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Irrational prescribing of drugs is a major health concern in developing countries like Bangladesh. A study was therefore undertaken in a hospital, situated in Rajshahi region of Bangladesh, to find the prescribing pattern and to detect the prescription errors to the admitted patients. Prescriptions of 200 patients were collected from various depart...
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Context 1
... this study, errors in the prescription writing process were found to be 345 representing 44.86% of total errors and decision errors were found to be 424 representing 55.14% of the total errors (Table 3). As shown in the present study, the most common prescription errors out of 978 prescribed medicines were in the name of 35 prescribed drugs, which were not clear due to ambiguous hand writing, strength of medicines were not mentioned in case of 279 drugs whereas these drugs were present in the market in various strengths (Table 4). This study also identified 31 improper abbreviations and 15 prescriptions containing therapeutic duplication. ...
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Background: Large numbers of new drugs are introduced into the market every day and pharmaceutical companies are in the business of development and selling of new drug. There are different modes of drug promotion which include visual aids, leave behind leaflets and audio visuals. Drug Promotional Literatures (DPL’s) claim to provide vital and accur...
Citations
... In similar research dating from 2007, the EMGO (Dutch) and NIVEL (Netherlands) have found that a large number of people died due to unintentional medication errors [14,15]. In several other studies, high medication errors have also been reported in India [16,17] and Bangladesh [18,19]. Many unintentional medication errors are avoidable by using an e-prescription management system. ...
ABSTRACT
Objectives: The healthcare management authorities are responsible for delivering convenient services to the
patients. The traditional healthcare management system is quite old and impractical in many cases, including a
physical visit. Additionally, the COVID-19 epidemic makes the existing system unattainable, which creates an
uncomfortable situation for visiting doctor’s chambers that is risky both for doctors and patients. An electronic prescription (e-prescription) management system can switch the existing one to the online appointment and doctor consulting system. Many developed countries have already adopted such e-prescription management
systems, although low-and-middle-income countries (LMICs) like Bangladesh are apathetic. So implementing e prescription management systems in all countries, including Bangladesh, is the demand of time, especially when information and communication technologies (ICT) are at hand.
Method: We design, develop and test an ICT-based online doctor and patient management system utilizing the
latest software and web development tools.
Results: In the developed e-prescription management system, the patient can visit their profile to make an
appointment according to their need and doctor’s availability. After that, the patient consults with the doctor
based on the appointment’s approval by the admin panel. Finally, the patient receives an online e-prescription
and collects the medicine from a registered pharmacy with access to the online e-prescription. The e-prescription
management system records patient history, including e-prescription, making handling patients easy.
Conclusion: The proper use of the developed e-prescription management system will solve many existing problems of the existing healthcare management system, including many concerns that arise due to the advent of
COVID-19.
... This figure was lower than the previous study in Eritrea (7.8%) [5], but higher than a study conducted in India 5.7% [26]. On the other hand, it was much lower than the studies in China (22.9%) [19], Bangladesh (38.1%) [27], Kenya (24.9%) [16] and Sri Lanka (30.1%) [15]. This lower value could be due to high preference of oral route by prescribers as injectable preparations are associated with higher risks of disease transmission, incompliance by patients and are expensive [8]. ...
Rational use of medicine (RUM) for all medical conditions is crucial in attaining quality of healthcare and medical care for patients and the community as a whole. However, the actual medicine use pattern is not consistent with that of the World Health Organization (WHO) guideline and is often irrational in many healthcare setting, particularly in developing countries. Thus, the aim of the study was to evaluate rational medicine use based on WHO/International Network of Rational Use of Drugs (INRUD) core drug use indicators in Eritrean National and Regional Referral hospitals. A descriptive and cross-sectional approach was used to conduct the study. A sample of 4800 (600 from each hospital) outpatient prescriptions from all disciplines were systematically reviewed to assess the prescribing indicators. A total of 1600 (200 from each hospital) randomly selected patients were observed for patient indicators and all pharmacy personnel were interviewed to obtain the required information for facility-specific indicators. Data were collected using retrospective and prospective structured observational checklist between September and January, 2018. Descriptive statistics, Welch’s robust test of means and Duncan’s post hoc test were performed using IBM SPSS (version 22). The average number of medicines per prescription was 1.78 (SD = 0.79). Prescriptions that contained antibiotic and injectable were 54.50% and 6.60%, respectively. Besides, the percentage of medicines prescribed by generic name and from an essential medicine list (EML) was 98.86% and 94.73%, respectively. The overall average consultation and dispensing time were 5.46 minutes (SD = 3.86) and 36.49 seconds (SD = 46.83), respectively. Moreover, 87.32% of the prescribed medicines were actually dispensed. Only 68.24% of prescriptions were adequately labelled and 78.85% patients knew about the dosage of the medicine(s) in their prescriptions. More than half (66.7%) of the key medicines were available in stock. All the hospitals used the national medicine list but none of them had their own medicine list or guideline. In conclusion, majority of WHO stated core drug use indicators were not fulfilled by the eight hospitals. The results of this study suggest that a mix of policies needs to be implemented to make medicines more accessible and used in a more rational way.
