A CROSS-SECTIONAL STUDY ON ADVERSE DRUG REACTIONS AND RATIONAL PRESCRIBING PATTERNS WITH COST-EFFECTIVE ANALYSIS IN A TERTIARY CARE CENTRE OF BUNDELKHAND REGION

Background: Adverse drug reactions (ADRs) are a significant challenge in clinical medicine frequently contributing in increasing morbidity, hospital stays, and treatment costs. Despite advancements, irrational prescribing remains common and compromises patient safety. Methods: This prospective, cross-sectional observational study was conducted over 13 months (Feb 2024–Mar 2025) at Maharani Laxmi Bai Medical College, Jhansi. A total of 200 patients with suspected ADRs were enrolled. ADRs were assessed using the Modified Hart wig and Siegel severity scale and WHO-UMC causality scale. Post-ADR prescriptions were analyzed for WHO prescribing indicators and cost-effectiveness. Results: The mean patient age was 38.4±12.6 years, with males comprising 55.5%. Dermatological ADRs were predominant (46%), followed by systemic symptoms (20.5%), gastrointestinal (15%), hepatic (7%), and others (11.5%). Antibiotics (52.5%) and NSAIDs (18%) were the main offending drug classes. Most ADRs were of moderate severity (94%) and classified as “possible” (55.5%). Post-ADR, the average number of drugs per prescription was 2.37, 66.95% of which were from the National List of Essential Medicines (NLEM). The average daily prescription cost was ₹ 97.48. Conclusion: ADRs impose a significant clinical and economic burden. Strengthening pharmacovigilance and rational prescribing, including adherence to WHO indicators and NLEM, can reduce ADR incidence and treatment costs.