Prescribing trend of fixed-dose drug combinations in a tertiary hospital in Nepal

Abstract

The objective of this study was to analyze the prescribing trend of the different fixed-dose drug combinations (FDCs) in a tertiary hospital in Nepal. A retrospective study was conducted after collecting prescriptions from patients attending Manipal Teaching Hospital, Pokhara. The rationality of FDC formulations were studied on the basis of FDCs recommended by Department of Drug Administration (DDA), Ministry of Health (MoH), Nepal and the World Health Organization (WHO). An audit of the prescriptions revealed that 40% of the prescriptions contained FDC formulations. However, FDCs in accordance with recommended DDA, MoH Nepal and WHO lists of FDCs were only 0.8% and 2.1%, respectively. The most commonly prescribed FDCs were multivitamins, cough and cold remedies and antimicrobials which constitute nearly 63% of the total FDCs prescribed. In 48.4% of the prescriptions, the prescribed FDCs contained ingredients which were not essential for the desired therapeutic effect. Nearly 98% and 95% of the FDCs prescribed did not conform to the recommended Nepal and WHO lists of FDCs, respectively. The prescription of certain FDCs, however, were justifiable and in accordance with rational drug usage.