Prescription audit of a teaching hospital in South India using World Health Organization core prescribing indicators – A cross-sectional study

Abstract

Aim: World Health Organization (WHO) core prescribing indicators are highly standardized tools in reliably assessing the essential aspects of drug utilization pattern. It is critical that the rational use of drug prescribing is scrutinized for the utmost benefit of patient welfare. In this study, we aim to assess the prescription pattern and prescribing behavior of physicians using the WHO-recommended core prescribing indicators at a teaching hospital in South India. Materials and Methods: A prospective, descriptive cross-sectional study was conducted in the general medicine outpatient department of a tertiary care hospital for a period of 1 month in June 2019. A total of 600 prescriptions were sampled based on the WHO “How to investigate drug use in health facilities” document recommendation. The WHO guidelines and methods were observed to ensure data reliability. Descriptive statistical analyses such as frequencies, percentages, mean, and standard deviation were used to present the data. Results: The WHO core prescribing indicators analysis revealed that the average number of drugs per encounter was 2.38 ± 1.1 and only 796 (55.4%) of the drugs were prescribed by generic name. Whereas, the percentage of encounters prescribed with an antibiotic 44 (7.3%) and an injection 63 (10.5%) was less than the ideal recommendations as per WHO and 1265 (88%) of the drugs were prescribed from the National List of Essential Medicines. Conclusion: This study on prescription pattern audit done using the WHO core prescribing indicators highlights that prescriptions encountered with antibiotic and injection use were in accordance with the WHO recommendations.

Social and cultural determinants of antibiotics prescriptions: analysis from a public community health centre in North India

“…This study supports study results with (Kaur et al, 2018) who found that greater than 65% of prescriptions were from broad spectrum antimicrobials such as Amoxicillin-Clavulanic acid, Ceftriaxone, Ciprofloxacin, Clindamycin and Piperacillintazobectum. Further, we found the average number of drugs per prescription to be 2.6, which is higher than the WHO recommendation of 1.6-1.8 drugs per encounter, since a larger set of prescribed drugs increases the risks of drug interactions (Meenakshi et al, 2022).…”

“…What was reassuring was that we found that most of the drugs prescribed (98.9%) were from the Essential Drug List (EDL), which compared favorably with the claim by the clinicians expressed in the interviews that they prescribed 100% of the medicines from EDL. Other studies, for example, Meenakshi et al (2022) have reported from a study in a teaching hospital in Southern India that 88% of the drugs prescribed were from the EDL list. However, there were differences across the OPDs, and we found 27% belonged to dental OPD, followed by 20% from pediatrics, 19.3% from general medicine, and 11% from skin and so on.…”