GERIATRIC PRESCRIBING IN THE MEDICAL WARDS OF A TEACHING HOSPITAL IN NEPAL

A retrospective study on prescribing patterns for 100 randomly selecte d geriatric patients admitted over a period of 1 year to the medical w ards of the Tribhuvan University Teaching Hospital (TUTH) in Nepal sho wed that polypharmacy was prevalent. During a hospital stay, 73% patie nts received more than five, 54% received more than eight, and 24% rec eived more than nine drugs concurrently. Although the average drug exp osure per patient during a hospital stay was found to be 11.2, this fi gure would actually go up to 14.5 if all the active ingredients of the fixed-dose combination products prescribed (15.4% of all drugs) were taken into account. Intravenous fluids were the most commonly prescrib ed drugs and were given to 91% of the patients. Antibiotics (excluding metronidazole and antituberculous drugs) were given to over three-qua rters (77%) of the patients. Ciprofloxacin was the most commonly presc ribed antibiotic. Of the 42 patients treated with this drug, 31 (73.8% ) received it intravenously, either for a part of or throughout the co urse. This antibiotic was prescribed concurrently with theophylline in 14 patients without the facility for monitoring plasma-theophylline l evels. It was also administered at the same time as antacid in nine pa tients. Nearly half (46.4%) of the drugs were prescribed by brand or p roprietary names. The prescribing error of leaving the prescription ca rd undated or unsigned when prescribing or stopping drugs was found to be high. The results of this survey indicate that there is considerab le scope for improving geriatric prescribing practices in the medical wards of TUTH. (C) 1997 John Wiley & Sons, Ltd.