Morbidity profile and prescribing patterns among outpatients in a teaching hospital in Western Nepal
Background: Recent studies on prescribing among outpatients in hospitals in Western Nepal are lacking. The main objectives of the study were to obtain information on the morbidity pattern among outpatients and to analyze prescribing using drug use indicators.
Methods: A retrospective hospital record based study from 01.01.2004 to 31.12.2004 was carried out among individuals attending the outpatient department (OPD) of the Manipal Teaching hospital, Pokhara, Western Nepal. A total of 32,017 new patients attended the OPD during the study period. Systematic random sampling (1 in every 20 patients) was done and 1600 patients selected. After excluding patients visiting the emergency department, those who got admitted and whose records were not available, 1261 cases were analyzed. The demographic details, morbidity pattern, average number of drugs prescribed, percentage of drugs prescribed by generic names and from the Essential drug list of Nepal (Essential drugs are those which satisfy the priority healthcare needs of the population), percentage of encounters with an antibiotic and an injection prescribed were noted.
Results: 1261 patients made 1772 visits. Upper respiratory tract infection and acid peptic disease were the most common diagnoses. The mean number of drugs was 1.99. Only 19.5% and 39.6% of drugs were prescribed by generic name and from the Essential drug list. Antibiotics and injections were prescribed in 26.4% and 0.96% of encounters. Cetrizine, vitamins, amoxicillin, the combination of paracetamol and ibuprofen and ranitidine were most commonly prescribed.
Conclusions: Upper respiratory tract infections and acid peptic disease were the common illnesses. Generic prescribing and use of essential drugs were low. Some of the drug combinations being used were irrational. Prescriber education may be helpful in encouraging rational prescribing.
- World Health Organization. Introduction to drug utilization research. Oslo: 2003.
- Uppal R, Nayak P, Sharma PL. Prescribing trends in internal medicine. Int J Clin Pharm Ther Toxicol 1984; 22:373-376.
- Krishnaswamy K, Dinesh Kumar B, Radhaiah G. A drug use survey- precepts and practice. Eur J Clin Pharmacol 1985; 29:363-370.
- Pradhan SC, Shewade DG, Shashindran CH, Bapna JS. Drug utilization studies. National Med J India 1988; 1:185-189.
- Marshner JP, Thurmann P, Harder S, Rietbrock N. Drug utilization review on a surgical intensive care unit. Int J Clin Pharmacol Ther 1994; 32:447-451.
- Hogerzeil HV. Promoting rational prescribing: an international perspective. Br J Clin Pharmacol 1995; 39:1-6.
- Joshi MP. Rational prescribing. In: Joshi MP, Adhikari RK, eds. Manual of drugs and therapeutics. Kathmandu: Health Learning Materials Centre 1996:1-10.
- Sarkar C, Das B. Prescribing trends in a teaching hospital in Western Nepal. Journal of Nepalgunj Medical College 2:4-5; 2002.
- Shankar PR, Partha P, Nagesh S. Prescribing patterns in medical outpatients. Int J Clin Pract 2002; 56:549-551.
- Mishra P. Enhancement of consumer safety and rational use of drug: an important role of Drug and Therapeutics Committee (DTC). HAI News 2005; 132:21-22.
- Department of Drug Administration. National list of essential drugs, Nepal (Third revision). Kathmandu: 2002.
- Central Bureau of Statistics. Population monograph of Nepal. Volumes I and II. Kathmandu:2003.
- Department of Health Services. Annual Report 2058/59 BS (2001/2002 AD). Kathmandu: 2003.
- Bajracharya S, Pandey S, Shakya YL. Drug prescribing pattern and disease pattern in KMC Duwakot health center. Kathmandu University Medical Journal 2004; 2:35-42.
- World Health Organization. Scaling up the response to infectious diseases - A way out of poverty. Report on infectious diseases 2002. WHO/CDS/2002.7. Geneva: 2002.
- INRUD, Nepal. 18th National training course on rational use of drugs. 15-20 April 2005. Kathmandu: 2005.
- Chukwuani CM, Onifade M, Sumonu K. Survey of drug use practices and antibiotic prescribing pattern at a general hospital in Nigeria. Pharm World Sci 2002; 24:188-195.
- Pavin M, Nurgozhin T, Hafner G, Yusufy F, Laing R. Prescribing practices of rural primary health care physicians in Uzbekistan. Trop Med Int Health 2003; 8:182-190.
- Rishi RK, Sangeeta A, Surendra K, Tailang M. Prescription audit: experiences in Garhwal (Uttaranchal), India. Trop Doct 2003; 33:76-79.
- Shankar R, Kumar P, Rana M, Dubey A, Shenoy N. A comparative study of drug utilization at different levels of the primary health care system in Kaski district, Western Nepal. N
- Z Med J 2003: 116.
- Orrett FA. Antimicrobial prescribing patterns at a rural hospital in Trinidad: evidence for intervention measures. Afr J Med Sci 2001; 30:161-164.
- World Health Organization. WHO global strategy for containment of antimicrobial resistance.
- WHO/CDS/CSR/DRS/2001.2. Geneva: 2001.
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