Assessment of drug use pattern using WHO prescribing indicators at Hawassa University teaching and referral hospital, south Ethiopia: a cross-sectional study

Abstract

BackgroundTo promote rational drug use in developing countries, it is important to assess drug use pattern using the World Health Organization (WHO) drug use indicators. The aim of this study was to assess the drug prescription patterns at the Medical Outpatient Pharmacy of Hawassa University Teaching and Referral Hospital, using some of the WHO core drug use indicators.MethodsA descriptive, quantitative, and cross-sectional survey was conducted to determine the current prescribing practices at Hawassa University Teaching and Referral Hospital. The sample was selected using systematic random sampling. 1290 patient encounters were reviewed retrospectively for a 2-year period from September 2007 to September 2009. Data were collected from prescriptions and Prescription registration books retained in the pharmacy.ResultThe average number of drugs prescribed per encounter or mean was 1.9 (SD 0.91) with a range between 1 and 4. The percentage of encounters in which an antibiotic or injection was prescribed was 58.1% (n = 749) and 38.1% (n = 491), respectively. The Percentage of drugs prescribed by generic name and from an essential drug list was 98.7% (n=2419) and 96.6% (n=2367), respectively. The most commonly prescribed forms of antibiotics were amoxicillin (16.4%), ampicillin (15%), gentamicin (14.9%) and chloramphenicol (11.6%). On the other hand, the most commonly prescribed injections were ampicillin (21.4%), cloxacillin (13.4%), crystalline penicillin (12.4%), ceftriaxon (9.8%) gentamicin (9.8%), diclofenac (9.4%), chloramphenicol 41 (8.4%) and furosemide 25 (5.1%).ConclusionOn the basis of the finding of this study, the prescribing practices for antibiotic and injection shows deviation from the standard recommended by WHO. These two commonly overused and costly forms of drug therapy need to be regulated closely. Drug use evaluation should be done for some of the antibiotics to check whether they were appropriately prescribed or not. On the other hand, polypharmacy, generic prescribing and prescribing from EDL were not found to be a problem in this study. Teaching hospitals have a special responsibility to society to promote rational prescribing by their staff and, through them, the future generations of doctors.

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.…”

“…This value has completely adhered to the WHO adopted standard (100%) [10]. However, values that are lower than this finding were documented in various settings such as 94.7% in United States [17], 53% in India [22], 81.5% in Pakistan [25], 96.6% in southern Ethiopia [28] and 95.2% in northern Ethiopia healthcare setting [29]. Prescribing from the EDL has a plenty of advantages.…”

“…This finding is more than twice the upper limit of the standard (injection safety index=0.42). Better injection prescribing practices were reported from several studies (5.7%, 28.50%, 17.18%, 28.3% and 38.1%) in India [22], GUTRH, northwest Ethiopia [19], tertiary care hospital of Bangladesh [26], four selected hospitals of west Ethiopia [23] and HUTRH, southern Ethiopia [28], respectively. On the contrary, higher prevalence of injections was also reported in outpatient setting of Bahawal Victoria Hospital of Pakistan (98.0%) [25].…”

“…Similarly, finding from Ayder referral hospital, Tigray region, northern Ethiopia showed that he most commonly prescribed antibiotics were ceftriaxone (19.6%), gentamicin (15.8%) and ampicillin (14.7%) [29]. Apart from this, the most commonly prescribed antibiotics were amoxicillin (16.4%), ampicillin (15%), gentamicin (14.9%) and chloramphenicol (11.6%) in HUTRH, southern Ethiopia [28]. Inappropriate utilization of antibiotics has come with a significant concern for our globe.…”

“…However, several reports indicated that the prevalence of prescriptions containing antibiotics is even more than this finding. These percentages include 63% in Sudan [32], 56% in Uganda [33], 52.4% in Pakistan [25], 78% in Bangladesh [26], 54.7% in four selected hospitals of west Ethiopia [23] and 58.1% in HUTRH [28].…”