Abstract:
In Bangladesh, inappropriate and irrational use of drug is
widespread. The purpose of this study is to update the knowledge
on disease management practices in government health facilities
and to understand the reason for current behavior of drug
prescribers and dispensers. The study focused on determination of prescribing and health care
practices of doctors and pharmacist in the Thana health
complexes in Bangladesh. Drug use indicators developed by
international network for rational use of drug (INRUD) were used in
the study. The study used the indicators like prescribing, patient
cares, and drug systems and captured the key information on
prescribing pattern, patients care and health facility management.
This was done through collecting prospective data.To determine the pattern of drug prescription by consultants In
Thana Health Complex of Bangladesh, 30 prescriptions were
collected from Araihazar Thana Health complex. In total, 62 drugs
were prescribed. The average number of drugs per encounter was
2%. This survey revealed that 60% drugs were prescribed by
generic names and 71 % drugs were prescribed from essential drug list. Poly-pharmacy was observed in 80% of all encounters.
Information about the prescribing physician and the patient was invariably deficient. Name of patient, age and gender were totally
absent in all prescriptions. In addition, none of the prescriptions
mentioned address, diagnosis, or allergy of the patient. The most
commonly prescribed therapeutic classes of drugs of total cases
were as follows: 40% antibiotics, 13.30/0 antidiarrhoeal and 26.6%
antiulcer. Other drugs included vitamin supplements (17%
), ferrous
sulphate (6.7%) and Co-trimoxazole (40%) of total cases. Other agents prescribed in small proportions of encounters collectively
amounted to 6% of total cases. No patients were given injection.
The average consultation time was found to be 1.7 minutes and
the dispensing time was only 20 seconds. The availability of key
drugs was 58% and there was no essential drug list. The su~ey
showed that 68% of the total prescribed drugs were actually dispensed and no dispensed drugs were adequately labeled. 77%
patients had adequate knowledge on correct dose.
In many case the doctors were found to comply with the patients
demand by prescribing unnecessary drugs. From the result of the
Study it is understood that many drugs were prescribed irrationally
or inappropriately.
Description:
This thesis submitted in partial fulfillment of the requirements for the degree of Bachelor of Pharmacy (B.Pharm) in East West University, Dhaka, Bangladesh.