A cross-sectional study on rational use and prescribing pattern of drugs used in pregnant women with comorbidity in a tertiary care hospital, Bengaluru (Bangalore), Karnataka, India

• Author Details:   
• Aleena Shine
• Abhishek U.N
• Ritwam Mukhopadhyay ^*
• Animesh Das
• Satheesh Kumar E
• Padma L Gopinath
• Ashna U Anilkumar

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Background: Prescription data offer valuable insights into trends in drug utilization, therapeutic decision-making, and the use of generic medicines. Rational drug use entails selecting appropriate medications with the correct dosage and administration. Pregnant women with comorbid conditions present a unique challenge, as inappropriate prescriptions can have adverse outcomes for both mother and fetus.
Objective: This study aimed to evaluate prescribing patterns, assess rational drug use, and identify inappropriate medication use and drug interactions in this population.
Materials and Method: A cross-sectional study was conducted on 362 pregnant inpatients at the obstetrics and gynecology department of a tertiary care hospital in Bengaluru. Data were collected using a customized form, capturing patient demographics, clinical details, and prescription information. Drug interactions were analyzed using Lexicomp software, and Microsoft Excel was utilized for statistical analysis.
Results: Among 362 patients, anemia was the most prevalent comorbidity (41.43%). The majority of drugs prescribed were Category B (71.92%). Drug interactions were noted in 145 patients, with Tramadol and Metoclopramide accounting for the highest incidence (34.40%). Most interactions (59.17%) were of moderate severity, with pharmacodynamic mechanisms being predominant (86%). The WHO core prescribing indicators revealed an average of 9.31 drugs per prescription and an average antibiotic use of 26.62 per 100 encounters. Injections were administered to 88.39% of patients. Of the 3,373 drugs prescribed, 47.19% were generics, and 60.83% were listed on the Essential Drug List (EDL).
Conclusion: The findings indicate significant deviations from rational prescribing standards, including high polypharmacy rates and suboptimal use of generics and EDL drugs. The frequent occurrence of moderate pharmacodynamic drug interactions further highlights the need for enhanced prescribing vigilance. Strengthening adherence to WHO guidelines and ensuring the availability of EDL medications are crucial steps toward improving maternal healthcare outcomes.