Monitoring irrational medicine prescription

The health ministry is conducting a survey to study prescription patterns

Medical: The health ministry is monitoring and studying the irrational prescription of medicines in the hospitals across the country.

Beginning January this year, the medical services department mandated all dzongkhag hospitals including the regional referrals to participate in the prescription survey. All they need to do is collect details of one random prescription every day. Fill up a survey form that requires details such as date of prescription, prescriber, total number of drugs, antibiotics, injections and the number of drugs dispensed with diagnosis details among others.

A compilation of at least 30 prescriptions a month has to be submitted to the department. This has been included in the Annual Performance Agreement as well.

Chief programme officer of the essential medicines technology division, Dechen Choiphel presented this at the central regional coordination meeting yesterday in Tsirang.

He said that although the ministry initiated the study on prescription patterns a few years back, all hospitals have not fully participated.

The survey, he said, is to monitor and evaluate rational use of medicines in the country. “Irrational use of medicines can result in wastage of resources and significant patient harm in terms of poor patient outcomes, adverse drug reactions and antimicrobial resistance,” he said. “We want to avoid this with proper study of the current pattern.”

He added that this will help improve service delivery and patients will be provided with correct medicines. It is also expected to minimise wastage of medicines by prescribing one correct drug instead of two to three drugs without a proper disgnosis.

Currently, hospitals are in the process of forming therapeutic committees, which consists of prescribers. The committees will sit together to discuss improving the prescription pattern, following bi-annual feedback from the department. The Thimphu and Mongar referral hospitals have already established the committees.

Department of Medical Services director general, Dr Ugen Dophu said that the survey will only study the prescription pattern to avoid over-prescription of essential drugs and misuse of antibiotics.

“We’re studying not to penalise prescribers but to get overall knowledge of prescription pattern, which will follow with necessary trainings to prescribers,” he said. “Our prescribers are already knowledgeable. They just need awareness on reasonable prescription of drugs.”

The department of medical supplies and health infrastructure in its recent meeting with medical store managers advised the storekeepers to periodically update the available stock of drugs to doctors in the hospitals. It was learnt that the rational use of medicines solely depended on the doctors or the prescribers.

Health ministry officials also said that annually a substantial quantity of expired drugs are disposed. This can be avoided, they said. Although no study has been done to find out the monetary loss, it is estimated that at least five percent of the Nu 120 million annual drug expenditure is wasted.

Starting next year the prescription survey will be initiated in Basic Health Units as well.

Nirmala Pokhrel

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