Drug use studies are an integral part of medical audits and are often conducted to monitor and evaluate prescribing practices. The primary goal of rational drug use is to ensure that patients receive medications that are appropriate to their clinical needs, in doses that meet their individual requirements for an adequate duration and at the lowest cost to both the patient and the community. Irrational drug use can occur through polypharmacy, underuse, or improper use of effective medicines. This study aims to evaluate prescribing patterns and the rationality of drug use in the General Medicine Department of a tertiary teaching hospital (Navodaya Medical college Hospital and Research Centre, Raichur, Karnataka, India). A prospective observational study was conducted over six months, enrolling 100 patients admitted as inpatients. Prescription data from seriously ill patients and those transferred to the ICU were excluded from the study. Data were analysed using descriptive statistics, such as mean and percentage. The study found that the majority of participants (37%) were elderly, indicating a higher representation of older patients, while 30% were middle-aged and only 11% were in the youngest age group. Gender distribution was nearly equal, with male patients comprising 49% and female patients 51%, resulting in a male-to-female ratio of 1:1. Most patients (57%) were discharged within 1-5 days, suggesting that most admissions involved mild or less complicated cases. A significant portion of patients (29%) stayed for 6-10 days, while only 11% stayed for 10-15 days and 3% stayed for 15-20 days. The study also observed that infectious diseases (6.30%), respiratory diseases (32.43%), cardiovascular disorders (2.70%), central nervous system disorders (4.50%), gastrointestinal disorders (3.60%), renal disorders (2.70%), liver disorders (6.30%), Anaemia (10.81%) and thyroid disorders (10.81%) were among the most common diagnoses, with other conditions including fever under evaluation, pancytopenia, acute febrile illness and fever under observation (27.02%). In the pre-interventional phase, the average number of drugs per prescription was 7.47. The percentage of drugs prescribed by generic names was 55.15%, the percentage of injections prescribed was 44.71% and the percentage of antibiotics prescribed was 21.40%. Furthermore, 57.29% of drugs were prescribed from the essential drug list. In the post-interventional phase, the average number of drugs per prescription decreased to 5.42, the percentage of drugs prescribed by generic names increased to 64.02%, the percentage of injections prescribed dropped to 20.21% and the percentage of antibiotics prescribed rose to 36.53%. Drugs prescribed from the essential drug list increased to 62.36%. Drug-related problems included adverse drug reactions (ADRs) in 2% of patients, medication errors observed in 33% and drug-drug interactions in 18%. The study highlights the over-prescription of antibiotics and the prevalence of irrational drug use, particularly in the pre-interventional phase. However, following educational interventions for healthcare professionals, rational prescribing practices were significantly improved. The study underscores the need for policies and procedures to guide prescribing practices and optimize cost-effective drug therapy, ultimately improving patient outcomes and quality of life.
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