Patterns of drug use in the public sector primary health centers of Bhopal district.
OBJECTIVE
To study drug use in public sector out-patient centers in Bhopal district, Madhya Pradesh Province, India. This study was conducted as part of the provincial health Department's efforts to develop a state drug policy. It was intended to inform policy elements concerned with the promotion of rational drug use.


METHODS
Health facilities studied included the functioning 9 primary health centers (rural) and 17 civil dispensaries (urban) in the district. World Health Organization core drug use (prescribing, patient care and facility) indicators were used. A total of 1,051 patient prescriptions were analyzed for prescribing indicators. Patient care indicators for 1,034 (of these patients) were measured. To study facility indicators, a list of 20 essential drugs was developed by the research team (as the province did not have its own drug list at the time of the study). The availability of these drugs was studied. Main outcome measure Core drug use indicators.


RESULTS
The overall average number of prescribed drugs per patient was 2.76 (higher in rural than in urban centers). Only 1.4% of the 1,051 prescriptions did not have any drugs (non pharmacological management only). Generic drugs included 48.4% of all drugs prescribed. The proportion of consultations with antibiotics and injections prescribed was 63.5% and 13.8%, respectively. The proportion of drugs prescribed from the list we developed was 66.8%. Three quarter of all prescribed drugs were dispensed at the facility. In total, 87.1% of patients knew the dosage schedule of the medication prescribed.


CONCLUSIONS
Antibiotic use in our setting was high, while generic drug prescribing was lower in comparison to other recent studies in Asia. The study provides a baseline measure against which changes in practice can be monitored as elements of the state drug policy are put into place.
De Costa
Ayesha
A
Department of Public Health Sciences, Division of International Health (IHCAR), Karolinska Institutet, Nobels Väg 9, 171 77 Stockholm, Sweden. ayesha_de_costa@yahoo.co.uk
Bhartiya
Shekhawat
S
Eltayb
Amani
A
Nandeswar
Sunil
S
Diwan
Vinod K
VK
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000706:statistics & numerical data; D016568:Drugs, Generic / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000627:therapeutic use*; D011320:Primary Health Care / Q000706:statistics & numerical data; D017150:Public Sector / Q000706:statistics & numerical data; D014944:World Health Organization
D000900:Anti-Bacterial Agents; D016568:Drugs, Generic; D055553:Prescription Drugs