A study of prescribing practices in a tertiary care hospital using who core indicators

A prospective study based on WHO core indicators was undertaken in the Departments of Medicine, Surgery, Ophthalmology, Orthopaedics and Gynaecology to determine the prescribing practices at the Christian Medical College and Hospital, Ludhiana (India). It was conducted by interacting with 225 patients on their first and second visits to the outpatient department (OPD). It was observed that the average number of drugs prescribed was more on the second visit as compared to the first visit and only 25% of the drugs were prescribed by generic name. Two-thirds of the drugs were prescribed from the hospital formulary. Antimicrobials and injectable preparations were prescribed judiciously. The number of investigations requested during the first visit was highest in medicine (1-12) and lowest in ophthalmology (1-2). The mean number of investigations for all five departments (2.7) decreased considerably from the first to the second visit. About 87% of the prescribed drugs were dispensed from the hospital pharmacy. The average dispensing time was 340 seconds per patient and all the dispensed drugs were adequately labelled. However, only 46% of patients/attendants were aware of the correct dose of the various drugs procured from the pharmacy. This study reveals that there is scope for improvement in patient care indicators in areas of rational prescribing in the hospital.