Prescribing practices: an overview of three teaching hospitals in Pakistan.

The extent and nature of irrational prescribing of drugs has not been explored in Pakistan A pilot study was therefore undertaken in three major teaching hospitals located in the twin cities of Rawalpindi/Islamabad. Six hundred and one prescriptions from medical, paediatrics and psychiatry units of these hospitals were analyzed to study the prescribing pattern. The mean number of drugs per prescription was found to be 2.97. Only 23.6% drugs were prescribed by their generic names. About 80% of the prescribed drugs were from the National Essential Drug List of Pakistan. Use of injectable preparations was 17.1%. Antimicrobials constituted 20.4% of the drugs prescribed, frequently for cases of acute respiratory infections and gastroenteritis. The average cost of treatment per day was Rupees 26.10 in the outdoors and Rs. 88.36 in indoors. Treatment did not correlate to the diagnosis in 24.6% of the cases. Doses of drugs were inappropriate in 30.6% prescriptions. Duration of treatment was not specified on a vast majority (73.4%) of the prescriptions. The data highlights the need for educational, managerial and regulatory interventions to rationalize the drug use in Pakistan.