Drug Utilization Pattern by Using WHO Core Prescribing Indicators in Orthopedics and Obstetrics / Gynecology Departments of a Tertiary Care Hospital

Abstract

Introduction: Drug utilization research is an important tool to facilitate rational use of drugs. In low income countries irrational use of drugs is a common problem like overuse of drugs and inappropriate use of antibiotics, leading to poor treatment outcome and increased burden of treatment. This study was conducted to provide understanding of drug utilization pattern by using WHO Core Prescribing Indicator. Methods: This study was conducted in Orthopedics and Obstetrics / Gynecology departments. Patients visiting these Out Patient Departments with at least one drug on prescription form were included in the study. Further, information related to WHO Core Prescribing Indicators were collected in pre-designed proforma. Results: Average number of drugs prescribed per prescription was 2.6. Means of number of drugs prescribed in Orthopedics and Obstetrics / Gynecology departments were 2.9 and 2.3 respectively (p < 0.001). Drugs prescribed in generic name and from essential drug list was 41.4% and 34.3% respectively. Prescription forms with generic name in Orthopedics department were significantly more compared to Obstetrics / Gynecology department (p = 0.00002). However, there was an increased tendency to prescribe drugs from essential drug list in Obstetrics / Gynecology department compared to Orthopedics department (p < 0.001). Conclusion: Drugs were prescribed by generic name and from essential drug list, but this was not sufficient to meet the ideal values of WHO Core Prescribing Indicator. Therefore, prioritization on prescribing drugs by generic name and from essential drug list by respective departments to achieve the standards of WHO needs to be encouraged.

Drug utilization pattern and rational drug use at orthopedics and traumatology outpatient clinics: A cross-sectional study

“…The rate of drugs from essential drug list in our study was 33.8% which was quite low than the expected WHO value (100%) [7] and was found to be significantly lower in young adults compared to elderly (p=0.038). Our result is consistent with those reported by Karki et al [16] who found that 34.3% of drugs were prescribed from essential drug list at the orthopedics department. In a recent study, which evaluated the rational drug use at the obesity outpatient clinic of a tertiary care hospital in Turkey, higher percentages of drugs prescribed from essential drug list were found (61.4%).…”

“…Unlike our findings, two studies reported acute trauma and fractures as the most common diagnoses at the orthopedic departments. [15,16] Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently used drugs for the management of musculoskeletal conditions. [17] Gastroprotective agents are commonly prescribed concomitantly with NSAIDs to reduce the adverse effects (gastrointestinal ulcers, bleeding), morbidity and mortality due to NSAIDs long-term use.…”

“…[7] Similar to our results, many studies from distinct countries reported higher values than WHO ideal ranges, differing from 2.36 to 5.79. [13,15,16,[22][23][24][25][26] Polypharmacy was significantly higher in patients aged ≥65 years (average number of drugs per prescription: 3.1) than young adults aged between 18 and 44 years (p=0.001). This is an anticipated result due to the increased number of drugs used by increasing age related to existing comorbidities.…”

“…Unlike our findings, two studies reported acute trauma and fractures as the most common diagnoses at the orthopedic departments. [ 15 , 16 ]…”

Evaluation of the potential drug-drug interactions at orthopedics and traumatology outpatient clinics of a tertiary care hospital

“…In the present study, the average number of drugs per patient, that is an important prescribing indicator evaluating rational drug use, was 2.9 which is higher than the WHO ideal values (1.6-1.8). Our finding was similar to those reported by Kumar et al and Karki et al (3 and 2.9, respectively), 19,20 . The most commonly prescribed drugs in this study were NSAIDs, PPIs and skeletal muscle relaxants (Figure 1).…”