Teaching Exercise of Drug Utilization by Medical Students

Abstract

The prescription is a vital written document communicating between the physician, the patient and the pharmacist.
The audit of prescribing pattern is a component of medical audit, which seeks monitoring, evaluation
and necessary modifications in the prescribing practices of prescribers to achieve rational and cost effective
medical care for the patients. The present drug utilization study was conducted by fourth year MBBS students
during their research posting in the department of Pharmacology at B.P. Koirala Institute of Health Sciences
(BPKIHS), Dharan. The prescriptions were randomly collected from BPKIHS pharmacy over a period of 3
weeks. The auditing was done in the form of a semi structured performa containing the patients particulars
with regard to age, sex, and residence, the details of the illness and prescribed drug information. The data
was analyzed at the end of the study. The study points out that the maximum (27.5%) prescriptions were
from General Outpatient Department (GOPD) followed by ENT (16.5%), Internal medicine (15.5%) and
General surgery (10%). This indicates the distribution of patient load in hospital and the dominant areas
to be targeted for intervention. Further, the proportion of antimicrobial agents (AMAs) i.e. 26.03% use was
low and was prescribed empirically in most of the cases. There was use of expensive AMAs and irrational
prescribing of combinations of AMAs in some prescriptions. Other prevailing drugs which were prescribed
were analgesics. The usage of nimesulide and rofecoxib, withdrawn by FDA were used recurrently in this
setup. There was greater use of dubious drugs of unproven benefit like vitamins, calcium etc .The diagnosis
of the disease were not mentioned in 32.5% of prescriptions. The dose, frequency and duration of drugs were
unascertained in majority of prescriptions that might lead to health hazards. This exercise might change the
behavior of existing prescribers and also of the future doctors.
Key Words: Drug Utilization, Teaching Exercise, Medical Students, AMA.