A retrospective study of drug utilization pattern in the outpatient department of pediatrics in a tertiary care teaching hospital of Rajasthan, India
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20163231Keywords:
Drug utilization, Poly-pharmacy, Generic name, AntimicrobialsAbstract
Background: Though irrational prescribing is known throughout the world, but in developing countries because of small amount of funds available in the overall health budget for drugs, it has become more meaningful to prescribe drug rationally for optimum use of the allocated funds. The objective of this study was to study drug utilization pattern in paediatric patients attending paediatrics outpatient department, J. L. N. Hospital, Ajmer, Rajasthan.
Methods: Study was carried out retrospectively, for a period of one year, by analysing a total 2100 carbon copies of prescriptions of patients who had visited the O.P.D. of Pediatric of J. L. N. Hospital Ajmer.
Results: Among the total of 2100 patients, 67.71% patients were in age group of 1 to 14 years. 56.76% of total prescriptions accounted for the respiratory system followed by gastrointestinal system (26.62%). The most frequent classes of drugs prescribed were: antimicrobials (77.42%) followed by analgesic-antipyretics (69.28%). Cephalosporins were the most common among the antimicrobials prescribed. Total 7531 drugs were prescribed. The average number of drugs per prescription was 3.59. Of total medicine formulations prescribed, only 13.09% were prescribed by generic names and 38.03% were matching with those listed in model list of essential medicines. 50.68% medicine formulations were in the form of fixed dose combinations (FDCs) of which 26.96% were form the essential medicine list.
Conclusions: There is a lot of scope in prescribing pattern regarding poly-pharmacy, medicines prescribed by generic name and from Essential Drug List and usage of fixed dose combinations.
References
Rehana HS, Nagarani MA, Rehan M. A study on the drug prescribing pattern and use of antimicrobial agents at a tertiary care teaching hospital in eastern Nepal. Indian Journal of Pharmacology. 1998;30:175-80.
Sanz E, Hernandez MA, Ratchina S, Stratchounsky L, Peire MA, Lapeyre Mestre M, et al. Drug utilization in outpatient children. Acomparison among Tenerife, Valencia, And Barcelona (Spain) Toulouse (France) Sofia (Bulgaria), Bratislava (Slovakia) And Smolens K (Russia). Eur J Clin Pharmacol. 2004;60:127.
Rani TS, Deepthi V, Sowjanya N, Maheshwari E, Saraswathy GR. Study of utilization pattern of antimicrobials in paediatric outpatients. Journal of Pharmaceutical Research. 20007;6(2):104-7.
Dowell SF, Marcy SM, Phillips WR, Gerber MA, Schwartz B. Principles of judicious use of antimicrobial agents for pediatric upper respiratory tract infections. Pediatrics. 1998;101:163-5.
Bukhari S, Gaash B, Ahmad M, Farheen A. household survey of childhood morbidity and parental practices in Budgam District. Indian Journal for the Practising Doctor. 2008;4(6).
Nami P. Prescription pattern of antibiotics in paediatric hospital of Kathmandu valley. Journal of Nepal health Research Council. 2004;2(1):6-12.
Ashraf H, Hnada S, Khan NA. Prescribing pattern of drugs in outpatient department of child care centre in Moradabad city. International journal of Pharmaceutical Sciences and Research. 2010;3(2):Article 001.
Soodan V, Tandon VR, Gupta BM, Kapoor B. Rational prescription trends in pediatrics OPD in one of a tertiary health care center in India. Latest Reviews. 2005;3(6).
Dimri S, Tiwari P, Basu S, Parmar VR. Drug use pattern in children at a teaching hospital. Indian Pediatrics. 2009;46:(2):165-7.
Singh J, Bora D, Sachdeva V, Sharma RS, Verghese T. Prescribing pattern by doctors for acute diarrhoea in children in Delhi, India. J Diarrhoeal DisRes. 1995;13(4):229-31.
Tomson G, Diwan V, Angunawala I. Paediatric prescribing in out-patient care Sri Lanka. Eur J Clin Pharmacol. 1990;39:469-73.
Pathak D, Pathak A, Marrone G, Diwan V, Lundborg CS. Adherence to treatment guidelines for acute diarrhoea in children up to 12 years in Ujjain, India - a cross-sectional prescription analysis. BMC Infectious Diseases. 2011;11:32.
Bhatnagar S, Bhandari N, Mouli UC, Bhan MK. Consensus statement of IAP National task force: status report on management of acute diarrhea. Indian Pediatr. 2004;41(4):335-48.
Litalien C, Jacqz-Aigrain E. Risks and benefits of nonsteroidal anti-inflammatory drugs in children: a comparison with paracetamol. Paediatric Drugs. 2001;3(11):817-58.
Ferreio S, Vivas F, Jorquera AB, Dom'uez J, Herrera A, Fern'ez MJ, et al. Nimesulide-induced hepatotoxicity. Case report and bibliography review. Gastroenterol Hepatol. 2000;23:428-30.
WHO, the management of acute respiratory infections in children, practical guidelines for outpatient care. World Health Organization, Geneva; 1995.
Mainous AG, Hueston WJ, Davis MP, Pearson WS. Trends in antimicrobial prescribing for bronchitis and upper respiratory infections among adults and children. American J Public Health. 2003;93(11):1910-4.
Karande S, Sankhe P, Kulkarni M. Patterns of prescription and drug dispensing. Indian J Pediatr. 2005;72:117-21.
Sanz E, Hernández MA, Ratchina S, Stratchounsky L, Peiré MA, Lapeyre-Mestre M, et al. Drug utilization in outpatient children. A comparison among Tenerife, Valencia, an Barcelona (Spain), Toulouse (France), Sofia (Bulgaria), Bratislava (Slovakia) and Smolensk (Russia). Eur J Clin Pharmacol. 2004;60:127-34.
Nwolisa CE, Erinaugha EU, Ofoleta SI. Prescribing practices of doctors attending to under-fives in a children’s outpatient clinic in Owerri, Nigeria. J Trop Pediatr. 2006;52:197-200.
Prakash O, Mathur GP, Singh YD, Kushwalia KP. Prescription audit of fewer than six children living in periurban areas. Indian Pediatr. 1989;26:900-04.
Ansari KU, Singh S, Pandey RC. Evaluation of prescribing pattern of doctors for rational drug therapy. Indian J Pharmacol. 1998;30:43-6.
Desai S. Essential drugs and rational drug therapy. Bull Soc Rational Ther. 2001;12:27.
WHO Model List of Essential Medicines for Children 2nd List, 2008. Available at http://www.who.int/selection_medicines/committees/expert/17/DRAFT_SECOND_EMLc.pdf.
WHO Model List of Essential Medicines for Children 2nd List, 2010. Available at http://www.who.int/ medicines/publications/ essentialmedicines/ Updated second_ children_list_en.pdf.
National List of Essential Medicines 2003. Available at http://www.searo.who.int/Link Files /Essential_Drugs_and_Medicines_India.pdf.
Biswas NR, Biswas RS, Pal PS. Patterns of prescriptions and drug use in two tertiary hospitals in Delhi. Indian J Physiol Pharmacol. 2000;44:109-12.
Amitava S. Indian market's fixation with fixed dose combinations (Editorial) Rational Drug Bulletin. 2002;12:1.
Burke A, Smyth E, Gerald GAF. Analgesic-antipyretic agents; pharmacotherapy of gout. In: Brunton LL, Lazo JS, Parker KL, editors. Goodman and Gilman's the Pharmacological Basis of Therapeutics.11 New York: Mc Graw-Hill; 2006:685.