A prospective surveillance of drug prescribing and dispensing in a teaching hospital in western Nepal.

OBJECTIVE To evaluate the drug dispensing practices and patients' knowledge on drug use among the outpatients and to identify and analyze the problems in drug prescribing and dispensing. METHODS A prospective cross-sectional descriptive study was conducted using World Health Organization (WHO) core drug use indicators from July 13, 2008 to August 15, 2008 in Manipal Teaching Hospital, Pokhara, Nepal. RESULTS A total of 4231 prescriptions were encountered with the total of 10591 drugs prescribed. The average number of drug per prescription was 2.5. Only 13% (n=10591) of drugs were prescribed by generic name. Percentage of drug prescribed from WHO model list of Essential drugs, Essential drug list of Nepal and Nepalese National Formulary was 21.7%, 32.8% and 42.3% respectively. Antibiotics and injections encountered were 28.3% and 3.1% respectively. Average cost per prescription was found to be Nepalese Rupees (NRs) 285.99 (US $ 3.73). Patient knowledge on correct use of drugs and appropriate labeling was found to be 81% and 1.4% respectively. Average dispensing time per prescription was 52 seconds. CONCLUSION The finding from current study shows a trend towards irrational prescribing and dispensing. Hence, there is a need for effective intervention programme to encourage the physicians and dispensing pharmacists in promoting more rational drug use.