A comparative study of drug utilisation at different levels of the primary healthcare system in Kaski district, Western Nepal.
OBJECTIVE
Studies that compare prescribing patterns at different levels of the primary healthcare system are lacking in Western Nepal. The present study was undertaken to obtain information on age, sex distribution, and morbidity profiles of patients, prescribing patterns and defined daily dose of commonly used drugs.


METHODS
The study was carried out over a three-month period (1 June 2000 to 31 August 2000) at four centres in the Kaski district, Western Nepal. Chi-square test was used to compare differences in morbidity profiles and prescribing patterns (p <0.01).


RESULTS
There were significant differences in the average number of drugs per prescription across different levels. The morbidity profiles were also different. Vitamins were more commonly prescribed at the primary health centre level. Antibiotics were prescribed in 67% of encounters at the level of primary health centre, but the prescribing decreased at the levels of health post and sub-health post.


CONCLUSIONS
The average number of drugs per prescription and the average cost were higher at the primary health centre level and this may be due to the increased prescribing frequency of vitamins and tonics. Comparisons of prescribing patterns at different levels of healthcare, and between government and private healthcare institutions, are urgently required.
Department of Pharmacology, Manipal College of Medical Sciences, Deep Heights, Pokhara, Nepal. pathiyilravi@hotmail.com
Ravi
R
Shankar
Pawan
P
Kumar
Manu
M
Rana
Arun
A
Dubey
Nagesh
N
Shenoy
D017723:Drug Utilization Review; D006801:Humans; D009390:Nepal; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*