Oct-Dec, 2011 - Indian Journal of Pharmacy Practice

Mihir Y.P - Study of Prescribing Pattern for Evaluation of Rational Drug Therapy in Warangal(g) Date of issuing the prescription, whether mentioned ornot.(II) Rationality of prescription(a) Number of drugs prescribed.(b) Number prescribed in generics.c) Number of fixed dose combinations used.(d) Dose strength and dosage of drug whether written or not.(e)(f)Duration of therapy – short, long, or not mentioned.Banned drug formulations.All the drugs used were assigned different categories using[6]criteria suggested by Kunin et.al .RESULTSPatient's Identity: Name, age, address were mentioned in100 %, 15 % and 0 % of the prescriptions respectively. Date ofwriting prescription was mentioned in 100% of prescriptions.Superscription: Traditionally denoted by letter 'Rx' wasmentioned in 35 % of prescriptions. 65% of prescriptionswere without superscription.Inscription & Subscription: It consists of four componentsi.e. base, adjuvant, corrective and vehicle. Since only alreadycompounded drugs were studied, these components ofinscription were not analyzed separately. Route of drugadministration was mentioned in 24 % of drugs only, rest ofthe drugs were in oral dosage forms (76%). However, dosageforms were mentioned in 74.8 % of the drugs. In 57.7 % ofprescriptions, duration of therapy was mentioned.Instructions to the patient: Instructions to the patient wereinadequate in 32 % of the prescriptions. Instructions weregiven in simple English in 20% and using local language in 80% of the prescriptions. Instructions regarding refilling ofprescription and substitution of products were not given in allthe cases.Prescriber's Identity: Name and qualification of theprescriber were known in 100 % of the prescriptions.Registration number was also known in 100 % of theprescriptions.For rationality of prescription: Average number of drugsper prescription was 3.41. Drugs were not prescribed undergeneric name in any of the cases. Fixed drug combinationswere used in 7.9 % of prescriptions.Dose strength & dosage: Dose and dosage were notmentioned in 25.2 % of the prescriptions. Dose and dosagewere found incorrect in 8% of the prescriptions in which theyare mentioned.Duration of therapy: Duration of therapy was not mentionedin 42.3 % of prescriptions. In majority of the cases,instructions' regarding duration of drug therapy was verbal. Inthose cases where the duration had been mentioned, it wasfound to be correct in 52 %, short in 38 % and prolonged in 10% of prescriptions.Overprescribing: Over prescribing was encountered in 25 %of the prescriptions e.g. paracetamol was prescribed inaddition to various anticold preparations which alreadycontain paracetamol, more than one NSAIDS was prescribedto same patients.Banned drug formulations: None of the drugs banned bydrug controller of India were used in the present study.On analysis of various drugs based on the criteria suggested[6]by Kunin et al, 1973 , it has been found that use of drug wasinappropriate in 20% of the cases.Table 1: Analysis of PrescriptionsParticularNumberTotal number of prescriptions 250Total number of drugs used 854Average number of drugs per prescription 3.41Drugs prescribed under generic names 0.0 (0%)Drugs prescribed under brand names 854 (100%)Fixed dose combinations used 68 (7.9%)Dose and dosage not mentioned 216 (25.2%)Duration of therapy not mentioned 362 (42.3%)DISCUSSIONTwo parameters were assessed in the present study i.e.adherence to prescription format and rationality ofprescription. Results obtained after auditing prescriptions forprescription format indicate that majority of prescriptions donot adhere to the ideal pattern of prescription writing.Important demographic parameters like age and gender werenot written in majority of the cases. Directions regarding totalamount of drug to be dispensed and instructions regarding useof drug were inadequate in 45 % & 28 % of the prescriptionsrespectively.Second component of the present study was auditingprescriptions for rationality. Though quality of prescribing isassociated with use of relatively limited number of7pharmaceutical products. It is preferable to keep the numberof drugs prescribing as low as possible since higher figuresalways lead to increased risk of drug interactions and8,9increased treatment cost. Average number of drugs perprescription (3.41) in the present study was less than that10,11,12reported by various Indians and international workers.Indian Journal of Pharmacy Practice Volume 4 Issue 4 Oct - Dec, 2011 78