... As drug resistance grows, there is a great need to take steps to promote sensible use of antibiotics. Antibiotics are drugs that are widely used and can be misused by patients and prescribers [15]. ...
... Tracking down that 88.42% of the patients were treated for certain anti-microbial agent's shows rather high utilization of anti-microbial, which could point more towards use in prophylaxis as opposed to in authoritative treatment. Percentage of antibiotic prescribed was found to be 88.42% which was higher than the study conducted by pathak et al, narendra et al, ulhas [10][11][12][13][14][15][16][17]. ...
Aims: The evaluation of antibiotic agents conveyed is critical for guaranteeing that the quality and fittingness of therapy. The study's purpose was to assess the use of antibiotics on the basis of WHO indicator in surgery department. Study Design: A prospective observational study was carried out in the surgery inpatient department for a period of six months after the approval of the ethical committee in tertiary care hospital. Place and Duration of Study: Department of Surgery, National Institute of Medical Sciences (NIMS), Tertiary Care Teaching Hospital Jaipur, Rajasthan, between Feb 2019 and July 2019. Methodology: The information was gathered in a predesigned performa from the clinical case sheets, drug charts of patients. Descriptive statistics were applied to the gathered information and dissected utilizing Microsoft Excel programming. Results: A total of 190 prescriptions were collected of which 995 drugs were prescribed. The total number of antibiotics in prescription was found to be 263. The percentage of antibiotics was found to be 88.42% which was found to be higher on comparing with the WHO marker. Various class of antibiotics was prescribed in which cephalosporin with a total of 120 (45.62%) followed by penicillin 33 (12.54%), macrolide 1 (0.38%) fluoroquinolones 23 (8.75%), nitroimidazole 39 (14.82%), aminoglycoside 38 (14.44%) and other classes 9 (3.45%). Conclusion: The adequacy of anti-microbial is undermined by the worldwide ascent in bacterial resistance and antimicrobial resistance is currently perceived as a significant medical issue. The study shows that the pattern of antibiotics was found to diverge from the WHO recommendation and also practice was lacking in terms of selection of antibiotics as there was no culture sensitivity test was performed. There gives off an impression of being an urgent requirement for the improvement of recommending rules with regards to the use of antibiotic agents.
... [13] Prescription errors also cause health care less or ineffective and nearly four errors per prescription were found in a survey that was conducted at a tertiary hospital in Bangladesh. [14] Most of the studies previously have been performed on prescription surveys reported prescription errors, irrational use of drugs, incomplete information and overuse of antibiotics, analgesics, etc. [14][15][16][17][18] However, those studies mainly focused on urban areas or tertiary level hospitals which usually does not provide proper information about district-level hospitals of Bangladesh. Periodic monitoring and evaluation of prescription pattern is a tool for facilitating rational use of medicines. ...
... [13] Prescription errors also cause health care less or ineffective and nearly four errors per prescription were found in a survey that was conducted at a tertiary hospital in Bangladesh. [14] Most of the studies previously have been performed on prescription surveys reported prescription errors, irrational use of drugs, incomplete information and overuse of antibiotics, analgesics, etc. [14][15][16][17][18] However, those studies mainly focused on urban areas or tertiary level hospitals which usually does not provide proper information about district-level hospitals of Bangladesh. Periodic monitoring and evaluation of prescription pattern is a tool for facilitating rational use of medicines. ...
... Prescription pattens of different tertiary care hospitals in urban areas of Bangladesh were reported previously, but those studies did not represent the prescribing pattern in a secondary hospital. [14][15][16][17][18] After vigorous literature survey, it was found that this study reported first time the prescription pattern and errors in a district hospital as well as the frequency of different therapeutics classes of drugs according to the patient's age and gender. Moreover, Spearman's rank parametric bivariate correlation coefficient was also determined to find the correlation of PPIs with other medicines. ...
