Prescribing behaviour of practitioners in public and private hospitals in Pakistan evaluated using the World Health Organization (WHO) indicators: A comparative approach

Summary Introduction The non-rational use of medicines by medical practitioner in their prescribing practices might lead to therapeutic failure. The aim of this research was to evaluate medical prescriptions and to highlight differences in behaviour between prescribers of public and private hospitals in Karachi (Pakistan). Materials and methods This is a retrospective study conducted between November 2015 to October 2016 in 4 public hospitals and 4 private hospitals in Karachi. A total of 120,096 ( n ) prescriptions were collected from both public and private hospitals. The data were evaluated with WHO indicators for rational use of medicines. Results The average number of drugs per prescriptions in public and private hospitals was 7.14 and 5.4 respectively. The generic prescription rate was measured in public and private health care settings respectively. The prescription level of injectable drugs is comparable between the public (67.94%) and private (64.36%) hospitals. Use of antibiotics is higher in public hospitals (67.94%) than in private hospitals (51.59%). Discussion The prescribing model of doctors in private hospitals seems rational and more appropriate than that of doctors in public hospitals. But the average cost of a prescription is lower in public hospital, possibly linked to a higher use of generic drugs. Prescription rates for antibiotics and injectable forms are still high compared to other countries. Conclusion It is necessary to include education programs on subjects related to treatment and use of medicines. Polypharmacy is one of the priority targets as well as the establishment of protocols to improve the management of patients. Pharmacists could also help patients better understand their prescriptions to improve drug adherence and drug use.