Prescribing Practices in the Outpatient Department in a Tertiary Care Teaching Hospital in Bangladesh

Abstract

A cross-sectional descriptive study was carried out among individuals attending the Out Patient Department (OPD) of Medicine, Paediatrics, Dermatology & Venerology, ENT, Orthopaedics and Gynaecology & Obstetrics from December 2011 to March 2012 in East-West Medical College Hospital, Dhaka, Bangladesh, to see the patterns of prescriptions using World Health Organization (WHO) core prescribing indicators and some additional indices. A total of 300 prescriptions were collected and analyzed by the 3rd year MBBS students in this study. The average number of drugs per encounter was 3.22 and 5.33% drugs were prescribed by generic name. Use of antibiotic (48.67% of encounters) was frequent, but injection use (6.67% of encounters) was within the recommendation of WHO. Only 26.09% drugs were prescribed from national essential drug list. Percentage of encounters with a NSAID, an anti-ulcerant, an antihistamine, a calcium preparation and a multivitamin & multimineral prescribed were 44.33%, 43.33%, 22.33%, 19.33% and 15.67% respectively. So, the findings from current study showed a trend towards inappropriate prescribing, particularly the over-prescribing of antibiotics and under-prescribing of generic drugs and also most of the drugs were prescribed out of national essential drug list. Hence, there would be needed for effective intervention program to encourage the physicians and healthcare providers in promoting more appropriate drug use. DOI: http://dx.doi.org/10.3329/updcj.v2i2.15483 Update Dent. Coll. j: 2012; 2 (2): 13-17

Morbidity and drug prescribing patterns at a rural primary health care center of Bangladesh

“…The results of the present study revealed that the average number of drugs prescribed per encounter was 3.3 which were not within the recommended range of WHO guideline. Similar prescribing trends were reported from earlier studies in Bangladesh and several other developing countries [9,10,17]. However, practice of prescribing drugs within the WHO recommended range (≤3) was observed in Zimbabwe, Jordan, Brazil, India and Nepal [18][19][20][21][22].…”

“…About 45.6% of drugs in this study were prescribed by generic name which was far less than WHO recommended guideline of 100%. A previous study conducted at a tertiary care hospital of Bangladesh reported the rate of prescription of drugs by generic name around 50%, while another study at a Government referral hospital in northern Bangladesh found no prescription by generic name [9,10], The rate of prescribing drugs in generic name ranges from 27% to 61% in other developing countries of Asia and Africa [10,[24][25][26][27].…”

“…In this study, the rate of prescribed parenterally administered drugs (13.6%) was found higher than the acceptable range of WHO guideline. Previous studies in tertiary care hospitals of Bangladesh reported this rate as 17.2% and 6.7% [9,10]. The rate was even higher in tertiary health care facilities in countries like Nigeria (26.9%-40.6%) and Ethiopia (38.1%) [35][36][37].…”

“…In Bangladesh, there are few studies on the morbidity and related drug prescription pattern in rural primary health care facilities. Most of the available studies were conducted in tertiary care hospitals [9,10]. In 2015, a study conducted in primary level rural hospital of Bangladesh reported high use of antibiotics [11].…”

Prescribing Pattern in Outpatient Departments of Two Tertiary Care Teaching Hospitals in Dhaka

“…The result was similar with the study result of Bangladesh (3.22) and Nigeria (3.3). 8,9 The trend of polypharmacy may be due to the patient's expectations and demand of quick relief, the incorrect diagnosis and the influence of the lucrative promotional programs of the drug companies. 4 Polypharmacy is known to cause unnecessary adverse reactions, drug interactions, unnecessary drug expenses and complications.…”