Context: The rational prescription leads to a healthy and good-quality life of a patient. Irrational, inappropriate, and unnecessary prescriptions are major therapeutic issues in Bangladesh, which can cause severe consequences.
Aim: This cross-sectional study was conducted to evaluate the prescription patterns and errors as well as to review the most frequently prescribed drug classes among outpatients at a secondary hospital in Pabna, a district of Bangladesh.
Methods: A total of 400 prescriptions were reviewed from March 2019 to May 2019. In this study, statistical data analysis was implemented by IBM SPSS Statistics V22 and data revealed in frequencies, mean, and percentage. Spearman's rank correlation coefficient was calculated to show the correlation between bivariate coded variables.
Results: The results revealed that majority of the prescription were prescribed for females (73.5%) where proton-pump inhibitors (PPIs), analgesics, vitamins, and single antibiotics were most frequently prescribed medicine for the female patients compared to male patients. Almost half of the collected prescription contained four medicines (47%). Maximum number of prescriptions contained two (30.5%) essential drugs and among 1402 medicines of 400 prescriptions, antiulcerants were most frequently prescribed medicine (23.32%) where esomeprazole was highly prescribed generic drug (44.75%). Moreover, Spearman's rank correlation coefficient suggested that PPIs and analgesics were frequently prescribed medicines at a time for the patients (0.182). According to the age group, the study also got some significant variations in prescribing pattern. However, most common prescription errors were prescriber's name not mentioned (100%), diagnosis not mentioned (96.75%), dose not indicated (15.41%), and wrong drug name (0.36%).
Conclusion: Findings of the current study represent the existing prescribing trends of different therapeutic classes of drugs and common prescription errors in a secondary health facility of Bangladesh. From this study, it is observed that physicians prescribed rationally in some cases but need to ensure rationality in all prescriptions. Continuous monitoring of drug use, development of prescribing guidelines, and training are recommended to ensure and implement good-quality prescribing practices for promoting the rational and cost-effective use of drugs.
... The 20 . ...
Background
Rational drug management has become an increasingly important topic in order to make optimal use of
the drug budget to offer health services of the highest possible standard. It is important that continuous
assessment for rational prescribing and use of the drug has to be carried. The objective of this study was to gather
data on existing drug prescription and dispensing practices and to evaluate the prescribing and dispensing
indicators as described by the WHO
... Strength of the drug was missing for 279 drugs and 31 drugs were abbreviated wrongly. 17 This shows any small change in the strength or dose which is an important component of prescription will reflect on the clinical outcome. ...
Background: Awareness about rational use of Medicines is required to improve the quality of health care system. Attitude towards rational drug use is also an utmost importance as they constitute the future generation doctors.Methods: A set of 13 questionnaire is given to the interns through an online link to their e-mail which contains informed consent and questionnaires. Respondents has to select the best suitable option and after which the data will be compiled and statistically analyzed.Results: Age of the study participants range from 22-26yrs. Half of them have finished major postings. Almost 96.1 % of them were aware of the term essential drugs. Only 25% of them said that they have NLEMI at work place, 75% of them were aware of the term Rational use of Medicines. Only 32% of them were aware of the term P drugs. 44% of them were aware of STEP criteria for selection of drug and 47% of them were aware of the updated prescribing format. 8% knew the difference between old and new prescription format, 25% of them always prescribe. Almost 82% of them narrate regarding the disease and drug therapy, 31% of them prescribe only generic name.Conclusions: Educational intervention like CME and practical hands on training in Rational use of Medicines would help them in better understanding of the subject and its clinical implications thereby decreasing the prescribing errors.
... Values that are lower than the present finding were reported from various healthcare settings including 30.3 and 24.27% in Indian tertiary-care hospitals [23,31], 52.8% in Dessie referral hospital [5], 28.1% in Nigerian army hospital [35], 52.% in Bahawal Victoria hospital, Pakistan [26], and 29.14% in Gondar University referral hospital [10]. In contrary, even more deviation were presented from several studies such as 70.6% in Bule Hora hospital, southern Ethiopia, [22] and 78% in tertiary-care hospital of Bangladesh [25]. Summoro et al. also reported that the percent encounters with antibiotics ranged from 46.7 to 85% in four hospitals of southern Ethiopia [9]. ...
