DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20195925

Investigation of drug use at primary health centres in Nashik, Maharashtra, India

Prashant P. Shivgunde, Archana D. Kodilkar

Abstract


Background: By recognizing the need to promote rational utilization of medicines, the World Health Organization (WHO) in collaboration with the International Network for Rational Use of Drugs (INRUD) developed a set of core indicators. This study aimed to investigate drug use based on it.

Methods: The study was performed in Primary Health Centers (PHC) in Nashik District, Maharashtra, India. Prescriptions data for the last one year from PHCs were sampled out retrospectively. Outpatients from PHCs were selected, observed and interviewed for the patient-care indicators, prospectively. Pharmacy personnel was interviewed for the facility-specific indicators. The data were analyzed; results and conclusions were drawn.

Results: The average number of drugs per prescription was 3.48 (SD=0.36). The percentages of drugs prescribed by generic name and from Essential Drug List or formulary were 83.98% and 68.97% respectively. The percentages of encounters with antibiotics and injections were 60.33% and 50.83% respectively. The average consultation and dispensing times were 3.89 minutes and 58.28 seconds respectively. 98.19% of the prescribed drugs were actually dispensed. 67.27% of the dispensed drugs were labelled. The percentage of patients’ knowledge of the correct dosage was 87.78%. The percentage availability of the EDL or formulary was 100% and of the key drugs in the stock was 85.71%.

Conclusions: The need for improvement in prescribing practices can be encouraged by devising strategies such as training to physicians, rewards systems, etc. There should be plans to increase staff members for a particular working period and to educate patients with healthcare, hygiene, medicines’ compliance and common diseases.

 


Keywords


Facility-specific indicators, Patient-care indicators, Prescribing indicators, Prescription (encounter), Rational drug use

Full Text:

PDF

References


Rural population (% of total population). World Bank staff estimates based on the United Nations Population Division's World Urbanization Prospects: 2018 Revision. Available at: https://data.worldbank.org/indicator/SP.RUR.TOT.ZS. Accessed 6 March 2019.

Thayyil J, Jeeja M. Issues of creating a new cadre of doctors for rural India. Int J Med Pub Heal. 2014;3(1):8.

The rational use of drugs. Report of the Conference of Experts. Geneva, World Health Organization, 1985. Available at: https://apps.who.int/medicinedocs/en/m/abstract/Js17054e/. Accessed 6 March 2019.

Srinivasan I. A network for the rational and ethical use of drugs. Indian J Med Ethics. 2004;(1):13-4.

Plan; Department of Health. Available at: https://zpnashik.maharashtra.gov.in/vibhag_arogya. Accessed 6 March 2019.

Promoting rational use of medicines: Core components. WHO Policy Perspectives on Medicines, No.5. Geneva, World Health Organization, 2002. Available at: http://apps.who.int/medicinedocs/pdf/h3011e/h3011e.pdf. Accessed 7 March 2019

How to investigate drug use in health facilities: Selected drug use indicators. Geneva, World Health Organization, 1993. Available at: http://apps.who.int/medicinedocs/pdf/s2289e/s2289e.pdf. Accessed 7 March 2019.

Chetia D, Nada N, Rudrapal M. Study on the use of medicines in some selected health care facilities of Arunachal Pradesh. Asian J Pharm Clin Res. 2011;4(3):80-1.

WHO Model List of Essential Medicines. 2017. Available at: http://www.who.int/medicines/publications/essentialmedicines/en/. Accessed 7 March 2019.

Zhang Y, Zhi M. Index system, appraising method for comprehensive appraisal. J North Jiaotong Uni. 1995;393-400.

Atif M, Sarwar MR, Azeem M, Naz M, Amir S, Nazir K. Assessment of core drug use indicators using WHO / INRUD methodology at primary healthcare centres in Bahawalpur, Pakistan. BMC Health Serv Res. 2016;16(684):1-9.

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 Heal Serv Res. 2017;17(161):1-9.

Chandelkar UK, Rataboli PV. A study of drug prescribing pattern using WHO prescribing indicators in the state of Goa, India. IJBCP Int J Basic Clin Pharmacol. 2014;3(6):1057-61.

Prasad PS, Rudra JT, Vasanthi P, Sushitha U, Sadiq MJ, Narayana G. Assessment of drug use pattern using World Health Organization core drug use indicators at Secondary Care Referral Hospital of South India. Chrismed J Heal Res. 2015;2(3):223-8.

Singh T, Banerjee B, Garg S, Sharma S. A prescription audit using the World Health Organization ‑ recommended core drug use indicators in a rural hospital of Delhi. J Edu Health Promot. 2019;8:1-5.

Aravamuthan A, Arputhavanan M, Subramaniam K. Assessment of current prescribing practices using World Health Organization core drug use and complementary indicators in selected rural community pharmacies in Southern India. J Pharm Policy Pract. 2017;10(1):1-6.

Hazra A, Tripathi SK AM. Prescribing and dispensing activities at the health facilities of a non-governmental organization. Nat Med J Ind. 2000;13(4):177-82.

Hussain S, Yadav SS, Sawlani KK, Khattri S. Assessment of Drug Prescribing Pattern Using World Health Organization Indicators in a Tertiary Care Teaching Hospital. Ind J Pub Health. 2018;62(2):156-8.

Karande S, Sankhe P, Kulkarni M. Patterns of prescription and drug dispensing. Ind J Pediatr. 2005 Feb 1;72(2):117-21.