Prescription Audit in Outpatient Pharmacy of a Tertiary Care Referral Hospital in Haryana Using World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) Core Prescribing Indicators: A Step Towards Refining Drug Use and Patient Care.
Nikhil Verma, Shanmugapriya Vinayagam, Niti Mittal, Rakesh Mittal, Neeraj Bansal
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Abstract
Background: The evaluation of internationally comparable indicators of medicine use is important to devise strategies to promote the rational use of medicines (RUM).
Methods: A cross-sectional study was conducted in a tertiary care hospital from January to June 2024. Prescriptions were collected from the outpatient pharmacy using systematic random sampling and analyzed for WHO/INRUD core prescribing indicators, index of rational drug prescribing (IRDP) and completeness (general, treatment and prescribers' details).
Results: Out of 844 prescriptions collected, 607 were analyzed. A total of 1837 drugs were prescribed, with a mean (SD) of 3.03 (1.51) drugs per prescription; 1378 (75%) drugs were prescribed as generic names; 125 prescriptions (20.59%) had an antibiotic prescribed; and injectables were given in 7 (1.15%) prescriptions. Of the total 1837 drugs, 1018 (55.4%) were mentioned in the National List of Essential Medicines (NLEM) 2022, while 934 (50.8%) were included in the Haryana state essential medicines list (2013-2014). The IRDP was calculated as 3.86. The mean (SD) completeness score of the prescriptions was 10.33 (0.8) (range 5 to 11).
Conclusions: There was a high incidence of polypharmacy, brand name and non-essential drug prescribing, while antibiotic and injection use were in accordance with WHO standards.