... In contrary to our findings, Prakash et al. reported that the percentage of drugs prescribed by generic name and from EDL were 0.5 and 53%, respectively [23]. There was also 0.0% generic prescribing practice as reported from tertiary hospital of Bangladesh [25]. This gap might be, in part, related to variation in the healthcare system, knowledge and experience of prescribers, healthcare policies and regulations (e.g. ...
Background:Rational prescribing remains an important component of rational drug use. The World HealthOrganization (WHO) standardized and validated core prescribing indicators for evaluating prescribing pattern of drugs.The prescribing practice has been shown to deviate from national and WHO guidelines in Ethiopia. The aim of thisstudy was; therefore, to investigate the overall prescribing behavior of four governmental hospitals: Hiwot FanaSpecialized University Hospital (HFSUH), Federal Harar Police Hospital (FHPH), Jugel Hospital (JH) and SoutheastCommand III Hospital (SECIIIH), Harar, eastern Ethiopia.Methods:Hospital based retrospective cross-sectional studywas employed to evaluate outpatient prescriptionsdispensed from January 1–December 31, 2016. A total of 2400 prescriptions (600 from each hospital) wereassessed. A combination of prescription completeness and prescribing indicator forms were used to collect the data.Result:From a total of 2400 prescriptions reviewed, only HFSUH and FHPH were using standard prescription atprevalence of 92.5 and 99.8%, respectively. Name and weight of the patient were the most and the least commonlyrecorded information, respectively. A total of 5217 drugs were prescribed with an average number of drugs perencounter to be 2.17 (±0.39) and the highest value (2.60) was observed at FHPH. The frequency of administration wasthe most commonly written component (85.0%) with an average of 1.85 per prescription. Among all prescriptionsanalyzed, the percentage of encounters with antimicrobials and injectables prescribed were 66.9 and 26.5%,respectively. The prevalence of drugs prescribed with generic name and from essential drug list were 4644 (89.01%)and 4613 (88.42%), respectively. Among health professional related information, dispenser name was the leastdocumented in all hospitals with the prevalence being 3.9%.Conclusion:JH and SECIIIH were not using standard prescriptions at all during the review period. Besides, someimportant components of the prescription such as age, sex and diagnosis were not properly recorded or missed at allin the selected hospitals. The tendency of prescribing drugs with dose and dosage form was very poor. Overall, noneof the core prescribing indicators was in line with the WHO standards. These and other related problems should beinvestigated in-depth to find out the underlying problems for which interventional strategies can be designed toreverse this worrying practice.Keywords:Prescribing behavior, WHO, Prescribing indicators, Eastern Ethiopia
(3) Investigation of prescribing behavior at outpatient settings of governmental hospitals in eastern Ethiopia: an overall evaluation beyond World Health Organization core prescribing indicators | Request PDF. Available from: https://www.researchgate.net/publication/327791424_Investigation_of_prescribing_behavior_at_outpatient_settings_of_governmental_hospitals_in_eastern_Ethiopia_an_overall_evaluation_beyond_World_Health_Organization_core_prescribing_indicators [accessed Oct 08 2018].
... 3,4,5 A study conducted in tertiary hospitals in Bangladesh found the prevalence of prescription error during the study period (October -December 2011) was 44.86%. 3 A study in tertiary heart hospitals in India also found that the prevalence of prescription error was 23.35% -which was the highest among all components of medication errors. 4 Similarly, a prospective study involving 20 hospitals in England found that the total cases of prescription error was 11,235 out of 124,260 medication orders. ...
... with median values [IQR] between pre and post test measurements were 1 [1] vs. 1 [1] (p=0.001).Total prescription error at Angsoka Ward after the implementation of electronic prescribing was reduced significantly. The negative rank vs. positive rank values for prescription error were 47.5 vs 0 with median values [IQR] between pre and post intervention were 5[3] vs. 0[1] (p<0,001). In contrast, total prescription error at Kamboja Ward between pre-test and post-test measurements remained steady. ...
