Primary health care physicians’ prescribing patterns for children under five in Qassim, Saudi Arabia

Abstract

Background: Irrational prescription of drugs in children is reported to be widespread. There are scarce studies on the pediatric prescribing pattern especially at primary health care (PHC) level. Aim: To determine the physicians’ prescribing patterns for children under five years, to explore completeness of prescriptions’ recorded information, and to analyze the core indicators of drug prescribing at primary health care centers (PHCC) in Qassim. Methods: This cross-sectional study was conducted on 25 randomly selected PHCCs. All prescriptions, for the first week of first six months of the year 1437 Hijrah (October 2015 to April 2016), were reviewed. Among 25 012 prescriptions, 4125 (16.5%) were for children under five years. We randomly selected 1212 prescriptions for the study. World Health Organization (WHO) specified drug use indicators, and index of rational drug prescribing (IRDP) with a maximum value of 5, were calculated. The physicians and pharmacists of sampled PHCCs were also surveyed to explore prescribing issues. Findings: The completeness of recorded date, patient age, and gender was more than 90%. The diagnosis was legibly written in 842 (69.5%), while the patient weight was recorded in 307 (25.3%) prescriptions. The least commonly recorded instruction was the drug strength (26.8%), while the dose and frequency of use were stated for 91.3% and 90.8% of the drugs, respectively. The average number of drugs per prescription was 2.35 ± 0.89; 72.97% drugs were prescribed by generic name; in 65.98% patient encounters, antibiotics were prescribed. The overall IRDP was 3.56. Most of the physicians and pharmacists reported availability of the drug list and Saudi PHC formulary in their PHCCs. Conclusion: PHC physicians’ drug prescribing was not at the optimal level of rational use, especially regarding prescription of antibiotics. Creating awareness about rational drug use and hazards of overuse of antibiotics is needed.

Evaluation of Prescribing Indicators and Prescription Writing at the Outpatient Department of a Pediatric Teaching Hospital in Libya

“…However, a similar study conducted in India showed an even lower rate (38.9%) than our finding (Pandey et al, 2010). In contrast, studies from other countries have reported better adherence to drug prescribing from the EDL including Pakistan (93.4%) (Atif et al, 2016) and Saudi Arabia (100%) (Jahan et al, 2019). Prescribing drugs from the EDL issued by the WHO is one significant approach for rational prescribing as those drugs are older, have established clinical use, already been practically tested and cheaper than newer drugs (Akl et al, 2014).…”

“…Although a brief diagnosis of the patient's condition could be helpful for pharmacists to accurately dispense the correct drugs, it was included in less than one third of prescriptions in our study. This parameter, however, was better recoded in other countries as in the United Arab Emirates (64.42%) (Sharif et al, 2015) and in Saudi Arabia (89.4%) (Jahan et al, 2019). None of the prescriptions in our study had the patient's contact information.…”

“…The strength and treatment duration in this study, however, were the least recorded drug information, 46.28% and 56.67% of drugs, respectively. A study performed in a number of primary health care centers in Saudi Arabia showed that the drug's strength was written for only 26.8% of prescribed drugs and treatment duration for 51.4% (Jahan et al, 2019).…”

“…Writing all prescription components can significantly reduce irrational medicines use, which in turn decreases medication errors and adverse drug reactions (Rasool et al, 2010). However, various factors could explain the tendency of prescribers to write incomplete prescriptions such as the high patient burden that leads to hurried prescription writing as well as lack of doctors' awareness about the importance of the completeness of the recorded information (Jahan et al, 2019).…”

Evaluation of Rational Use of Medicine Using WHO/INRUD Core Drug Use Indicators at Teda and Azezo Health Centers, Gondar Town, Northwest Ethiopia

“…35,68 Similarly, a consultation time lower than the optimal value was recorded in many previous studies done in developing countries including Ethiopia (ranging from 1.2 to 7.3 minutes). 19,25,32,37,42,43,45,47,54,56 However, optimum consultation time was recorded by studies done at Debre Markos Referral Hospital, Northern Ethiopia (10.46 minutes); 66 in Rural Rwanda (10.1 minutes), and western Nepal (30.33 min). 33 The workload of the prescribers, the number of patients visiting the institutions, and the number of staff may affect the consultation time, so that the institutions should work on improving the consultation time.…”