Drug utilization studies using WHO prescribing indicators from India: A systematic review

•Drug utilization studies are playing an essential role in detecting flaws in therapy and thus helping to rectify and rationalizing prescriptions. Monitoring of prescriptions also forms a part of ‘drug utilization’ studies.•World Health Organization has developed prescribing indicators to address the problems associated with prescribing habits such as poly-pharmacy, low generic drug prescriptions, minimum use of essential drug list medicines.•The current systematic review of drug utilization studies conducted in India identifies the higher percentage of antibiotics prescribing in different healthcare settings and minimum prescribing of drugs by generic names. It also reports the optimal use of injectables (except few outliers) and satisfactory use of drugs from the essential medicine list.•Hence, the current review illustrates the usefulness of prescription monitoring studies and highlights the scope for educational intervention and improvement in prescribing practices. Objective: The World Health Organization (WHO) provides standard drug use indicators used globally for drug utilization studies. This systematic review examines and reports the drug utilization profiles captured by individual drug utilization studies conducted in India's different states using World Health Organization prescribing indicators. Methods: PubMed, ScienceDirect, and Google Scholar resource databases were searched up to April 2020. The search included drug utilization studies conducted in India using WHO prescribing indicators and focused on all drug classes and had a considerable variance with study design, data source, and sample size. Results: A total of 561 studies were scanned and retrieved from the database. Forty-two studies met the inclusion criteria and were selected for the final analysis. The prescription pattern was mixed across different geographic locations in India. The average number of drugs prescribed per encounter from the included studies was found to be 3.08. Whereas 24 studies (60%) reported more than 30% of encounters with an antibiotic. The percentage of drugs prescribed using a generic name was poor, and none of the studies recorded 100% prescribing using the generic name. Use of injections as the route of administration was low, and only five studies (14%) had reported more than 20% use of injections. Out of 42 selected studies, 37 (81%) studies reported the percentage of drugs prescribed from the list of essential medicines (ELM). However, only one (2.4