Drug utilization and prescription pattern study in the outpatient department of a tertiary care hospital: A cross-sectional study.

Dr. Anand  Acharya; Dr. Nethala Ravi  Kumar; Dr. Bhavika

doi:10.51168/sjhrafrica.v6i12.2340

Authors

Dr. Anand Acharya Dean and Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India
Dr. Nethala Ravi Kumar Associate Professor, Department of Pharmacology, Shri Shankaracharya Institute of Medical Sciences, Bhilai, Chattisgarh, India
Dr. Bhavika.D Associate Professor, Department of Pharmacology, Government Medical College and General Hospital, Quthbullapur, Telangana, India

DOI:

https://doi.org/10.51168/sjhrafrica.v6i12.2340

Keywords:

Drug utilization, Prescription pattern, WHO prescribing indicators, Antibiotics, Generic prescribing, Essential Medicines List, Outpatient department

Abstract

Background:

Drug utilization studies using WHO prescribing indicators help identify irrational prescribing and guide corrective interventions.

Objectives:

To evaluate outpatient drug utilization and prescription patterns in a tertiary care teaching hospital using WHO core prescribing indicators and to highlight key gaps affecting rational drug use.

Methods:

A hospital-based cross-sectional study was conducted in the outpatient department of a tertiary care teaching hospital. A total of 464 prescriptions were selected through systematic sampling. Data were collected using a pretested structured proforma and analyzed for WHO prescribing indicators, including average number of drugs per encounter, proportion of drugs prescribed by generic name, encounters with antibiotics and injections, use of fixed-dose combinations (FDCs), and adherence to the National Essential Medicines List (EML). Descriptive statistics were used for data analysis.

Results:

Among 464 encounters, 248 (53.4%) prescriptions were for males and 216 (46.6%) for females; the mean age was 42.8 ± 16.3 years, with most patients in the 21–40-year group (38.4%). A total of 1,322 drugs were prescribed (mean 2.85 ± 0.92 drugs/encounter). Generic prescribing was 47.2% (624/1,322), and EML adherence was 77.3% (1,022/1,322). Antibiotics were prescribed in 30.6% of encounters (142/464), while injections were used in 8.2% (38/464). FDCs were present in 27.5% of prescriptions (128/464). Among antibiotics (n = 188), cephalosporins were predominant (58/188; 30.8%), followed by fluoroquinolones (42/188; 22.3%). Gaps indicating irrational use included higher-than-ideal drug count per prescription, suboptimal generic prescribing, frequent FDC use, and incomplete diagnosis/clinical notes in 17.3% of prescriptions.

Conclusion:

OPD prescribing showed low injection use and moderate EML adherence, but persistent gaps in polypharmacy tendency, generic prescribing, antibiotic exposure, and FDC use remain.

Recommendations:

Regular prescription audits, strengthening antimicrobial stewardship, continuous prescriber education, promotion of generic prescribing, and periodic revision of hospital formularies are essential to enhance rational drug use in outpatient settings.

Author Biographies

Dr. Anand Acharya, Dean and Professor, Department of Pharmacology, Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh, India

MBBS, MD (Pharmacology), currently serves as Dean and Professor, Department of Pharmacology, at the Konaseema Institute of Medical Sciences & Research Foundation (KIMS&RF), Amalapuram, Andhra Pradesh, India. A distinguished academician, researcher, and medical education leader, he has been pivotal in transforming KIMS&RF from its formative phase into a premier medical institution with over 200 undergraduate and 100 postgraduate seats.

With more than 18 years of teaching and administrative experience, Dr. Acharya has held several leadership positions, including Vice Principal, Principal, Chief Warden, Member Secretary of Institutional Ethics and Animal Ethics Committees, and is an approved PhD Guide under Dr. NTR University of Health Sciences, Vijayawada. His visionary leadership has significantly enhanced the institution’s academic quality, clinical exposure, research infrastructure, and postgraduate training standards.

He has completed prestigious national faculty development programs such as the Revised Basic Course Workshop (rBCW), Advanced Course in Medical Education (ACME), and National Teacher Training Course (NTTC, JIPMER, Puducherry). He also serves as Coordinator for Pharmacovigilance and Materiovigilance Programs under IPC–PvPI and MoHFW, Government of India, contributing actively to national drug safety and regulatory initiatives.

A prolific academician, Dr. Acharya has authored and co-authored more than 100 scientific publications in reputed national and international indexed journals. His wide-ranging research covers toxicology, pharmacovigilance, antimicrobial resistance, endocrinology, neuropharmacology, and clinical pharmacology. His recent studies include long-term analyses of pyrethroid, paraquat, and chlorpyrifos poisoning, investigations into antimicrobial resistance trends, and predictive models for treatment outcomes in dermatological and toxicological emergencies.

Dr. Acharya’s professional interests include clinical pharmacology, toxicovigilance, rational drug use, pharmacovigilance systems, and innovations in medical education technologies. He continues to mentor numerous postgraduate and undergraduate researchers while playing an integral role in curriculum reform, ethics governance, and institutional academic advancement.ORCID iD: https://orcid.org/0009-0000-7967-9092

Dr. Nethala Ravi Kumar, Associate Professor, Department of Pharmacology, Shri Shankaracharya Institute of Medical Sciences, Bhilai, Chattisgarh, India

PhD (Medical Pharmacology), is an Associate Professor in the Department of Pharmacology at Shri Shankaracharya Institute of Medical Sciences, Bhilai, Chhattisgarh, India. He holds a PhD in Medical Pharmacology, with academic and research interests focused on drug safety evaluation, experimental pharmacology, and the translation of pharmacological evidence into clinical practice. He is actively involved in teaching pharmacology to undergraduate and postgraduate medical students, guiding research projects, and strengthening departmental academic activities. His work reflects a commitment to advancing rational therapeutics and fostering high-quality medical education. ORCID iD: https://orcid.org/0000-0002-9231-6947

Dr. Bhavika.D, Associate Professor, Department of Pharmacology, Government Medical College and General Hospital, Quthbullapur, Telangana, India

MBBS, MD (Pharmacology), is currently serving as Associate Professor in the Department of Pharmacology, Government Medical College Quthbullapur. She worked as Assistant Professor at SVS Medical College, Mahbubnagar for a period of 1 year, She also worked as Assistant Professor at Kamineni Academy of Medical Sciences & Research centre for a period of 3 years then she joined as Assistant Professor at Government Medical College Nalgonda and served there for 5 years after which she was promoted to Associate Professor at Government Medical College Quthbullapur. She has guided Undergraduate and Postgraduate students in research work and thesis work. She has a teaching experience of 11 years and has authored 11 publications in reputed journals focusing on Pharmacology. ORCID iD: https://orcid.org/0000-0001-8921-1557

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