Prescription auditing based on World Health Organization (WHO) prescribing indicators: A case of Dilla University referral hospital

Abstract

Introduction: Rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of time, at the lowest cost to them and their community. The issues of irrational use of medicines is global and that a global approach coordinated by WHO with more vigorous implementation of leadership and evidence based advocacy of rational use of medicine is essential
 Materials and Methods: Cross-sectional descriptive and quantitative study was conducted at Dilla University Referral Hospital to determine the current prescribing practices. 1440 prescription were selected using systematic random sampling and reviewed retrospectively for a 2-year period from from September 01/2016 to August 31/ 2018 using prescriptions and Prescription registry.
 Results: The average number of drugs prescribed per prescription was 1.813 ranging from 1 and 6. 1437(99.79%), 1287(89.38%), 1392 (96.67%), 1428 (99.17%) and 0(0%) of the analyzed prescriptions had name of the patient, date, medical record number, age and address of the patients respectively. Antibiotic and injection was prescribed in 842(58.47%) and 94(6.53%) of encounters respectively. The Percentage of drugs prescribed by generic name and from an essential drug list was 85.33% (n=2227) and 97.43% (n=2543), respectively. Of the total 2610 drugs, 2431(93.14%) drugs were actually dispensed.
 Conclusion: Polypharmacy, percentage of encounters with with injection and percentage of drugs from essential drug list was within acceptable range. The prescribing practice for antibiotics and generic medicines shows significant deviation from WHO.
 Keywords: Prescription auditing, WHO prescribing indicators, Dilla University Referral Hospital.

<p>Assessment of Drug Use Pattern Using WHO Core Prescribing Indicators at Outpatient Settings of Governmental Hospitals in Dessie Town</p>

“…This finding is comparable with findings reported from previous Ethiopian studies which reported a percentage from 0 to 1%. 12,13,15,17 One Ethiopian study, however reported a higher result, 7.3%. 16 Failure to write weight of patients may be due to inadequate availability of weighing balance to the prescribers in the study settings.…”

“…For example, percentage of prescription papers on which date was written were 93.5%; which was relatively higher than findings from previous similar studies conducted in Ethiopia and different parts of the world which reported a percentage of 16.1 to 89.4%. [12][13][14][15][16][17] Date should be written on all prescription papers for retrieval and legal purposes. In this study, on the other hand, name of patient was mentioned in 94.7% of the prescription papers which is comparable with findings from similar studies conducted in Jimma and Harar, Ethiopia which reported 93.3% and 93.9%, respectively.…”

“…Though this itself is poor practice, this finding is a much better practice compared to seven similar study findings from different parts of Ethiopia which reported a practice of <21%. [12][13][14][15][16][17][18] In this study, diagnosis was recorded in 61.3% of the prescription papers recruited from DRH and BMH. This may be due to lack of confidence and skill of prescribers in confirming the exact diagnosis of a disease.…”

“…This finding is higher compared to findings from similar studies conducted in Ethiopia and Sudan. [12][13][14][15][16][17][18][19]21 Pharmacy professionals will be unable to evaluate prescription orders if prescribers fail to write diagnosis on prescription papers, hence they should write diagnosis on every single prescription paper to promote optimal therapeutic patient outcomes.…”

“…1,14,15,17,26,27,29,32,33,36 On the contrary, the finding was lower than other similar study findings (48.9-75.1%). 12,13,[19][20][21][22][23][24][25]28,30,31,34,35,37,38 Antimicrobial resistance is at the edge of indiscriminate antibiotics prescribing practice which is a pressing global problem nowadays impacting infection control efforts and costs of antimicrobial treatment, among others. Prescribers should limit themselves from over prescribing these type of drugs.…”