WHO Indicators and its Compliance by General Practitioners of Lahore, Pakistan

Authors

1 School of Pharmacy, Department of Pharmaceutics, China Pharmaceutical University, Nanjing, Jiangsu 211198, PR China

2 Faculty of Pharmacy, Lahore College of Pharmaceutical Sciences, Lahore, Punjab, Pakistan

3 Institute of Pharmacy, Physiology &Pharmacology, Agriculture University, Faisalabad, Punjab, Pakistan

4 Department of Pharmacy, The University of Faisalabad, Punjab Pakistan

10.22034/ijps.2019.38704

Abstract

Abstract
Background: Prescribing pattern is also important factor to identify the problems related to prescribing and best tool to improve the quality of prescription and patient care.
Methods: The aim of current study was to evaluate the quality of prescription and prescribing practices as per WHO drug core indicators in Lahore, Pakistan. A descriptive and cross- sectional study was carried out to access the prescribing pattern in Lahore, Pakistan. A sample of 300 prescriptions were collected from well –known Pharmacies and hospitals located in Lahore, Pakistan. A Structured data collection form was designed. The standard world health organization (WHO) drugs core prescribing indicators were used to determine the prescribing pattern of physicians. Data was analyzed using IBM SPSS V21.0.
Results: The name of patients was mentioned 93% of total prescriptions. While age and sex mentioned on prescriptions were 67% and 53% respectively.
Only 22% prescriptions were containing patient weight description.32% of total prescriptions were mentioned prescriber address. 16% of total prescriptions were containing patient address. While 60% of total prescriptions were mentioned specliazation of prescribers. The total numbers of drugs prescribed on all encounter was 1122. The average number of drugs prescribed per encounter was 3.74(optimal value 1.6-1.8). The total number of drugs prescribed under generic name was 0% (optimal value 100%). Antibiotics were 42.5% of total drug prescribed (optimal value 20-26.8). Injections were 19.25% of prescriptions (optimal value less 10%). Prescription writing is a tough task.
Conclusion: The result of current study show a poor compliance rate of legal requirement required for prescription writing. Most of prescribers were deviated from standard guidelines. There is dare need to improve the knowledge about prescription writing and prescribing practices. Continuous education is required to ensure the rational prescribing at Lahore, Pakistan in future.

