Prescribing trend of treating malaria patients by public and private healthcare facilities in Lahore

Abstract

Malaria is an infectious disease caused by parasites of the Plasmodium genus. It is one of the major causes of morbidity and mortality worldwide. The World Health Organization (WHO) has recommended artemisinin combination therapy (ACT) to manage malaria among children and adults. However, chloroquine as monotherapy and ACT are commonly prescribed in treating malaria in Pakistan's healthcare delivery system. Therefore, this study assessed the prescribing trends for treating malaria patients in public and private healthcare facilities. Moreover, the study also determined the number of drugs prescribed per prescription by physicians and consultants. This descriptive study was conducted for six months in Lahore's major public and private healthcare facilities. A purposive sampling technique was employed to review 300 malaria patients' prescriptions accessed from the hospital records. Descriptive statistics and the chi-square test were used to achieve the study's objectives. The study showed that most malaria prescriptions were from both public (64.67%) and private healthcare facilities (42.67%) and comprised a dual-drug regimen involving antimalarials, antibiotics, antipyretics, or their combinations. There was a significant difference (p = 0.002) in the prescription trend between public and private healthcare facilities regarding the number of drugs prescribed for treating malaria. Moreover, prescriptions from private healthcare facilities mainly contained antimalarial drugs (58.59%) and antibiotics (17.60%), while most prescriptions from public healthcare facilities contained antipyretics and other drugs (60.67%) (p = 0.001). Most of the consultants prescribed two (66.67%) or three drugs (33.33%), while the prescribing trends of physicians ranged between one and four, which was also statistically significantly different (p = 0.001). In addition, most prescriptions from public healthcare facilities were rationally prescribed (68%). On the other hand, most prescriptions from private healthcare facilities were rational (54%) and semirational (42%). The rationality of prescriptions by public and private healthcare facilities was also significantly different (p = 0.001). Public healthcare facilities were found to exhibit more rational prescribing trends for managing malaria compared to private healthcare facilities, with a focus on prescribing an optimal number of drugs per prescription and a lower usage of antimalarial and antibiotic medications.