REVIEW OF PRESCRIBER APPROACH TOWARDS RATIONAL DRUG PRACTICE IN HOSPITALISED PATIENTS
Abstract
Background: The rational drug prescribing practice is an important health concern around the globethat not only interferes patient's life but also the socioeconomic issues. Objective: The aim of
current study was to evaluate the rational use of drug, prescribing behaviour of consultant physicians,
role of medical team members in irrational therapy and form the basis for providing necessary
information to the policy makers. Methods: This cross-sectional study was conducted involving a
set of 340 medication orders containing about 1,755 medications prescribed to patients in DHQ
Teaching Hospital DI Khan, Pakistan from March to July 2009. The WHO operational package for
monitoring and assessing country pharmaceutical situations indicators were used for data collection.
Results: Among drugs prescribed per average encounter, 75% were dispensed from hospital
pharmacy. Generally about 22.3% encounters of overdosing, 16.16% drug duplication, 24.25% drugdrug interactions, 3.5% adverse drug effects and 3.8% cases of contraindications were recorded. The
proportion of consultations with antibiotics and injectables prescribed was 80% and 57%
respectively. Likewise not less than 70% patients were prescribed NSAIDS, 67% steroids, 55%
vitamin supplements, and 34% oral re-hydration solutions. Minimum 5 drugs per prescription were
recorded and 70% of prescriptions were reported with high cost of therapy. Conclusion: The drug
practice among hospitalised patients was clearly irrational accompanied by high levels of medication
error. An accurate prescribing decision, appropriate treatment, and rational use of drugs are major
needs of the day to ensure safe medication practice.
Keywords: Rational drug use, adverse drug effects, generic drugs, medication profile
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