Evaluating drug prescription patterns in children according to World Health Organisation's indicators, Kigali, Rwanda: A cross-sectional study

Abstract

Background Irrational drug use is a worldwide problem at all levels of health care, especially in hospitals. Prescribers in community tend to omit hospital prescribing practices, thus this problem is present at all levels of health care. Use of medicines can be greatly improved and wastage reduced if simple principles of drug management are followed. To help in solving this problem, World Health Organization (WHO) has designed prescribing core indicators that were used to evaluate drug prescription patterns in Rwanda Social Security Board (RSSB) affiliated patients.Material and Methods A retrospective cross-sectional study with quantitative analysis was carried out for a period of six months. Among the 1000 prescriptions collected, 18 of them were rejected for not fulfilling the inclusion criteria, the remaining 982 prescriptions were almost distributed equally from either private and public hospital or clinics. The study analyzed prescriptions from health facilities located in Kigali City, Rwanda. The results were presented in table with comparisons with the WHO prescription indicators.Results The average number of drugs per prescription is 2.4 which is higher than 1.8 recommended by WHO. The percentages of drugs prescribed with a generic name and those from National Essential drug List are 28.5% and 61.1% respectively, which are very low compared to WHO target of 100% for both core prescribing indicators. The percentage of encounters with an antibiotic prescribed is 42.5% and the encounters who received an injections account 1.2%.Conclusion This study revealed that there is a big gap in implementing WHO core indicators of prescription and concerned stakeholders should take measures to address this issue.

Evaluating drug use patterns among paediatric outpatients in Burundi

“…The percentage of encounters in which a patient was prescribed at least one injection in the present study was 9.9%, which is closer the value found in 2014 Burundi outpatient encounter study all ages considered (Holloway & Henry, 2014 ), was lower than the value recommended by WHO (13.4–24.1). Results were similar to those from studies conducted in India (1.98%; 0.64%), Northwest Ethiopia (9.5%), Nepal (0.6%, 4.2%), UAE (9.5%; 0.5%), Pakistan (0%), Sri Lanka (1.2%), Ghana (7%), and in Rwanda (1.2%) (Abu Farha et al, 2022 ; Amponsah et al, 2022 ; Aryal et al, 2020 ; Atal et al, 2021 ; Atif et al, 2016b ; Galappatthy et al, 2021b ; Habimana et al, 2020 ; Mandal et al, 2022 ; Rabbani et al, 2023 ; Sema et al, 2021 ; Shrestha et al, 2021 ). In contrast, the results that exceeded the WHO optimal values were revealed from Iran (24.4%), the 1995–2015 African region systematic review (25%), and Kenya (24.9%) (Ahmadi & Zarei, 2017 ; Nyabuti et al, 2020 ; Ofori-Asenso et al, 2016 ).…”

“…The higher cost value of injectables compared to other forms of medication may also contribute to their limited utilisation. Additionally, injectables are most commonly used for inpatients (Habimana et al, 2020 ).…”

“…The studies carried out in East African Countries revealed non-implementation of the core drug use indicators as recommended by WHO. In Rwanda, a study carried out in child prescribing indicators in 2017 revealed a big gap in implementing WHO indicators (Habimana et al, 2020 ). According to a drug prescribing evaluation conducted in four Tanzanian regions in 2014 revealed injectable and antibiotic irrational prescribing (Irunde et al, 2017 ).…”