PRESCRIPTION PATTERN ANALYSIS IN TERTIARY CARE HOSPITALS: A CROSS-SECTIONAL OBSERVATIONAL STUDY

Abstract

Background: Prescription pattern analysis is a fundamental pharmacoepidemiological tool for evaluating rational drug use and healthcare quality. Tertiary care hospitals, serving as referral centres for complex cases, are particularly susceptible to polypharmacy and irrational prescribing. This study aimed to assess prescribing patterns using World Health Organization (WHO)/International Network for Rational Use of Drugs (INRUD) core prescribing indicators at a tertiary care teaching hospital.

Methods: A prospective, cross-sectional observational study was conducted over six months (July–December 2025) in the outpatient departments (OPDs) of a tertiary care teaching hospital. A total of 1,200 prescriptions were randomly selected and analysed for WHO/INRUD prescribing indicators including average number of drugs per prescription, percentage prescribed by generic name, percentage from the National List of Essential Medicines (NLEM) 2022, antibiotic encounters, and injectable encounters. Prescription completeness was also evaluated.

Results: The mean number of drugs per prescription was 3.42 (±1.28). Drugs prescribed by generic name accounted for 58.7% of total prescriptions. NLEM adherence was 73.4%. Antibiotic prescribing was found in 28.6% of encounters, and injectables in 6.8%. Fixed-dose combinations (FDCs) were present in 38.2% of prescriptions. Proton pump inhibitors (pantoprazole) were the most frequently prescribed drug class (61.3%), followed by analgesics, antihypertensives, and antimicrobials. Prescription completeness was 84.3%, with deficiencies noted primarily in diagnosis documentation and prescriber designation.

Conclusion: Prescribing patterns at the study hospital showed partial adherence to WHO rational use standards. Polypharmacy, suboptimal generic prescribing, high antibiotic use, and over-reliance on FDCs remain key concerns. Targeted educational interventions, prescription audits, and antimicrobial stewardship programmes are urgently required to improve prescribing practices.