Background and purpose: Medication error is any preventable event that may lead to inappropriate medication use or patient harm. Prescription error, one component of medication error, at Sanglah General Hospital Denpasar is high. An electronic prescribing has been piloted at Angsoka Ward, Sanglah General Hospital Denpasar to reduce prescription errors. However, the evaluation of such implementation is never been conducted. This study aims to evaluate the effect of electronic prescribing on prescription errors at Sanglah General Hospital Denpasar.Methods: An evaluation study was conducted by adopting pre and post control design at Sanglah General Hospital Denpasar. Prescription errors at Angsoka Ward where the electronic prescribing is implemented, were compared to Kamboja Ward that uses manual prescribing. Heterogeneity of patients in these two wards was comparable. Prescription samples were selected using a simple random sampling. Prescription samples prior to implementation of electronic prescribing were taken from June and July 2016, while samples after implementation were taken from March and April 2017. Prescription samples from the control group were also taken from the same periods. A total of 96 prescriptions were taken from each arm – leading to 384 prescription samples in total. Prescription error was evaluated using three requirements namely: administrative (9 components), pharmacy (5 components) and clinical (3 components).Results: Our study found that there was a significant difference of prescription errors between pre and post implementation of electronic prescribing at Angsoka Ward (p<0.05). The median values [IQR] for prescription error based on administrative requirements between pre and post intervention were 2 [3] vs. 0 [0] (p<0.001); based on pharmacy requirements were 1 [2] vs. 0 [0] (p<0.001); based on clinical requirements were 1 [2] vs 0 [0] (p<0,001). In contrast, prescription error based on administrative and pharmacy requirements in Kamboja Ward was insignificantly reduced. The median values [IQR] for prescription error based on administrative requirements between pre and post intervention were 2 [2] vs. 2 [2] (p=0.505) and based on pharmacy requirements were 1 [2] vs. 1 [1] (p=0.295). There was a significant difference of prescription errors (p<0.05) based on clinical requirements with median values [IQR] of 1 [1] vs. 1 [1]. Implementation of electronic prescribing reduced the proportion of prescription errors by 67.8%. After implementation of electronic prescribing, some errors were still apparent related to drug administration and order duplication.Conclusions: Implementation of electronic prescribing reduces prescription errors. Scaling-up of electronic prescribing followed by training on standardised prescribing practices are warranted.
... In our survey, the average number of drugs prescribed was 3.36, and it was higher than that reported in studies conducted in government set up across India, 3.03 in Delhi [21] and 2.0 in North Goa [22]. However, a recent study reported higher rate 4.89 drugs per prescription in a government hospital in Bangladesh [23] and our data represented although not ideal but better than that reported earlier. ...
... According to WHO, in developing countries, 15-25% of prescriptions with antibiotics are expected where infectious diseases are prevalent [26]. Previous studies reported that the use of antibiotic was 78% in Bangladesh whereas it varied from 40-80% in India [23,27]. In this study, the percentage of prescriptions with antibiotics was 54% which is less but do not comply WHO standard. ...
Objective: Irrational drug use increased the risk of adverse drug reactions (ADRs), the emergence of drug resistance and a leading cause of morbidity and mortality worldwide. The study was designed to analyse prescription patterns and antibiotic use among outpatients in a tertiary care teaching hospital in Bangladesh. Methods: This prospective survey was conducted among the outpatients in a district hospital. The prescribed drugs were classified according to Anatomical and Therapeutic Chemical (ATC) classification system. Patient characteristics and drug data were recorded. The prescription pattern was analysed using general drug use indicators according to World Health Organisation (WHO). Results: A total of 405 prescriptions were analyzed of which 54% of child and 46% of adult prescriptions. The age and body weight of the patients were not mentioned in 30% of child and 62% of adult prescriptions and none of the prescriptions included sex of the patients. Physician's handwriting was not clear and legible in 31% prescriptions. A total 1362 drugs were used in this study with an average 3.36 drugs per prescription. However, none of the drugs was prescribed in generic name. Children were highly exposed to antibiotics (66%) than to adults (44%) of which cephalosporin's (30%) and macrolides (14%) were commonly used. Interestingly, non-steroidal anti-inflammatory drugs (NSAIDs) were also highly accounted in children (53%) than to adults (36%). Conclusion: Our results suggested that the prescription information was incomplete and physicians did not follow the standard guideline for drug treatment resulting in polypharmacy and indiscriminate use of antimicrobials irrespective to the age of patients.
... In our survey, the average number of drugs prescribed was 3.36, and it was higher than that reported in studies conducted in government set up across India, 3.03 in Delhi [21] and 2.0 in North Goa [22]. However, a recent study reported higher rate 4.89 drugs per prescription in a government hospital in Bangladesh [23] and our data represented although not ideal but better than that reported earlier. ...
... According to WHO, in developing countries, 15-25% of prescriptions with antibiotics are expected where infectious diseases are prevalent [26]. Previous studies reported that the use of antibiotic was 78% in Bangladesh whereas it varied from 40-80% in India [23,27]. In this study, the percentage of prescriptions with antibiotics was 54% which is less but do not comply WHO standard. ...
