Drug utilisation study in a tertiary care center: recommendations for improving hospital drug dispensing policies

Abstract

Drug therapy accounts for a major portion of health expenditure. A useful strategy for achieving cost efficient healthcare is drug utilisation research as it forms the basis for making amendments in drug policies and helps in rational drug use. The present observational study was conducted to generate data on drug utilization in inpatients of our tertiary care hospital to identify potential targets for improving drug prescribing patterns. Data was collected retrospectively from randomly selected 231 medical records of patients admitted in various wards of the hospital. WHO Anatomical Therapeutic Chemical/Defined Daily Dose methodology was used to assess drug utilisation data and drug prescriptions were analysed by WHO core drug indicators. Antibiotics were prescribed most frequently and also accounted for majority of drug costs. The prescribed daily dose for most of the antibiotics corresponded to defined daily dose reflecting adherence to international recommendations. Brand name prescribing and polypharmacy was very common.78% of the total drugs prescribed were from the National List of Essential Medicines 2003. Restricting the use of newer and costlier antibiotics, branded drugs and number of drugs per prescription could be considered as targets to cut down the cost of drug therapysignificantly.

Keywords: Defined daily dose; Drug utilisation; Essential medicines; Polypharmacy; Prescribed daily dose.

Fig. 1

Drug usage pattern in various speciality wards. 1: Emergency medicine ward, 2: emergency surgery ward, 3: medical ward, 4: surgical ward, 5: gynecology/maternityward, 6: private ward, 7: radiotherapy ward, 8: intensive/coronary care unit, antiinfectives, ■ GIT, nutritional, antiinflammatory, CVS, CNS and others.

Fig. 2

Generic and trade name drug prescription pattern. A: Antiinfectives, B: gastrointestinal tract drugs, C: nutritional agents, D: antiinflammatory, E: cardiovascular drugs, F: central nervous system drugs, G: hypolipidemics, H: antiplatelets, I: hormones, J: respiratory drugs, K: anticoagulants, L: oral hypoglycaemic agents, ■ trade, generic.

Fig. 3

Percent cost of various drug classes. GIT: Gastrointestinal tract drugs, CVS: cardiovascular drugs, CNS: central nervous system drugs, A: antiinfectives, B: GIT, C: nutritional, D: antiinflammatory, E: CVS, F: CNS, G: hypolipidemics, H: antiplatelets, I: hormones, J: respiratory, K: anticoagulants, L: oral hypoglycemics.