Drug Use Pattern in Upazilla Health Complexes of Bangladesh

Abstract

In Bangladesh, the government healthcare system remaIns a very minor source of health care. The treatments provided by the doctors remain open to question, with instances of maltreatment or inadequate treatment. The treatments are mostly symptomatic and polypharmacy is Common, with antibiotics and vitamins prescribed widely. On the other hand, rural people sometimes do not buy all the drugs that are prescribed for them, partly because off tnancial constraint. In addition, self medication is common. The provision of drugs is the component of primary health care that patients most often demand and expect. Nevertheless, drugs continue to be in short supply, even when large portions of the health care budget are allocated for their procurement. In June 1982 Bangladesh introduced a national drug policy (NDP) and a drugs ordinance, which follow WHO guidelines on the selection of essential drugs. Since the enactment of the drug policy, the production, quality, and availability of essential drugs have significantly improved. Although consultations with doctors most commonly result in drugs being prescribed, very little is known about the proper use of drugs. The quality of health care, particularly the rational use of drugs, depends on a wide range of activities, such as making the correct diagnosis, prescribing the appropriate drug and dispensing them properly. When used rationally, drugs cure ailments; on the other hand, they may be dangerous and can threaten life when used irrationally. The aim of the current survey was to assess drug use for common diseases and to record the availability of essential drugs. The survey examined current treatment practices at outpatient clinics, including Assessment of patient care, physical examination, and the time given to each patient; assessment of the dispensing process in terms of the time taken and whether drugs were dispensed according to prescription; patient's knowledge of how to take the drugs; the availability of twelve essential drugs on the survey date; and the availability of an essential drugs list in the facilities. The drug use pattern and the quality of care were assessed in 5 Upazilla Health Complexes of Bangladesh. A total of 30 prescriptions, consultations, and drug-dispensing practices were studied, and the availability and use of essential drugs and of the essential drugs list were recorded. The average consulting time was 2.4 minute. The mean number of drugs prescribed per patient was 2.3. 33.30/0 were treated with antibiotics, and 17% with metronidazole, irrespective of the diagnoses. The availability of essential drugs was 77% and there was no essential drugs list in the health facilities. However, 73% of the drugs were prescribed by their generic names, 85% complied with the essential drugs list, and 80% were dispensed according to prescription. The average dispensing time was 29 seconds. The patient's knowledge on the drug dosage was 100%. Contents