriptions.
Conclusions: The study reflects common ENT prescribing practices, with a focus on antimicrobials and oral formulations. While generic prescribing is fairly common, adherence to the NLEM and hospital formulary can be improved. Drug interaction incidence was low, indicating responsible prescribing practices.
Metrics
References
Kaur G, Dhingra R. Pattern of drug use in ENT patients: A prospective study. Int J Med Res Prof. 2021;7(1):22-4.
Qayyum SF, Fayyaz S. Frequency of diseases presenting in ENT OPD at Ayub teaching hospital Abbottabad. Sanamed. 2019;14(2):175-80.
World Health Organization. Deafness and hearing loss, 2026. Available at: https://www.who.int/health-topics/hearing-loss#tab=tab_2. Accessed on 02 January 2026.
Garud S, Buche A, Keche P, Chamania G. Socioeconomic impact on prevalence of chronic suppurative otitis media in school going children in a tribal district of India. Int J Med Sci Public Health. 2017;6(4):699-702.
Townsley RB, Huser CA, Hansell C. Viruses and antiviral agents. In: Watkinson JC, Clarke RW, eds. Scott-Brown’s Otorhinolaryngology Head and Neck Surgery Volume 1. 8th ed. Florida: CRC Press. 2018;195-204.
Nur Husna SM, Tan HT, Md Shukri N, Mohd Ashari NS, Wong KK. Allergic rhinitis: A clinical and pathophysiological overview. Front Med (Lausanne). 2022;9:874114.
Jain DM. Comparison of outcomes of management of chronic rhinosinusitis by conservative approach vs endoscopic sinus surgery with review of literature. J Med Sci Clin Res. 2017;5(03):19369-78.
Jain S, Upadhyaya P, Goyal J, Kumar A, Jain P, Seth V, et al. A systematic review of prescription pattern monitoring studies and their effectiveness in promoting rational use of medicines. Perspect Clin Res. 2015;6(2):86-90.
Johnson AR, Brown KM. Principles of clinical toxicology. In: Brunton LL, Knollmann BC, editors. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 14th ed. New York: McGraw Hill. 2023;160-1.
Vijay R, Atray M. Drug utilization pattern in ENT outpatient department in tertiary care teaching hospital in Southern Rajasthan. Natl J Physiol Pharm Pharmacol. 2022;12(10):1725-34.
Kumari N, Mishra SK, Kumar M, Shakur AA, Mishra H, Dikshit H. Prescription pattern of drugs prescribed in out patient department of ENT and adverse drug reactions reported from ENT department in a tertiary care hospital of Bihar. Int J Pharm Sci Rev Res. 2022;73(2):178-83.
Aalasyam N, Potnuru S, Sileveru CM, Pokala U, P. N. Antimicrobial prescription pattern in ENT outpatient department in a tertiary care teaching hospital, Telangana, India. Int J Recent Surg Med Sci. 2024;10:S28-34.
Sah BP, Paudel D, Sarraf DP. Drug utilization pattern using World Health Organization prescribing indicators at otorhinolaryngology OPD of a tertiary teaching hospital of Eastern Nepal. Birat J Health Sci. 2020;5(2):1076-81.
Fatima ZA, Samreen A, Namreen H, Siddiqui SA, Aleem MA. A study on drug utilisation patterns and use of corticosteroids in otolaryngology department. Int J Curr Sci Res. 2021;7(7):2171-87.
Jayaram S, Marnane C. Pharyngitis. In: Watkinson JC, Clarke RW, eds. Scott-Brown’s Otorhinolaryngology Head and Neck Surgery Volume 3. 8th ed. Florida: CRC Press. 2018;791-802.
Halli-Tierney AD, Scarbrough C, Carroll D. Polypharmacy: evaluating risks and deprescribing. Am Fam Physician. 2019;100(1):32-8.
Tripathi KD. Beta-Lactam Antibiotics. In: Tripathi M, editor. Essentials of Medical Pharmacology. 8th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2019:766-783.
Tripathi KD. Histamine and Antihistaminics. In: Tripathi M, ed. Essentials of Medical Pharmacology. 8th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2019:174-184.
Sonawane SD, Razvi SU, Baig MS. Prescription pattern and drug utilization study in patients attending otorhinolaryngology outpatient department at a tertiary care hospital. Indian J Appl Res. 2023;13(5):88-91.
Sharma HL, Sharma KK. Treatment of gastric acidity, peptic ulcer and gastroesophageal reflux disease. In: Sharma & Sharma’s Principles of Pharmacology. 4th ed. Hyderabad: Paras Medical Publisher; 2023: 390-401.
Satoskar RS, Rege NN, Tripathi RK, Kamat SK. Pharmacotherapy of Bronchial Asthma, COPD and Rhinitis. In: Pharmacology and Pharmacotherapeutics. 26th ed. Mumbai: Elsevier. 2021;353-4.
Gupta S, Kumaravel J, Prakash A, Medhi B. Concept of essential medicines and recent updates. Indian J Pharmacol. 2023;55(1):1-5.
Ahmad A, Khan MU, Haque I, Ivan R, Dasari R, Revanker M, et al. Evaluation of potential drug-drug interactions in general medicine ward of teaching hospital in southern India. J Clin Diagn Res. 2015;9(2):FC10-3.
Hall JJ, Bolina M, Chatterley T, Jamali F. Interaction between low-dose methotrexate and nonsteroidal anti-inflammatory drugs, penicillins, and proton pump inhibitors: A narrative review of the literature. Ann Pharmacother. 2017;51(2):163-78.
MacNaughton WK, Sharkey KA. Pharmacotherapy of Inflammatory Bowel Disease. In: Brunton LL, Knollmann BC, editors. Goodman & Gilman’s The Pharmacological Basis of Therapeutics. 14th ed. New York: McGraw Hill; 2023:1111-1113.