Drug Utilization Study in Ophthalmology Out-patient Department of a Medical College in India

BACKGROUND: Drug utilization studies provide a pharmacoeconomic basis for making evidence-based health-care decisions. In ophthalmology practice, rational prescribing plays a crucial role in reducing the ocular disease burden. AIM: The aim of the study was to investigate the drug utilization pattern in ophthalmology out-patient department (OPD) of a Medical College in India. SUBJECTS AND METHODS: A prospective, cross-sectional study was conducted for a period of 2 months. The prescriptions for all consecutive patients attending the OPD for the first time (first time encounter) were included and audited using a pre-designed form to record information from the OPD prescription cards of each patient. Data analysis was carried out using the descriptive statistical methods: Frequencies, percentage, mean and standard deviation. RESULTS: A total of 640 prescriptions were analyzed with the average number of drugs per prescription being 2.4 (0.9). The most common disorders diagnosed were refractive errors (31.6% [202/640]) followed by cataract, glaucoma and others. Drugs were prescribed in different dosage forms with eye drops being the most common (70.8% [1073/1516]) followed by tablets (15.9% [241/1516]), ointment (6.1% [93/1516]), syrup (1.1% [16/1516]) and others; injections contributed 2.1% (30/1516) of all dosage forms. The frequency of drug administration and duration of treatment was recorded in 96% (614/640) and 75% (480/640) of all prescriptions respectively. Antimicrobials were most commonly prescribed (36.4% [552/1516]) followed by anti-inflammatory and anti-allergic (24.2% [367/1516]), anti-glaucoma medications (21.4% [323/1516]), mydriatic and cycloplegics (7.2% [109/1516]), miotics (6.2% [94/1516]), multivitamins (4.6% [70/1516]). Drugs were predominantly prescribed in brand name 83% (1258/1516) instead of generic name. A total of 62% (940/1516) of drugs were prescribed from national essential medicine list. CONCLUSION: The present study revealed certain lacunae in the prescribing practices of the Ophthalmologists of the institute as evidenced by low generic prescribing, inadequate information about frequency of administration and duration of therapy in many prescriptions. This can be addressed through proper sensitization of clinicians in the art of rational prescribing.