Prescribing Patterns of Analgesics in Surgical Departments in a Tertiary Care Hospital

Abstract

Analgesics are routinely employed in the management of pain in surgical departments. Drug utilization studies evaluate the present trends of drug usage, drug expenditures, appropriateness of prescriptions and adherence to evidence-based recommendations. The Objectives were to study the prescribing pattern, approval status, inclusion in World Health Organization (WHO) essential medicines list/National List of Essential Medicines (NLEM), cost and rationality of analgesics prescribed in surgical departments. Data were collected from records of inpatients who had undergone surgical procedures, from SSIMS & RC Hospital, Davangere. The prescribing patterns, approval of analgesics by Drug Controller General of India (DCGI) and United States Food and Drug Administration (USFDA), cost and listing of analgesics in WHO essential medicines list/NLEM were analysed. The analgesics were classified into different groups based on WHO†Anatomical Therapeutic Chemical (ATC) classification. The results show a total of 276 analgesics prescribed to 126 patients, of which 207(75%) were single drug formulations, 69(25%) fixed dose combinations (FDCs), 255(92.4%) and 219(79.3%) analgesics were approved by DCGI and USFDA, respectively, 195(70.65%) and 3(1.08%) analgesics were included in NLEM and WHO essential medicines list, respectively. Parenteral formulations [174(63.04%)] were most commonly prescribed. The most commonly prescribed analgesics as per WHO-ATC class were N02A (Opioids) [132(47.83%)]. Only 51(18.48%) analgesics were prescribed by their recommended international non-proprietary names (rINN) [generic name]. Owing to the vital role of analgesics in the management of pain in surgical departments, more drugs need to be included in the essential medicines list.

Keywords: Prescribing patterns, Analgesics, Essential medicines, Drug utilization studies, WHO-ATC