Drug use pattern in out-patient children: A comparison between primary and secondary health care facilities in Northern Nigeria

Abstract

Children are more vulnerable to adverse events related to use of drugs. It is therefore important to study drug use in children in order to optimize pharmacotherapy. The aim of this study was to compare drug utilization in paediatric outpatient departments of primary and secondary health care facilities. The patient and drug information of 600 patients was analyzed for World Health Organization (WHO) recommended prescribing indicators. The average number of drugs per prescription was significantly (p < 0.0005) lower in secondary (2.97) compared to primary (3.62) facilities, while average consultation time was shorter (p < 0.0005) in primary than secondary facilities. Percentages of drugs prescribed from Nigerian Essential Drug List (EDL, primary {89.78%}; secondary {91.79%}) and by generic name (primary {55.04%}; secondary {57.88%}) were insignificantly different between the facilities. The use of injectables was low (8.32% in primary versus 3.74% in secondary facilities) while antibiotic use was high (54.14% in primary to 60.28% in secondary facilities). Analysis of the dispensing indicators showed that the secondary facilities were significantly (p < 0.05) better than the primary facilities, even though not a single drug was adequately labeled in both the primary and secondary facilities. Prescription from EDL was found to be fair in the study area while use of injections was low. There is a need for improvement in case of medicines prescribed by generic name.

Prescribing Indicators: A Review in the General Outpatient Clinic of a Nigerian Tertiary Hospital

“…The antibiotics encounter of 38.5 % obtained varies greatly from the WHO reference value of 20.0-26.8 % but lower than values of 45-67.7 % from private and 55-75 % obtained from public facilities in Nigeria 21,18,8 . There is abounding evidence that overuse of antibiotics potentially leads to antibiotic resistance 10,22 .…”

“…The fear of fake products cannot be ruled out as part of influence especially in developing countries where the challenge of fake drugs is enormous. Generic prescribing has been shown to put less financial burden in terms of cost of drugs both to the patients and the health establishments as well as reduce the incidence of therapeutic duplication errors 10,18,19 .…”

Assessing medication packaging and labelling appropriateness in Sri Lanka

“…It is difficult to compare our results with other studies due to differences in definitions. In some studies, patients stating they knew the dose was considered a positive response [7], while in others, patients had to be able to repeat at least the dose and frequency of medication administration [6]. We did not have the level of detail to compare awareness of dosing for prescription medicines versus other medicine types in the household or levels of knowledge of dosage regimens for new medicines compared to medicines taken previously.…”

Assessment of Utilization of Standing Order in the Management of Patients by Community Health Extension Workers in Ekiti State, Nigeria

“…Consequences of Polypharmacy which is the prescription of many drugs in one prescription for the patient include increased drug expenditure in the hospital, shortage of drugs and other health consequences for the patients [19]. Other consequences are drug resistance and its negative effects on the mortality and morbidity ratio of a country and unnecessary increase in the cost of health care services [20,21].…”