Published: 2019-08-28

Assessment of prescription writing practices in a government tertiary care hospital in Haryana by using WHO prescribing indicators

Kamaldeep Singh, Garima Bhutani, Seema Rani, Rahul Saini


Background: Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’s expertise. World Health Organization has defined certain parameters to promote rational drug use in all countries. This study was designed to assess the prescription writing practices in a government tertiary care hospital in Haryana by using WHO prescribing indicators.

Methods: A total of 2155 prescriptions were evaluated. Each prescription was evaluated for average number of drugs prescribed per patient per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed and percentage of medicines from Essential drug list prescribed. These indicators help us to check polypharmacy, practice of prescribing drugs by brand names, antibiotic overuse, preference of injectables and non-adherence to Essential drug list.

Results: The average number of drugs prescribed per patient per encounter was calculated to be 3.25±0.24. The percentage of medicines prescribed by generic names was 35.89%. Percentage of encounters with an antibiotic prescribed was 48.21 % and with an injection prescribed was 1.85%. The percentage of medicines form NLEM was 76.36%.

Conclusions: The values of WHO prescribing indicators obtained from this study show that there are some areas where the prescribers need to improve their prescribing practices.


Essential drug list, Generic names, Prescription, WHO prescribing indicators

Full Text:



Badyal D. Practical Manual of Pharmacology. 1st edition. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2008: 112-157.

World Health Organisation. Rational use of Medicines 2010. Available from: http://www.who. int/medicines/areas/rational_use/en/index.html. Accessed 15 July 2019.

Hassan NB, Ismail HC, Naing L, Conroy RM, Rahman AR. Development and validation of a new Prescription Quality Index. Br J Clin Pharmacol. 2009;70(4):500-13.

World Health Organization. Guide to drug financing mechanisms 1998. Available from: http://apps.who. int/medicinedocs/en/d/Jh2928e/#Jh2928e. Accessed 15 July 2019.

Potharaju HR, Kabra SG. Prescription audit of outpatient attendees of secondary level government hospitals in Maharashtra. Indian J Pharmacol. 2011;43(2):150-6.

Chetia D, Nada N, Rudrapal M. Study on the use of medicines in some selected health care facilities of Arunachal Pradesh. Asian J Pharm Clin Res. 2011;4(3):80-1.

Sisay M, Mengistu G, Molla B, Amare F, Gabriel T. Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study. BMC Health Serv Res. 2017;17(161):1-9.

Bilal AI, Osman ED, Mulugeta A. Assessment of medicines use pattern using World Health Organization’s Prescribing, Patient Care and Health facility indicators in selected health facilities in eastern Ethiopia. BMC Health Serv Res. 2016;16(144):1-8.