Study of drug utilization pattern in department of general practice and emergency medicine of a tertiary care hospital in Kathmandu, Nepal.
ABSTRACT: Background Irrational drug prescribing is considered one of the major challenges for the healthcare sectors worldwide, leading to negative outcomes in patients including various drugrelated problems, such as polypharmacy, adverse drug events, antibiotic resistance, more demands on drug m...
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| Format: | Book |
| Language: | English |
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c2020.
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| Summary: | ABSTRACT: Background Irrational drug prescribing is considered one of the major challenges for the healthcare sectors worldwide, leading to negative outcomes in patients including various drugrelated problems, such as polypharmacy, adverse drug events, antibiotic resistance, more demands on drug monitoring, and unwanted increase in drug consumption and treatment cost. Study on the drug utilization pattern in the Department of General Practice and Emergency Medicine is important not only for the general physician but also for the emergency physicians regarding rational prescription of medicine. It provides the means of evaluating drug prescribing trends, cost-effectiveness and efficiency of hospital formularies. Objective The objective of this study was to determine drug utilization pattern in the Department of General Practice and Emergency Medicine of Tribhuvan University Teaching Hospital of Nepal. Methods A descriptive (cross-sectional, observational) study was conducted for one year from October 2019 to September 2020 in the Department of General Practice and Emergency Medicine at Tribhuvan University Teaching Hospital. All the patients aged 18 years and more, irrespective of diagnosis, who met the inclusion criteria during the study period and had given written consent were enrolled, (n=384) in our study. The encounters included, patients who were prescribed at least one medication during their visit in emergency room. Result Of 384 patients prescriptions included in the study, a total of 1262 drugs were prescribed. The average number of drugs per encounters was 3.28. It was seen that, significant number of patients in the study (26.56%) received at least two drugs during emergency room visit. Drugs prescribed by generic name were 29.63% and those prescribed from National List of Essential Medicines Nepal (NLEM 2016) was 59.82%. The percentage of encounters with antibiotics or injections in the prescription was 33.33% and 89.58% respectively. Maximum of 8 drugs and minimum of 1 drugs was prescribed when polypharmacy was analyzed. Maximum numbers of patients were admitted for gastrointestinal disorders (26.82%). Pantoprazole was the maximum utilized drug (54.68%), having a drug consumption of 17.01 Defined Daily Dose/1000 patients/day. Among antibiotics, ceftriaxone was maximum utilized antibiotic (59.05%), having drug consumption of 3.25 Defined Daily Dose/1000 patients/day. Average drug cost per prescription was found to be Rupees 303.39. Adverse drug reactions were noted in 2 patients which was warfarin induced coagulopathy, Type A (Augmented) reactions. Conclusion Our study shows that the average number of prescribed drugs per encounter was higher than what was considered ideal according to WHO standards. In addition, it was seen that, lower percentage of generic prescribing compared to WHO ideal value. Only few number of drugs were prescribed from National List of Essential Medicines Nepal. Pantoprazole, Hyoscine butyl bromide and Ceftriaxone were the most commonly prescribed drugs in the emergency room. Excessive prescription of proton-pump inhibitors and multivitamins in emergency room should be discouraged. Also hospital pharmacy should be encouraged for the procurement of more cost effective alternative drugs. Drug utilization study can be eye opener and therefore, it should be done periodically for rational prescription, reduce error and suggest cost effective management. There is also a need of more of such studies including larger number of patients and other departments. Keywords Anatomic therapeutic chemical (ATC), core drug use indicators, cost of drug therapy, defined daily dose (DDD), drug utilization, emergency room. |
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| Item Description: | Thesis Report. |
| Physical Description: | xiii,106p. |