Abstract
PRESCRIBING IN RHEUMATOLOGY OUT-PATIENT DEPARTMENT OF A TERTIARY CARE TEACHING HOSPITAL: A CROSS SECTIONAL, OBSERVATIONAL STUDY

Rudra Paul, Shatavisa Mukherjee*, Shambo Samrat Samajdar, Kaushik Basu and Santanu Kumar Tripathi

ABSTRACT

Background: Globally, irrational drug prescribing is a great challenge for health care systems and a widespread phenomenon in developing countries. With musculoskeletal disorders being a prime contributor of chronic ill health and restricted daily activities, it necessitates use of spectrum of prescription and non-prescription drugs. The present study thus attempts to study the spectrum of presentations and prescribing in a rheumatology out-patient department (OPD) and assess the prescribing practices, using WHO core drug prescribing indicators. Methodology: A cross-sectional observational study was carried out in the outpatient Department of Rheumatology in a tertiary care teaching hospital in Eastern India for a period of four months. Prescriptions were evaluated for name, diagnosis, dose, frequency, duration and route of administration of drugs prescribed. Drug use in health facilities was investigated with the help of WHO prescribing indicators. Data collected was checked for completeness and then statistically analyzed. Results: DMARDs were the most commonly prescribed among the drug classes. DMARDs projected maximum prescriptions, with methotrexate toping the charts followed by sulfasalazine, hydroxychloroquine, leflunomide. Steroids included prednisolone, methylprednisolone, deflazacort. Immunosuppresants include azathioprine, tacrolimus, mycophenolate. Amongst NSAIDs, etoricoxib was maximally prescribed followed by naproxen, aspirin and diclofenac. Average number of drugs per prescription was found to be higher. Generic prescribing was 81.98%. Conclusion: Periodic assessments of drug usage pattern help identify specific drug use problems, promote rational drug prescribing and help in optimizing implementation of drug procurement policies.

Keywords: Prescription Pattern, WHO Core Drug Prescribing Indicators, NLEM, WB-EDL, Rational Drug Use.


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