Patterns of drug use in the public sector primary health centers of Bhopal district

Objective To study drug use in public sector out-patient centers in Bhopal district, Madhya Pradesh Province, India. This study was conducted as part of the provincial health Department's efforts to develop a state drug policy. It was intended to inform policy elements concerned with the promotion of rational drug use. Method Health facilities studied included the functioning 9 primary health centers (rural) and 17 civil dispensaries (urban) in the district. World Health Organization core drug use (prescribing, patient care and facility) indicators were used. A total of 1,051 patient prescriptions were analyzed for prescribing indicators. Patient care indicators for 1,034 (of these patients) were measured. To study facility indicators, a list of 20 essential drugs was developed by the research team (as the province did not have its own drug list at the time of the study). The availability of these drugs was studied. Main outcome measure Core drug use indicators. Results The overall average number of prescribed drugs per patient was 2.76 (higher in rural than in urban centers). Only 1.4% of the 1,051 prescriptions did not have any drugs (non pharmacological management only). Generic drugs included 48.4% of all drugs prescribed. The proportion of consultations with antibiotics and injections prescribed was 63.5% and 13.8%, respectively. The proportion of drugs prescribed from the list we developed was 66.8%. Three quarter of all prescribed drugs were dispensed at the facility. In total, 87.1% of patients knew the dosage schedule of the medication prescribed. Conclusion Antibiotic use in our setting was high, while generic drug prescribing was lower in comparison to other recent studies in Asia. The study provides a baseline measure against which changes in practice can be monitored as elements of the state drug policy are put into place.