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Drug utilization pattern using WHO prescribing, patient care and health facility indicators in a primary and secondary health care facility

Zahida Parveen, Seema Gupta, Dinesh Kumar, Shahid Hussain.

Abstract
Background: Incorrect prescribing practices result in ineffective and insecure treatment, exacerbation or continuation of illness, damage to patient, increased cost, and development of drug resistance.

Aims and Objective: To assess the pattern of drug utilization including rationality in the outpatient departments of primary and secondary health-care facilities in rural health block of Jammu, India, using WHO indicators.

Materials and Methods: Data was collected prospectively from 500 prescriptions on detailed prescribers indicator form, and prescribing, patient care, and health facility indicators were calculated.

Result: The average number of drugs per encounter was 2.75, and 51.8% drugs were prescribed by generic name. Use of antibiotic (55% of encounter) was frequent, and injection use was (11.6%) little high. Only 40.9% of drugs prescribed conformed to essential drug list. Most patients (75.6%) knew the correct dosage, and average consultation time taken was 3.13 min. No copy of essential drug list was available. The availability of key drugs was 26%. Interventions to rectify overprescription of antibiotics, underprescribing by generic names, lack of knowledge of dosage, and lack of access to an essential drug list are necessary to further improve rational drug use.

Conclusion: Some of drug prescribing and patientcare practices were found to be inappropriate indicating need for intervention. Strategies can be targeted toward changing specific problems of irrationality. Clear and comprehensive rules should be formulated and implemented by the state government to ensure rational use of drugs.

Key words: Drug utilization; Essential Drugs; Polypharmacy; Prescribing Indicators; Health Facility Indicators



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