Prescription and drug use patterns in non-Covid ambulatory patients in Bangladesh during Covid-19 pandemic

Abstract

Background: Irrational prescribing has been a major public health concern worldwide, including in Bangladesh. Lack of effective treatment guidelines and drug regulation policies to manage COVID-19 allowed an upsurge in this malpractice during the pandemic. This cross-sectional study aimed to evaluate the prescription pattern in non-COVID ambulatory patients during the COVID-19 outbreak in Bangladesh. Methods: A total of 600 prescriptions were randomly collected from non-COVID outpatients at three tertiary hospitals in Dhaka, Bangladesh, between December 2020 and June 2021. COVID-19 status was confirmed through verbal screening and antigen test verification when applicable. Data were organized and analyzed using Google spreadsheet, MS Excel, and SPSS software (version 26.0). Results: Mean±SD number of drugs prescribed per prescription was 5.25±2.1 and dependent on patients’ age groups (P<0.001) and gender (P=0.013). Drugs were prescribed by brand names, mostly 3107(98.69%), and 2452(77.9%) of them belonged to the essential drugs list. Most prescribed drugs were from gastroenterology 2025(64.33%) and respiratory group 1716 (54.50%). A mean of 7.38 errors were found per prescription of which the predominant type was error of omission. Each prescription carried 1.157 errors of omission related to the prescriber’s details, 349(50.29%), and diagnosis, 144(20.75%). A total of 427(13.56%) of all the prescribed drugs were at risk of drug-drug interaction. Conclusion: To address the above-mentioned concerns, targeted interventions, such as prescriber training on rational drug use and practicing World Health Organization (WHO) prescribing indicators, implementation and strengthening national prescription monitoring policies, and ensuring a robust supply of necessary drugs are recommended while planning for combating any future outbreak of COVID-19 or similar diseases.