Pharmacy World & Science

, 30:584 | Cite as

Patterns of drug use in the public sector primary health centers of Bhopal district

  • Ayesha De CostaEmail author
  • Shekhawat Bhartiya
  • Amani Eltayb
  • Sunil Nandeswar
  • Vinod K. Diwan
Research Article


Objective To study drug use in public sector out-patient centers in Bhopal district, Madhya Pradesh Province, India. This study was conducted as part of the provincial health Department’s efforts to develop a state drug policy. It was intended to inform policy elements concerned with the promotion of rational drug use. Method Health facilities studied included the functioning 9 primary health centers (rural) and 17 civil dispensaries (urban) in the district. World Health Organization core drug use (prescribing, patient care and facility) indicators were used. A total of 1,051 patient prescriptions were analyzed for prescribing indicators. Patient care indicators for 1,034 (of these patients) were measured. To study facility indicators, a list of 20 essential drugs was developed by the research team (as the province did not have its own drug list at the time of the study). The availability of these drugs was studied. Main outcome measure Core drug use indicators. Results The overall average number of prescribed drugs per patient was 2.76 (higher in rural than in urban centers). Only 1.4% of the 1,051 prescriptions did not have any drugs (non pharmacological management only). Generic drugs included 48.4% of all drugs prescribed. The proportion of consultations with antibiotics and injections prescribed was 63.5% and 13.8%, respectively. The proportion of drugs prescribed from the list we developed was 66.8%. Three quarter of all prescribed drugs were dispensed at the facility. In total, 87.1% of patients knew the dosage schedule of the medication prescribed. Conclusion Antibiotic use in our setting was high, while generic drug prescribing was lower in comparison to other recent studies in Asia. The study provides a baseline measure against which changes in practice can be monitored as elements of the state drug policy are put into place.


Bhopal district Drug use indicators India Public sector Primary healthcare WHO study model 



Danida (Danish International Development Assistance) assisted Madhya Pradesh Basic Health Services Programme, which supported the study as part of its support to the Provincial Drug Policy.

Conflict of Interest



  1. 1.
    National Commission on Macroeconomics and Health. New Delhi: Ministry of Health & Family Welfare Government of India; 2005.Google Scholar
  2. 2.
    Action Program on Essential Drugs. How to investigate drug use in health facilities. (WHO/DAP/93.1). Geneva: World Health Organization; 1993.Google Scholar
  3. 3.
    Census of India. New Delhi: Registrar General and Census Commissioner, India, Govt. of India; 2001.Google Scholar
  4. 4.
    Third Human Development Report. Madhya Pradesh: Government of Madhya Pradesh; 2002.Google Scholar
  5. 5.
    Awad AI, Himad HA. Drug-use practices in teaching hospitals of Khartoum State, Sudan. Eur J Clin Pharmacol. 2006;62(12):1087–93.PubMedCrossRefGoogle Scholar
  6. 6.
    Keohavong B, Syhakhang L, Sengaloundeth S, Nishimura A, Ito K. Rational use of drugs: prescribing and dispensing practices at public health facilities in Lao PDR. Pharmacoepidemiol Drug Saf. 2006;15(5):344–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Naseeb TA, Nasser MA. Drug prescribing indicators in primary health care centers in Bahrain. Saudi Med J. 2005;26(9):1436–8.PubMedGoogle Scholar
  8. 8.
    Santos V, Nitrini SM. Prescription and patient-care indicators in healthcare services. Rev Saude Publica. 2004;38(6):819–26.PubMedCrossRefGoogle Scholar
  9. 9.
    Hogerzeil HV, Bimo, Ross-Degnan D, Laing RO, Ofori-Adjei D, Santoso B, et al. Field tests for rational drug use in 12 developing countries. Lancet. 1993;342(8884):1408–10.PubMedCrossRefGoogle Scholar
  10. 10.
    Karande S, Sankhe P, Kulkarni M. Patterns of prescription and drug dispensing Indian J Pediatr. 2005;72(2):117–21.PubMedCrossRefGoogle Scholar
  11. 11.
    Memon KH. Use of drugs in Sind province Pakistan primary health care facilities. Concentration paper for MPH at Boston University school of Public Health. 2006. Accessed 10 Mar 2006.
  12. 12.
    Sivagnanam G, Thirumalaikolundusubramanian P, Mohanasundaram J, Raaj AA, Namasivayam K, Rajaram S. A survey on current attitude of practicing physicians upon usage of antimicrobial agents in southern part of India. Med Gen Med. 2004;6(2):1.Google Scholar
  13. 13.
    Kotwal A, Priya R, Thakur R, Gupta V, Kotwal J, Seth T. Injection practices in a metropolis of North India: perceptions, determinants and issues of safety. Indian J Med Sci. 2004;58(8):334–44.PubMedGoogle Scholar
  14. 14.
    Chaudhury RR, Parameswar R, Gupta U, Sharma S, Tekur U, Bapna JS. Quality medicines for the poor: experience of the Delhi programme on rational use of drugs. Health Policy Plan. 2005;20(2):124–36.PubMedCrossRefGoogle Scholar
  15. 15.
    WHO Health Organization. Health statistics. 2007. Accessed 22 April 2007.
  16. 16.
    De Costa A, Diwan V. ‘Where is the public health sector?’ Public and private sector healthcare provision in Madhya Pradesh, India. Health Policy. 2007;84(2–3):269–76.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2008

Authors and Affiliations

  • Ayesha De Costa
    • 1
    Email author
  • Shekhawat Bhartiya
    • 2
  • Amani Eltayb
    • 1
  • Sunil Nandeswar
    • 2
  • Vinod K. Diwan
    • 1
  1. 1.Department of Public Health Sciences, Division of International Health (IHCAR)Karolinska InstitutetStockholmSweden
  2. 2.Department of Community MedicineGandhi Medical CollegeBhopalIndia

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