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. 2025 Mar 25;13(2):48.
doi: 10.3390/pharmacy13020048.

Prescription Audit in Outpatient Pharmacy of a Tertiary Care Referral Hospital in Haryana Using World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) Core Prescribing Indicators: A Step Towards Refining Drug Use and Patient Care

Nikhil Verma  1 , Shanmugapriya Vinayagam  2 , Niti Mittal  2 , Rakesh Mittal  2 , Neeraj Bansal  1
Affiliations

Prescription Audit in Outpatient Pharmacy of a Tertiary Care Referral Hospital in Haryana Using World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) Core Prescribing Indicators: A Step Towards Refining Drug Use and Patient Care

Nikhil Verma et al. Pharmacy (Basel). .

Abstract

Background: The evaluation of internationally comparable indicators of medicine use is important to devise strategies to promote the rational use of medicines (RUM).

Methods: A cross-sectional study was conducted in a tertiary care hospital from January to June 2024. Prescriptions were collected from the outpatient pharmacy using systematic random sampling and analyzed for WHO/INRUD core prescribing indicators, index of rational drug prescribing (IRDP) and completeness (general, treatment and prescribers' details).

Results: Out of 844 prescriptions collected, 607 were analyzed. A total of 1837 drugs were prescribed, with a mean (SD) of 3.03 (1.51) drugs per prescription; 1378 (75%) drugs were prescribed as generic names; 125 prescriptions (20.59%) had an antibiotic prescribed; and injectables were given in 7 (1.15%) prescriptions. Of the total 1837 drugs, 1018 (55.4%) were mentioned in the National List of Essential Medicines (NLEM) 2022, while 934 (50.8%) were included in the Haryana state essential medicines list (2013-2014). The IRDP was calculated as 3.86. The mean (SD) completeness score of the prescriptions was 10.33 (0.8) (range 5 to 11).

Conclusions: There was a high incidence of polypharmacy, brand name and non-essential drug prescribing, while antibiotic and injection use were in accordance with WHO standards.

Keywords: essential drugs; generic prescribing; index of rational drug prescribing; polypharmacy; prescribing indicators; rational prescribing.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Percentage distribution of prescriptions from various outpatient departments. ENT: ear, nose and throat; OBG: obstetrics and gynecology; medical superspecialties: cardiology, gastroenterology, nephrology, pulmonary and critical care medicine, rheumatology; surgical superspecialties: cardiothoracic surgery, urology, neurosurgery.
Figure 2
Figure 2
Proportion of various FDCs prescribed. Drugs for respiratory disorders included montelukast + levocetirizine and inhaled beta 2 agonists + corticosteroids; others included FDCs for neuropathic pain, urologic indications such as overactive bladder/benign prostate hyperplasia, cardiovascular indications, combined oral contraceptive pills and iron salt/folic acid. GERD: gastro-esophageal reflux disease.
Figure 3
Figure 3
Bar graph illustrating the percentage compliance for each parameter in the outpatient prescriptions analyzed.
See this image and copyright information in PMC

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