Evaluation of trends of drug-prescribing patterns based on WHO prescribing indicators at outpatient departments of four hospitals in southern Ethiopia

Abstract

BackgroundRational prescribing is a primary step to ensure rational drug use. Often, half of the medicines are prescribed irrationally and half of these are even used incorrectly as the patients fail to take their medicines appropriately. The aim of this research was to evaluate drug-prescribing patterns of four hospitals in southern Ethiopia.MethodsA retrospective cross-sectional study was conducted between May 15 and June 25, 2014, to evaluate the drug-prescribing patterns based on the World health Organization (WHO) prescribing indicators. The prescription papers, kept for the last 1 year in the outpatient departments of the four hospitals, were analyzed according to WHO guidelines. Also, prescriptions in the hospitals were analyzed to determine the most frequently prescribed drugs. All the statistical calculations were performed using SPSS® version 20.0 software.Results and discussionThe average number of drugs per prescription ranges from 1.82±0.90 to 2.28±0.90, whereas the percentage of use of antibiotics and injections ranged from 46.7 to 85 and 15 to 61.7, respectively. The average percentages of drugs prescribed by generic name and from the essential drugs list were 95.8 and 94.1, respectively. Anti-infective and analgesic drugs are found to be the most frequently prescribed medicines. In terms of polypharmacy, there was a slight deviation in prescribing patterns from what is acceptable according to the WHO criteria. Prescribing by generic name and from essential drug list was almost optimal. There was a significant deviation in the use of injectables in two of the four hospitals (50%), whereas their use in the other two hospitals was within the acceptable range. The use of antibiotics in all the hospitals in present study was higher than the acceptable range.ConclusionGenerally, it seems that there is need for improvement of the prescribing patterns in the hospitals, although this should be consolidated with further studies to link the patient diagnosis and the prescribed medications.

Drug Prescribing and Dispensing Practices in Tertiary Care Hospital of Eastern Ethiopia: Evaluation with World Health Organization Core Prescribing and Patient Care Indicators

“…This value is slightly lower than the ideal WHO standard (100%) [10]. In various outpatient settings around the globe, higher and closer to the standard values were reported such as 99.16% in GUTRH [19], 95.8% in four hospitals of southern Ethiopia [27], 98.7% in Hawassa University Teaching and Referral Hospital (HUTRH) [28], and 94.9% in Ayder referral hospital, Northern Ethiopia [29]. On the other hand, fewer values were documented in other health care settings including 83.1% in Pakistan [25] and 79.2% in southern Ethiopia.…”

Assessment of drug use patterns in terms of the WHO patient-care and facility indicators at four hospitals in Southern Ethiopia: a cross-sectional study

“…A survey conducted in 8 hospitals in southern Ethiopia that investigated their prescription patterns concluded that irrational prescribing, as evidenced by high mean number of drugs prescribed per encounter, high percentage of injections, and high percentage of antibiotic use, was prevalent in the studied region [9]. A more recent study in four hospitals in the same region revealed that there was excessive use of antibiotics and injectable medications in the hospitals [10]. Another study that evaluated the WHO patient care indicators in South West Ethiopia also reported that there was a lower than the set values of patient knowledge on their medications, availability of essential guidelines and key drugs in stock in the health facilities [11].…”

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“…Irrational drug prescribing usually leads to increased chances of treatment failure, antimicrobial resistance in case of antibiotics and social and economic burden on patient as well as on community as a whole. WHO and other standard guidelines always emphasize on the use of essential drugs with their generic names for the disease treatment 14,15 .…”