Analysis of the pattern of drug use using WHO core drug indicators among general OPD patients in rural Puducherry

Prescription auditing is a crucial tool for evaluating a range of concerns, including injectable usage, polypharmacy, the use of generic names, and the quality of treatment given to patients in primary care facilities. The objective of the study was to assess, using WHO core drug use indicators, the drug use patterns of general outpatients (OPD) at a rural healthcare facility.

A cross-sectional study was conducted in a rural peripheral health centre in Puducherry for a period of one year from September 2019 to August 2020. A total of 1200 prescriptions were analysed using the World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) monitoring tool to evaluate the prescription practices. Prescriptions of consenting patients attending OPD for general ailments were included in the study. Three to four prescriptions were chosen randomly on a daily basis. Patients who attended special clinics were excluded. The data was entered and analysed in MS Excel.

The average number of drugs per encounter was 3.10. The number of drugs prescribed by generic name was 65.7% and 39.8% of the encounters had antibiotics prescribed. Around 23.0% of the prescriptions contained injections. Of the prescribed drugs, 97.4% were available in the essential drug list. The average dispensing time observed was 20.80 sec. Out of the 3723 drugs prescribed 92.2% were actually dispensed and 77.5% were adequately labelled. Out of the 1200 patients interviewed regarding the dosage 72.0% had knowledge regarding the correct dosage. The health centre had a copy of the essential drug list and 83.0% of the drugs were available from the key drug list.

Many indicators had shown sub-optimal values when compared to the recommended ones by WHO/INRUD. Timely interventions like continuing medical education for budding physicians, improving the doctor-population ratio, adequate number of pharmacists in public health facilities will improve prescription practices which in turn may contribute to mitigating antimicrobial resistance.