Drug Use Pattern in Upazilla Health Complexes of Bangladesh

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.