Prescription Practises in the Emergency Department of a Tertiary Level Hospital of a Lower-Middle Income Country: Drug Use Indicator Analysis

IF 1.4 4区医学 Q2 EMERGENCY MEDICINE

Emergency Medicine Australasia Pub Date : 2025-10-01 DOI:10.1111/1742-6723.70145

Anjan Khadka, Sammodavardhana Kaundinnyayana, Kabir Thakali, Jebish Pradhan, Mili Koirala, Niranjan Chapagain, Madhu Sudan Aryal

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引用次数: 0

Abstract

Objective

Emergency departments are constantly overcrowded with patients in lower-middle-income countries (LMICs) like Nepal, where there is a high likelihood of prescription-related problems and deviations from lists of essential medicines. Few studies have reported the prescribing patterns in emergency departments in LMICs like Nepal. The objective of this study was to assess World Health Organization (WHO) core drug use indicators in the emergency department of a tertiary-level teaching hospital.

Methods

This cross-sectional descriptive study was conducted in a tertiary level hospital, assessing 384 prescriptions after obtaining Institutional Review Committee (IRC) permission. A validated proforma was used to collect demographic data, diagnoses, prescriptions, and patient outcomes. The time taken to administer the first drug, total turnaround time, commonly prescribed drug groups with commonly prescribed drugs, and common disease patterns were also recorded.

Results

The average age of a total of 384 patients was 51.58 ± 28.94 years. The average turnaround time was 100.37 ± 3.01 min. Gastrointestinal illnesses (26.37%) were the most prevalent illness, pantoprazole (11.05%) being the most frequently used drug. The average number of drugs per encounter was 2.38, and injections accounted for 86.76%, generic prescribing 18.70%, antibiotics for 8.10%, and 81.73% of the drugs were from the National List of Essential Medicines (NLEM) of Nepal.

Conclusion

This study found a higher average number of drugs per encounter than the WHO optimal value, with 81.73% of prescriptions containing medicines from the NLEM. While the study provides valuable insights into prescribing practises, there is a need to enhance generic prescribing.

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中低收入国家某三级医院急诊科处方实践：用药指标分析

目标：在尼泊尔等中低收入国家（LMICs），急诊科经常人满为患，很可能出现与处方有关的问题和偏离基本药物清单的情况。很少有研究报告尼泊尔等中低收入国家急诊科的处方模式。本研究旨在评估某三级教学医院急诊科的世界卫生组织（WHO）核心用药指标。方法：本横断面描述性研究在某三级医院进行，经机构审查委员会（IRC）批准，对384张处方进行评估。一个有效的形式被用来收集人口统计数据，诊断，处方和病人的结果。用药时间、总周转时间、常用药物组与常用药物、常见疾病类型也被记录。结果：384例患者平均年龄为51.58±28.94岁。平均周转时间为100.37±3.01 min。胃肠道疾病（26.37%）是最常见的疾病，泮托拉唑（11.05%）是最常用的药物。平均每次就诊药物数量为2.38种，其中注射剂占86.76%，仿制药占18.70%，抗生素占8.10%，81.73%的药物来自尼泊尔国家基本药物目录。结论：本研究发现，每次就诊的平均药物数量高于WHO的最优值，81.73%的处方含有NLEM中的药物。虽然这项研究为处方实践提供了有价值的见解，但有必要加强通用处方。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Emergency Medicine Australasia 医学-急救医学

CiteScore

3.70

自引率

13.00%

发文量

217

审稿时长

6-12 weeks

期刊介绍： Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine. Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.