Table 1.
Description of the prescriptions and their quality indicators audited using the NAPS in four major hospitals in Bhutan, June 2022
| Variables | Overall (314) | JDWNRH (206) | CRRH (42) | ERRH (38) | PGH (28) | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| n | % | n | % | n | % | n | % | n | % | |
| Sex | ||||||||||
| Female | 148 | 47.1 | 95 | 46.1 | 21 | 50.0 | 20 | 52.6 | 12 | 42.9 |
| Male | 166 | 52.9 | 111 | 53.9 | 21 | 50.0 | 18 | 47.4 | 16 | 57.1 |
| Speciality departments | ||||||||||
| General medicine | 108 | 34.4 | 67 | 32.5 | 10 | 23.8 | 7 | 18.4 | 24 | 85.7 |
| General surgery | 67 | 21.3 | 41 | 19.9 | 17 | 40.5 | 9 | 23.7 | — | — |
| Paediatrics | 38 | 12.1 | 28 | 13.6 | 5 | 11.9 | 5 | 13.2 | — | — |
| Orthopaedic surgery | 35 | 11.1 | 23 | 11.2 | 2 | 4.8 | 10 | 26.3 | — | — |
| Intensive/critical care | 22 | 7.0 | 13 | 6.3 | 3 | 7.1 | 6 | 15.8 | — | — |
| Gynaecology | 17 | 5.4 | 9 | 4.4 | 4 | 9.5 | 1 | 2.6 | 3 | 10.7 |
| Ear/nose/throat surgery | 11 | 3.5 | 11 | 5.3 | — | — | — | — | — | — |
| Obstetrics | 9 | 2.9 | 8 | 3.9 | — | — | — | — | 1 | 3.6 |
| Dermatology | 3 | 1.0 | 3 | 1.5 | — | — | — | — | — | — |
| Neonatology | 2 | 0.6 | 2 | 1.0 | — | — | — | — | — | — |
| Oncology | 1 | 0.3 | 1 | 0.5 | — | — | — | — | — | — |
| Ophthalmology | ||||||||||
| History of drug allergy | ||||||||||
| Present | 4 | 1.3 | 1 | 0.5 | 1 | 2.4 | 2 | 5.3 | — | — |
| Absent | 218 | 69.4 | 151 | 73.3 | 39 | 92.9 | 25 | 65.8 | 3 | 10.7 |
| Not documented | 92 | 29.3 | 54 | 26.2 | 2 | 4.8 | 11 | 28.9 | 25 | 89.3 |
| Microbiological sample collected prior to antibiotics | 120 | 38.2 | 78 | 37.9 | 20 | 47.6 | 20 | 52.6 | 2 | 7.1 |
| Route | ||||||||||
| IV | 248 | 79.0 | 158 | 76.7 | 32 | 76.2 | 36 | 94.7 | 22 | 78.6 |
| Oral | 66 | 21.0 | 48 | 23.3 | 10 | 23.8 | 2 | 5.3 | 6 | 21.4 |
| Indication documented | 278 | 88.5 | 181 | 87.9 | 38 | 90.5 | 36 | 94.7 | 23 | 82.1 |
| Review or stop date | 102 | 32.5 | 61 | 29.6 | 24 | 57.1 | 15 | 39.5 | 2 | 7.1 |
| Number of antibiotics | ||||||||||
| One | 190 | 60.5 | 126 | 61.2 | 28 | 66.7 | 25 | 65.8 | 11 | 39.3 |
| Two | 112 | 35.7 | 73 | 35.4 | 10 | 23.8 | 13 | 34.2 | 16 | 57.1 |
| Three | 12 | 3.8 | 7 | 3.4 | 4 | 9.5 | — | — | 1 | 3.6 |
| Compliance with guideline | ||||||||||
| Compliant with guideline | 125 | 39.8 | 63 | 30.6 | 29 | 69.0 | 26 | 68.4 | 7 | 25.0 |
| Directed therapya | 26 | 8.3 | 21 | 10.2 | 1 | 2.4 | 3 | 7.9 | 1 | 3.6 |
| No guideline available | 15 | 4.8 | 4 | 1.9 | 11 | 39.3 | ||||
| Non-compliant with guideline | 134 | 42.7 | 109 | 52.9 | 11 | 26.2 | 9 | 23.7 | 5 | 17.9 |
| Not assessable | 14 | 4.5 | 9 | 4.4 | 1 | 2.4 | — | — | 4 | 14.3 |
| Appropriateness of prescription | ||||||||||
| Appropriate | 169 | 53.8 | 84 | 40.8 | 30 | 71.4 | 30 | 78.9 | 25 | 89.3 |
| Inappropriate | 132 | 42.0 | 112 | 54.4 | 10 | 23.8 | 8 | 21.1 | 2 | 7.1 |
| Not assessable | 13 | 4.1 | 10 | 4.9 | 2 | 4.8 | — | — | 1 | 3.6 |
CRRH, Central Regional Referral Hospital; ERRH, Eastern Regional Referral Hospital; JDWNRH, JDW National Referral Hospital; PGH, Phuentsholing General Hospital.
a
Directed therapy where prescription was changed from empirical to directed therapy with microbiology culture or susceptibility report was available.