EVALUATION OF PRESCRIPTION PRACTICES IN RURAL AND URBAN HEALTH TRAINING CENTRES OF A TEACHING HOSPITAL IN TIRUVALLUR, TAMIL NADU

Background: Rational drug prescription ensures patients receive medications appropriate to their clinical needs, in dosesmeeting individual requirements, for an adequate period and at the lowest cost. Rational drug utilization is essential forensuring safe, effective and cost-efficient health care. However, irrational prescribing practices, such as polypharmacy, lowgeneric prescribing and inappropriate antibiotic use, remain a significant concern, particularly in primary care settings. TheWorld Health Organization (WHO) core prescribing indicators provide a standardized tool for evaluating prescribingpractices. The objective is to assess and compare prescribing patterns at the Rural Health Training Centre (RHTC) andUrban Health Training Centre (UHTC) of a teaching hospital using WHO core prescribing indicators. Materials andMethods: A facility-based cross-sectional analytical study was conducted over three months at rural and urban healthtraining centres under Department of Community Medicine in a tertiary care teaching hospital. A total of 636 outpatientprescriptions (318 from each center) were selected using systematic random sampling. Prescriptions were collected andaudited using the World Health Organization core prescribing indicators by trained medical interns under the supervision ofthe faculty. Statistical analyses were performed using Epi Info and SPSS version 21. The chi-square test was applied tocompare indicators between centers, with p < 0.05 considered statistically significant. Results: The average number of drugsper encounter was higher than the WHO recommendations in both RHTC (2.4) and UHTC (2.8), indicating mildpolypharmacy. Generic prescribing was suboptimal, observed in 78.9% RHTC and 71.1% in UHTC. Antibiotic prescribingremained within WHO acceptable limits (19.5% vs. 22.6%), whereas injection use was significantly higher in UHTC(12.6%) than in RHTC (8.5%) (p = 0.039). Prescribing from the Essential Medicines List (EML) was 87.4% in the RHTCand 81.1% in the UHTC (p = 0.024). The completeness of prescriptions was satisfactory for identifiers but deficient indiagnosis (72.6%) and treatment details. Conclusion: Prescribing practices were acceptable in several domains; however,improvements are needed in generic prescribing, polypharmacy and adherence to the Essential Medicines List. Regularprescription internal audits, standardized prescription formats and focused training on rational drug use are recommended toimprove prescribing practices.