Publication: Prescribing patterns in the orthopaedics outpatient department in a teaching hospital in Pokhara, western Nepal
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Date
2006
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Kathmandu University
Abstract
Objectives: Information on the utilization patterns of drugs in the orthopaedics outpatient department (OPD) are
lacking in hospitals in western Nepal. The present study was carried out to obtain demographic information about
the respondents selected for analysis, information on the average number of drugs prescribed and the average cost of
drugs per prescription. The prescriptions were critically analyzed using predetermined criteria.
Methods: The study was carried out over a four-month period (01.09.2002 to 31.12.2002) at the Manipal Teaching
hospital, Pokhara, Nepal. The percentage of encounters with an injection or an antibiotic prescribed was noted. The
percentage of drugs prescribed from the Essential drug list of Nepal and the mean cost of drugs per prescription was
calculated.
Results: 1238 patients attended the orthopaedics OPD during the study period. 186 prescriptions were randomly
selected for analysis. The mean number of drugs per prescription was 1.9. Low backache was the most common
reason for attending the OPD. Nonsteroidal anti-inflammatory drugs (NSAIDs) were the most commonly prescribed
drug group. Diclofenac and meloxicam were the most commonly prescribed drugs. Mean ± SD cost of drugs was
166.2 Nepalese rupees. Injections and antibiotics were prescribed in 16 (8.6%) and 7 (3.8%) encounters
respectively. 51 prescriptions (27.4%) had various problems. Absence of diagnosis on the prescriptions and the
duration of treatment were most commonly observed.
Conclusions: Percentage of prescribing by generic name was low. Educational sessions for the doctors at different
levels to encourage prescribing by generic names and on correct writing of prescriptions are required. Studies
covering a larger number of patients and for a longer time period are required. A greater number of patients can be
studied, seasonal variations can be overcome and drug utilization can be measured quantitatively.
Key words: Drug use patterns, Drug utilization studies, NSAIDs, Prescription audit, Tertiary care hospital