Keywords


[1] Desalegn, A. A. Assessment of drug use pattern using WHO prescribing indicators at Hawassa University teaching and referral hospital, south Ethiopia: a cross-sectional study. BMC Health Serv. Res. (2013) 13(1): 170.
[2] Bachewar, N. R., Choudhari, S. R., & Dudhgaonkar, S. Assessment of prescription pattern using WHO drug prescribing indicators in medicine wards of a tertiary care teaching hospital: a retrospective observational study. Int. J. Basic. Clin. Pharmacol. (2018) 6(8): 2070-2077.
[3] Sisay, M., Mengistu, G., Molla, B., Amare, F., & Gabriel, T. Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study. BMC. Health Serv. Res. (2017) 17(1):161.
[4] Milton, J. C., Hill-Smith, I., & Jackson, S. H. Prescribing for older people. BMJ: Br. Med. J. (2008) 336 (7644)-606.
[5] Rode, S. B., Ajagallay, R. K., Salankar, H. V., & Sinha, U. A study on drug prescribing pattern in psychiatry out-patient department from a tertiary care teaching hospital. Int. J. Basic Clin. Pharmacol. (2017) 3(3): 517-522.
[6] Desalegn, A. A. Assessment of drug use pattern using WHO prescribing indicators at Hawassa University teaching and referral hospital, south Ethiopia: a cross-sectional study. BMC Health Serv. Res. (2013) 13(1): 522-527.
[7] Tavakoli-Ardakani, M., Eshraghi, A., Talasaz, A. H., & Salamzadeh, J. A drug utilization evaluation study of amphotericin B in neutropenic patients in a teaching hospital in Iran. Iran. J. Pharm. (2012) 11(1):151.
[8] Pathak, A. K., Kumar, S., Kumar, M., Mohan, L., & Dikshit, H. Study of drug utilization pattern for skin diseases in dermatology OPD of an Indian tertiary care hospital-A prescription survey. J. clin. diagn. (2016) 10(2): FC01.
[9] Odusanya, O. O. Drug use indicators at a secondary health care facility in Lagos, Nigeria. J. Commun. Med. Prim. Health care (2004) 16(1): 21-24.
[10] Chandelkar, U. K., & Rataboli, P. V. A study of drug prescribing pattern using WHO prescribing indicators in the state of Goa, India. Int. J. Basic Clin. Pharmacol. (2017) 3(6): 1057-1061.
[11] Saeed, S., Saeed, P., & Sharma, VCurrent scenario of rational usage of various drugs in indoor patients. Int. J. Basic Clin. Pharmacol. (2017) 1(1):27-31.
[12] Dilbato, D. D., Kuma, Z. G., & Tekle-Mariam, S. A baseline survey on prescribing indicators and the underlying factors influencing prescribing in Southern Ethiopia. Ethiop. J. Health. Dev. (2017) 12(2): 87-93.
[13] Jackson, S. H. D., Mangoni, A. A., & Batty, G. M. Optimization of drug prescribing. Br. J. Clin. Pharmacol. (2004) 57(3): 231-236.
[14] Irshaid, Y. M., Al Homrany, M., Hamdi, A. A., Adjepon Yamoah, K. K., & Mahfouz, A. A. Compliance with good practice in prescription writing at outpatient clinics in Saudi Arabia. (2005) (5-6):922-8.
[15] Sapkota, S., Pudasaini, N., Singh, C., & Sagar, G. C. Drug prescribing pattern and prescription error in elderly: A retrospective study of inpatient record. Asian J. Pharm. Clin. Res. (2011) 4(3): 129-32.
[16] Sharif, S. I., Al-Shaqra, M., Hajjar, H., Shamout, A., & Wess, L. Patterns of drug prescribing in a hospital in Dubai, United Arab Emirates. Libyan. J. Med. (2008) 3(1): 10-12.
[17] Karande, S., Sankhe, P., & Kulkarni, M. Patterns of prescription and drug dispensing. Indian J. Pediatr. (2005) 72(2):117-121.
[18] Maxwell, S. Rational prescribing: the principles of drug selection. Clinical medicine (2009) 9(5): 481-485.
[19] Sawalha, A. F., Sweileh, W. M., Zyoud, S. H., Al-Jabi, S. W., Shamseh, F. B., & Odah, A. A. Analysis of prescriptions dispensed at community pharmacies in Nablus, Palestine. E. Mediterr. Health J. (2010) 16(7): 788.
[20] Ghoto, M. A., Surehyani, I., Dayo, A., Memon, N., Hamiduddin, A. A., Arain, M. I., ... & Mughal, S. A Prescribing Trend of Private Consultants at Hyderabad, Pakistan. Int. J. Adv. Rev. (2014) 2(3): 956-962.
[21] Mohammad, I. S., Khan, H. M., Akhtar, N., Saqib, U., Rasool, F., & Ijaz, H. Significance of
prescription elements and reasons of prescription errors in South Punjab, Pakistan. World Appl. Sci. J. (2015) 33: 668-72.
[22] Alam, K., Mishra, P., Prabhu, M., Shankar, P. R., Palaian, S., Bhandari, R. B., & Bista, D. A study on rational drug prescribing and dispensing in outpatients in a tertiary care teaching hospital of Western Nepal (2006) (4):436-43.
[23] Aronson, J. K. A prescription for better prescribing. Br. J. Clin. Pharmacol. (2006) 61(5): 487-491.
[24] Aronson, J. K. (Rational prescribing, appropriate prescribing. Br. J. Clin. Pharmacol. (2004)57(3): 229-230.
[25] B hartiy, S. S., Shinde, M., Nandeshwar, S., & Tiwari, S. C. Pattern of prescribing practices in the Madhya Pradesh, India. (2008) 6(1):55-9.
[26] Cheraghali, A. M., Nikfar, S., Behmanesh, Y., Rahimi, V., Habibipour, F., Tirdad, R & Bahrami, A. Evaluation of availability, accessibility and prescribing pattern of medicines in the Islamic Republic of Iran. (2004) 10(3):406-15.
[27] Bawazir, S. A. Prescribing pattern at community pharmacies in Saudi Arabia. (1992) 6:222-224.
[28] KC, A. P., & Riyas, S. K. N. Assessment of Prescribing Trends and Rationality of Drug Prescribing Using WHO Indicators in Malappuram District, India. J. Pharm. Res. (2012) 5(6):3189-3192.
[29] Nabiswa, A., & Godfrey, R. Irrational drug prescribing in developing countries. The Lancet, (1994) 343(8893): 358-359.
[30] S., Sankhe, P., & Kulkarni, M. Patterns of prescription and drug dispensing. Indian J. Pediatr (2005) 72(2):117-121.
[31] Najmi, M. H., Hafiz, R. A., Khan, I., & Fazli, F. R. YPrescribing practices: an overview of three teaching hospitals in Pakistan. J. Pak. Med. Assoc. (1998) 48:73-76.
[32] Riaz, H., Malik, F., Raza, A., Hameed, A., Ahmed, S., Shah, P. A., & Hussain, S. Assessment of antibiotic prescribing behavior of consultants of different localities of Pakistan. Afr. J. Pharm. Pharmaco. (2011) 5(5): 596-601.
[33] Trap, B., Hansen, E. H., & Hogerzeil, H. V. Prescription habits of dispensing and non-dispensing doctors in Zimbabwe. Health Policy Plann. (2002) 17(3): 288-295.