Vol 15, Issue 2, 2022
Online - 2455-3891
Print - 0974-2441
PRESCRIPTION AUDIT USING THE WORLD HEALTH ORGANIZATION PRESCRIBING
INDICATORS FOR INDOOR PATIENTS TREATED UNDER CMAAY/PMJAY INSURANCE SCHEMES
IN A TERTIARY CARE TEACHING HOSPITAL
DEVENDER SACHDEV
1
*, KARTIK JANARDAN SALWE
2
, ANOOP DEV
3
, BINITA SINGHA
4
, HAGE AMBING
5
1
Department of Pharmacology, Tomo Riba institute of health and medical sciences, Naharlagun, Arunachal Pradesh, India.
2
Department
of Pharmacology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India.
3
Department of
Community Medicine, Tomo Riba Institute of Health and Medical Sciences, Naharlagun, Arunachal Pradesh, India.
4
Department of
Pharmacology, Tomo Riba Institute of Health and Medical Sciences, Naharlagun, Arunachal Pradesh,
5
Deprtment of Medicine, Tomo Riba
insititute of Health and Medical sciences, Naharlagun, Arunachal Pradesh,India India. Email: drdevendersachdev@gmail.com
Received: 10 December 2021, Revised and Accepted: 12 January 2022
ABSTRACT
Objective: This study focused on the prescriptions audit of indoor patients treated under Pradhan Mantri Jan Arogya Yojana (PMJAY) and Chief
Minister Arogya Arunachal Yojana (CMAAY) insurance schemes as per the World Health Organization (WHO) prescribing indicators.
Materials and Methods: Retrospective cross-sectional study was conducted and the prescriptions of around 960 patients were analyzed who
were treated from June 2020 to December 2020 under CMAAY/PMJAY insurance schemes at Tomo Riba institute of Health and Medical Sciences in
Arunachal Pradesh. Study was conducted in five departments and Information was collected through the review of case sheets. The post-operative
day prescription was analyzed for the patients who have undergone surgery and the patients who were managed conservatively; admission day
prescription was analyzed using the WHO core drug prescribing indicators. Following data were analyzed. (1) Average no of drugs prescribed per
encounter; (2) percentage of encounter having antibiotic; (3) percentage of drugs prescribed by generic name; (4) percentage of encounters with an
injection; and (5) percentage of drugs prescribed from the essential drug list.
Results: A total of 960 indoor patients treated under five departments, out of which 359 (37.4%) treated under general surgery, 383 (39.9%) under
Obstetrics and Gynecology department, 65 (6.8%) under ENT department, 68 (7.1%) under orthopedics department, and 85 (8.9%) under General medicine
department. All departments taken together, the average number of drugs used per patient was 4.91. Antibiotics were prescribed in 92.18% of the total
patients when all departments were included, single antibiotic was used in 72.18%, two antibiotics in 17.29%, and three in 2.7% of the total patients. Overall,
the generic names were written in 67.3% of the total drugs and the most commonly used route was parenteral route, in about 98.19% of the total prescribed
drugs. From the essential drugs list, 89.33% of the total drugs were prescribed. Fixed drug combination was used in 13.59% of the total drugs prescribed.
Conclusion: In our study, the percentage of prescriptions with average no of drugs per prescription, antibiotic used, injections used were much higher
when compared to the WHO core prescribing indicators. The reason might be because we have analyzed the prescription of indoor patients and most
of them were post-operative patients, so it is justified. While prescribing, the physicians and surgeons followed WHO essential drug list but use of
generic names was in few prescriptions. The generic name use to be more emphasized, encouraged, and promoted.
Keywords: Antibiotics, Essential drug list, Fixed drug combination, Generic name, Insurance Scheme, Routes, World Health Organization prescribing
indicators.
INTRODUCTION
Prescription audit helps to improve the quality of prescribing drugs in
the institute. By prescription audit the quality of the prescribing drugs
can be evaluated. It is a quality improvement process where a positive
change can be made in the patients care. The standard of prescription
reflects rational prescribing and the competence of the clinician [1,2].
The outcome and patient care can be improved by doing regular
prescription audits and comparing it with set standards of prescription
writing [3].
By doing regular prescription audits, the rational use of medicines can
be motivated. As a result, the quality of prescription can be increased in
a cost-effective way, decreasing the incidence of adverse drug reactions,
and also increasing proper utilization of resources [4,5].
The World Health Organization (WHO) has given the Internationally
accepted criteria for standard prescription writing as a guide for
good prescription [6-8]. The way of writing of prescriptions can be
compared with the WHO given internationally accepted criteria [4,9].
Various studies concerned with prescription audit have been done in
the past [10-12].
Pradhan Mantri Jan Arogya Yojana (PMJAY) and Chief Minister Arogya
Arunachal Yojana (CMAAY) are the initiatives of central and state
Government, respectively, which are employed by the Chief Minister
Arogya Arunachal Society for free cashless health-care services to the
people of the State [13].
The present study was planned to analyze prescription audit using
the WHO prescribing indicators for indoor patients treated under
CMAAY/PMJAY insurance schemes at Tomo Riba institute of Health
and Medical Sciences (TRIHMS) in Arunachal Pradesh, North East India
with following objectives.
1. To investigate the rational use of drugs for completeness legibility
and to characterize the drug use in the medical college as per the
WHO recommended core drug use indicators and to analyze the
prescription errors
2. To carry out a complete therapeutic audit and to know what was
© 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/
licenses/by/4.0/) DOI: http://dx.doi.org/10.22159/ajpcr.2022v15i2.43819. Journal homepage: https://innovareacademics.in/journals/index.php/ajpcr
Research Article