Evaluation of prescription patterns using World Health Organization prescribing indicators in outpatient department at a tertiary care hospital in Central India

Abstract

Background: Rational prescribing entails administration of safe, efficacious, and cost-effective medications. Adherence to standards in medical treatment can enhance quality of life in developing countries. One approach to promote rational use is the evaluation of drug utilization patterns in healthcare facilities. Objective of the study was to evaluate prescribing practices in outpatient department (OPD) of a tertiary care hospital using World Health Organization (WHO) standards. Methods: Total 2000 randomly selected OPD prescriptions from patients of all ages and genders were collected from 1/09/2024 to 28/02/2025 and analysed for WHO standards and completeness of prescription. Institutional Ethics Committee approval was obtained vide reference no 93/31/08/2024. Results: Among 6235 prescribed drugs in 2000 prescriptions, the average number of medicines was (3.1±1.49). Adherence to National List of Essential Medicine (NLEM) was high (90.67%), while generic prescribing was suboptimal (52.09%). Antimicrobial use was more (32.8%), injectable use was low (5.32%), brand names were used in 47.9%, and fixed drug combinations (FDCs) in 32.57%. The most frequently prescribed drugs were pantoprazole (54.57%), Diclofenac (38.5%), and Amoxycillin (28.7%). Prescriptions completeness in demographic information (90.67%), diagnosis (48.8%), legible handwriting (59.2%), capital letters (6.8%), abbreviations (100%), vernacular instructions (78.6%), and signature, designation, registration number, and qualification (36.9%). Conclusions: Prescribing practices deviated from WHO standards, with incomplete documentation of patient-related information. The study identified inappropriate prescribing, including polypharmacy (3.1±1.49), limited generic drug use (52.09%), and high use of NLEM drugs (90.67%). Prescription completeness was low (52.09%). These practices could result in adverse health outcomes and higher costs, indicating the need for continuous education of healthcare professionals.