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Objective: The
main objective of this study is to analyze the prescribing pattern of medicine
in outpatient departments of Tertiary Care Centre in Kathmandu.
Methodology: As
per WHO consideration, 100 prescriptions were be taken from each OPD including
Orthopedics, Obstetrics and Gynecology, Surgery, Medicine, Ophthalmology,
Otorhinolaryngology (ENT), Pediatrics, Dermatology and Psychiatry, i.e., 900
prescriptions were assessed using WHO drug use prescribing indicators.
Results: In
total, 47.7% were male and 52.3% were female patients. Average medicine per
prescription was 2.43 ± 0.039. Number of prescriptions with single medicine was
188 (20.9%) and the polypharmacy (≥ 4) was 129 (14.3%). Number of medicines
prescribed by generic name 76 (3.4%), antibiotics 416 (19%), Injection 34
(1.5%), from Essential Medicine List (EML) 1312 (60.1%) and Fixed Dose
Combination (FDC) was 468 (21.4%). The average cost of medicine per
prescription was NPR 404.72 ± 19.3 and duration of treatment was 16.43 ± 0.73
days. The prescribing drugs as tablets 1191 (54.5%), capsules 184 (8.4%),
liquid suspension 365 (16.7%), injections 34 (1.5%) and topical was 409
(18.7%). Patient’s age had positive correlation with number of medicines
(p=0.002) and negative correlation with antibiotics (p=0.988). Cost of
treatment had positive correlation with number of medicines prescribed
(p=0.00), prescribed from EML (p=0.00) and duration of treatment (p=0.00). A
positive correlation was found between cost and antibiotics (p=0.33) with no
statistical significance difference. Average medicines, prescription from EML,
antibiotic prescribed were high in ENT with statistical significance of
difference between mean. Prescription with FDC and intravenous (IV) were
significantly high in Obstetrics and Gynecology. Prescription with generic
names was significantly high in Medicine department. Cost and duration of
treatment were significantly high in Psychiatry department.
Conclusion: For
rational prescription writing, healthcare facilities need to develop and
implement specific guidelines and record them. Continuing medical education
program are essential for more rational and safer drug prescribing and
successful drug therapy.
Keywords: Essential medicine
list (EML), Polypharmacy, Fixed dose combination (FDC), WHO drug use indicator,
Medicine utilization
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