Publication: Assessing Drug Utilization in the Emergency Medicine Department at a Tertiary Care Teaching Hospital Using WHO Drug Use Indicators
Date
2024
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
ABSTRACT
Background
Patients might need urgent care in critical cases. Limited resources and limited
manpower are limitations seen in developing countries. Very few studies have been
conducted on drug utilization in the emergency department in Nepal.
Objective
To find out the drug utilization pattern and the cost of medicines in emergency
medicine department as per WHO drug use indicators.
Method
The study design was a hospital based retrospective cross-sectional study done at
the emergency department of KIST Medical College and Teaching Hospital, Lalitpur,
Nepal. The study population were patients visiting the emergency department. The
data was collected during the period from April to June 2023. Data was collected
for one month from each quarter for the year 2023 from the medical records of the
patients from the medical records section. A structured proforma was used for the
data collection process. Census sampling method was used.
Result
Maximum patients, 257 (25.1%) were from age group 21-30 years. Females were
slightly more than males, 537 (50.5%). The top three diagnosis among the admitted
patients were soft tissue injury, 148 (13.9%), dengue fever, 138 (12.9%) and viral
fever, 51 (4.7%). Maximum patients, 346 (32.5%) were given two therapeutic classes
of drugs, followed by only one therapeutic class of drug for 251 (23.6%) patients. The
common classes of drugs prescribed for the patients were analgesics, 639 (60.1%)
followed by intravenous fluids, 410 (38.5%) and antiulcer drugs, 377 (35.4%). The
total cost of drugs used was calculated as Rs. 305126.4 (2280.99 USD) and the average
cost per patient was Rs. 297.97 NPR; 2.23 USD. The WHO drug prescribing indicators
showed maximum percentage, (85.4%) of encounters with injection prescribed
followed by the percentage of drugs prescribed from the Nepalese National List of
Essential Medicines 81.71%.
Conclusion
On the basis of the findings from this study injection prescribing, and the number of
drugs prescribed per encounter showed considerable deviation from the standards
recommended by the WHO. Hence, it is important for the hospital to design and
implement a system to promote judicious prescribing and injection medication
administration.
KEY WORDS
Drug utilization, Emergency department, WHO core drug use indicators, Nepal
Description
Jha N,1 Manandhar T,2 Oli E,3 KC P,4 Jha AK,5 Karki PS,6 Hada Batajoo K,7 Shankar PR8
1,2,7KIST Medical College and Teaching Hospital
Lalitpur, Nepal
3Nepalgunj Medical College and Teaching Hospital
Nepalgunj, Nepal
4Institute of Medicine
Kathmandu, Nepal
5Sita Nursing Home
Janakpur, Nepal
6Frontline Hospital
Kathmandu, Nepal
8IMU Centre for Education
IMU University, Kuala Lumpur, Malaysia
Keywords
Drug utilization, Emergency department, WHO core drug use indicators, Nepal