Assessment of drug use practices among dermatology out-patients using WHO core drug use indicators

Abstract

INTRODUCTIONWith the spurge of basic and clinical research activities, and the subsequent recognition of newer dermatological disorders; dermatology, venereology and leprology is now considered to be the one of the most important specialties in a healthcare setup. The skin, the largest organ of the body, epitomize for most of the underlying internal diseases. Dermatological conditions accounts for up to 2% of consultations in general practice worldwide. 1 Dermatological problem in India manifests as primary and secondary cutaneous complaints. 2 In India the most prevalent dermatological condition includes dermatitis , ABSTRACTBackground: Considering the economic burden the skin diseases cause owing to its high prevalence, it is of interest to periodically monitor the drug use pattern so as to increase the therapeutic efficacy, decrease adverse effects and provide feedback to prescribers. The present study thus assessed the drug use practices among dermatology outpatients in a tertiary care teaching unit in Eastern India. Methods:The study assessed drug use practices for all prescriptions of patients attending the concerned OPD using WHO core drug use indicators which consist of mainly three domains, prescribing indicators, patient care indicators and healthcare indicators. Results: Total number of drugs in 471 prescriptions was found to be 1050. Number of drugs per prescription varied from 1 to 6 with average of 2.22. The most commonly prescribed drugs were antibiotics, followed by steroids and steroidal combinations. Prescribing indicators revealed that 2.09% drugs were generic prescribing, with about 18.78% of the drugs being prescribed from the WHO essential drug list. The proportion of encounters with at least one antibiotic prescribed was 34.82%. 13.9% drugs actually dispensed from hospital supply, of which all were adequately labelled. Conclusions: Increasing dermatological prescribing has necessitated assessment of their rational usage. Promoting rational drug use policy is recommended for effective healthcare management.

Drug utilization study in patients visiting dermatology outpatient department in tertiary care hospital

“…14,15 The current study findings suggested that 63.2% of the drugs were prescribed in the form of tablets, 20.4% were prescribed in the form of creams, 14.7% was in the form of capsules and 1.7% were in the form of syrups, which was similar to the study conducted by Khobragade et al, having 55% in the form of tablets, 23.1% in creams and 6.4% in the form of capsules and Kumar et al, having 35% in the form of tablets, 21% in creams and 4.1% in the form of capsules. 14,15 Under WHO core drug use indicators, in the present study, 100% of the drugs were prescribed by generic names, which was 89.3% in study conducted by Khobragade et al, and just 2.1% in the study by Mukherjee et al 12,14,16 Whereas only 7.9% of the encounters had an antibiotic prescribed in present study, compared to 23.1% in study by Khobragade et al and 34.8% by Mukherjee et al 14,16 Percentage of encounters having at least one steroid prescribed were 12.3% in the present study, was 11.9% in study conducted by Khobragade et al and 51.8% in study conducted by Mukherjee et al 14,16 Percentage of encounters having at least one injectable prescribed were 0% in present study, was 3.1% in study conducted by Khobragade et al and 11.9% in study conducted by Mukherjee et al 14,16 Percentage of prescribed drugs featuring in WHO essential drugs list were 68.9% in present study, was 90.3% in study conducted by Khobragade et al 12,14 Percentage of drugs prescribed by FDCs were 10.8% in current study and 9.75% in study conducted by Mukherjee et al 16…”

Assessment of Drug use Practices among Patients Visiting Outpatient Department of Dermatology at a Hospital in Pokhara, Nepal.

“…Similar data was found in study of 19 (11.07%) where it was higher than our study 18 (28.61%). Antibiotics were most commonly prescribed class of drugs 22,5 and. 4 The result of the study regarding percent encounter with an antibiotic prescribed (13%) is within the range of WHO.…”

“…2 WHO in collaboration with the International Network for the Rational Use of Drug (INRUD) developed core indicators (average number of drugs per encounter, percentage of encounters with an antibiotic prescribed, percentage of drugs prescribed from WHO essential drug list, percentage of fixed drug combination from WHO essential drug list. 5,6 Commonly used drugs for treatment of dermatological conditions include antibiotics, antiseptics, corticosteroids, antifungals, antivirals, anti-histaminic, local anesthetics, emollients, keratolytic, anti-parasitic, vitamins and so on. Irrational drug combinations, over use of multivitamins, emollients, unnecessary use of antibacterial in fungal infections and prescribing drug from same class led to the unnecessary skin diseases.…”