Prescription Analysis of Pediatric Outpatient Practice in Nagpur City

BACKGROUND: Medication errors are probably one of the most common types of medical errors, as medication is the most common health-care intervention. Knowing where and when errors are most likely to occur is generally felt to be the first step in trying to prevent these errors. OBJECTIVE: To study prescribing patterns and errors in pediatric OPD prescriptions presenting to four community pharmacies across Nagpur city and to compare the prescription error rates across prescriber profiles. MATERIALS AND METHODS: The study sample included 1376 valid pediatric OPD prescriptions presenting to four randomly selected community pharmacies in Nagpur, collected over a period of 2 months. Confirmed errors in the prescriptions were reviewed and analyzed. The core indicators for drug utilization studies, mentioned by WHO, were used to define errors. RESULTS: The 1376 prescriptions included in the study were for a total of 3435 drugs, prescribed by 41 doctors. Fixed dose formulations dominated the prescribing pattern, many of which were irrational. Prescribing by market name was almost universal and generic prescriptions were for merely 254 (7.4%) drugs. The prescribing pattern also indicated polypharmacy with the average number of drugs per encounter of 2.5. Antibiotics were included in 1087 (79%) prescriptions, while injectable drugs were prescribed in 22 (1.6%) prescriptions. The prescription error score varied significantly across prescriber profiles. CONCLUSION: The findings of our study highlight the continuing crisis of the irrational drug prescribing in the country.