Assessment of medicines use pattern using World Health Organization’s Prescribing, Patient Care and Health facility indicators in selected health facilities in eastern Ethiopia

Abstract

BackgroundAbout one-third of the world’s population lack access to essential medicines and this is further compounded by inappropriate prescription, dispensing, sale and use of the available medicines. The objective of the study was to assess the patterns of medicine use among health facilities in eastern Ethiopia using World Health Organization’s Prescribing, Patient Care and Health facility indicators.MethodsA cross sectional study was carried out in eight randomly selected health centers and data were collected retrospectively as well as prospectively. Prescribing indicators were assessed retrospectively using 636 prescriptions selected by systematic random sampling technique among prescriptions filled between September 2013 and September 2014. Patient care indicators were assessed prospectively by interviewing 708 patients from the health facilities. Health facilities were assessed through observation. Data were entered and analyzed using Statistical Packages for Social Sciences version 20. P-value less than 0.05 at 95 % confidence interval considered for significance of relationships for associations in statistical tests.ResultsThe average number of medicines per prescription was 2.2 with standard deviation of 0.8. The proportion of medicines prescribed by generic name was 97 and 92 % of the prescribed medicines were included in List of Essential Medicines for Ethiopia, Prescriptions containing antibiotics and injections constituted (82.5 and 11.2 %) respectively. Of the total of 1426 medicines prescribed, 49.6 % were antibiotics, with amoxicillin (33.3 %) and co-trimoxazole (16.0 %) being the most commonly prescribed agents. The average consultation and dispensing times were 5.6 and 2.7 min, respectively. Among the medicines dispensed, 64.0 % were adequately labeled and the proportion of patients with adequate knowledge about medicines was 69 %.ConclusionThe prescribing and dispensing practices in the health facilities are fairly good and are not that far from the standard WHO requirements. However, there is a need to do more on some issues, including prescribing practice of antibiotics, average number of medicines per prescription, and patients’ dosage form knowledge.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1414-6) contains supplementary material, which is available to authorized users.

Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study

“…This result was somewhat lower than the ideal WHO standard (100%) [7]. Similarly, the current finding was lower than the findings of Gondar University Hospital (GUH) [26] and HUTRH [14], and health centers in Somali zone of eastern Ethiopia [19]. However, it was higher than studies undertaken in JUSH [16] and southern Ethiopia [15].…”

“…Similar study undertaken in different health care settings of Ethiopia found that amoxicillin to be the most frequently prescribed antibiotic in outpatient departments [14, 17, 19]. Inappropriate and over use of antibiotics, as observed in this study, might result in the emergence of antimicrobial resistance which is one of the major bottlenecks of chemotherapy for our globe [7].…”

“…Besides, 39.3% of prescriptions contained three or more drugs. However, lower average numbers of medicines per encounter (1.9, 1.7, 1.8, 1.8, 2.1 and 2.2) were reported in different areas of Ethiopia such as Hawassa University Teaching and Referral Hospital (HUTRH) [14], southern Ethiopia [15] Jimma University Specialized Hospital (JUSH) [16], Dessie Referral Hospital [17], four selected hospitals of west Ethiopia [18] and in eight health facilities of Somali zone of eastern Ethiopia [19], respectively. Similarly, other studies outside of Ethiopia also reported a low number of drugs per encounter, for example, 1.4 in Sudan [20] and 1.3 in Zimbabwe healthcare settings [21].…”

“…On average, 61.12 s was the average dispensing time calculated from this study. Time spent for dispensing was very short when compared to the average dispensing time for ten countries (105 s) [9, 31, 32] and from a similar study done in Zimbabwe (150 s) [33] and Nigeria (210 s) [34], India [23] and different healthcare settings of Ethiopia [19, 35]. This difference might be ascribed to variation on patient load on the individual health care settings.…”

Patient Care Indicator: Degenerative-Nondegenerative Patients and Compounded-Non-Compounded Prescription in One of Community Pharmacy in Bandung

“…Waktu konsultasi dan pemberian obat yang lebih singkat dapat menyebabkan informasi mengenai obat yang disampaikan kepada pasien menjadi tidak adekuat, dan pasien mendapatkan kesempatan yang lebih kecil untuk memperoleh informasi mengenai pengobatan yang diterimanya. 12 Hanya saja, adanya pemisahan tugas seorang apoteker dari kegiatan teknis selama proses pemberian obat dapat meningkatkan waktu yang tersedia untuk berinteraksi dengan pasiennya. Waktu yang tersedia tersebut dapat dimanfaatkan untuk melakukan penilaian klinis terhadap resep obat dan meningkatkan hasil klinis pada pasien.…”