<p>Rational Drug-Use Evaluation Based on World Health Organization Core Drug-Use Indicators in a Tertiary Referral Hospital, Northeast Ethiopia: A Cross-Sectional Study</p>

Abstract

Background: Irrational use of drugs is often observed in health-care systems throughout the world, particularly in developing countries. The World Health Organization estimates that more than half of all medicines are prescribed, dispensed, or sold inappropriately and that half of all patients fail to take them correctly. Therefore, the study was aimed at investigating the practice of rational drug use in a referral and teaching hospital in Northeast Ethiopia. Methods: A hospital-based cross-sectional design was employed to conduct the study from February 2019 to May 2019. Systematic random sampling was used to select prescriptions dispensed in outpatient pharmacies. Convenient sampling was employed to select patient attendants and their prescriptions in outpatient departments during the study period. Data were collected using a structured and technical observational checklist for prescribing, patient care, and health-facility indicators. Face-to-face interviews were also employed to assess patient knowledge of correct dosage among patient-care indicators. Data were analyzed using SPSS version 20. Descriptive statistics are given using frequency, proportions, and summary measures. Results: An average of 2.5 drugs per encounter were prescribed, with 34.64% and 13.80% of prescriptions being antibiotics and injections, respectively. Generics were used in 90.53% of prescription, and nearly 83% of drugs were prescribed from an essential-drug list. Average consultation and dispensing times were 1.57 minutes and 47 seconds, respectively. A total of 362 drugs were prescribed, with 82.6% actually dispensed and only 22.7% adequately labeled. The hospital had its own drug formulary and essential drug list, but no standard treatment guidelines. Moreover, except propyl thiouracil, all key essential drugs included in the study were available. Conclusion:The majority of World Health Organization-stated core drug-use indicators were not met by the referral hospital in this study, which is especially problematic regarding patient-care indicators.

Drug use pattern using WHO core drug use indicators in public health centers of Dessie, North-East Ethiopia

“…Moreover, the value was also higher than the findings from South Ethiopia (1.9) [ 12 ], North Ethiopia (1.96) [ 17 ], East Ethiopia (1.9) [ 28 ], and West Shoa zone (1.74) [ 29 ]. However, this was in line with the value reported from Nekemte helth center (2.1) [ 16 ] and less than that of a study conducted in North East Ethiopia (2.5) [ 30 ], North West Ethiopia (2.4) [ 13 , 15 ], and public hospital of Eastern Ethiopia (2.34) [ 31 ]. Lower findings were also reported from Sierra Leone (4.37) [ 32 ], Kenya (2.9) [ 11 ], Pakistan (3.4) [ 33 ], Zambia (2.4) [ 10 ], and Egypt (2.5) [ 34 ].…”

“…The percentage of encounters with antibiotics was 44% which was higher than the WHO standard value of 20.0—26.8% [ 5 , 26 ]. It was higher than the antibiotics utilization in East Ethiopia (37.5%) [ 28 ] and North East Ethiopia (34.64%) [ 30 ]. But, it was lower than reports from Nekemte health center (69.1%) [ 16 ], South Ethiopia (58.1%) [ 12 ], North Ethiopia (58.6%) [ 20 ], West Shoa zone (48.9%) [ 29 ] and North West Ethiopia (71.36%) [ 13 ].…”

Evaluation of drug prescription pattern using World Health Organization prescribing indicators in public health facilities found in Ethiopia: systematic reviews and meta-analysis

“…This finding was also relatively lower than the review performed at primary health care centers in the WHO Africa region, which reported a 25% injection use rate [ 6 ]. In comparison, this result was relatively less than the findings of the review in Ethiopia with an injection average of 18.3% [ 12 ]. This difference may be associated with the fact that this review included articles conducted after 2015, while the other review included all studies conducted since the beginning of the 1990s, and during this period injection dosage form was relatively the most widely used in Ethiopia [ 21 ].…”

“…The data were exported to OpenMeta Analyst software and the heterogeneity across the articles was assessed by determining the I 2 statistics using Der Simonian and Laird’s random-effects model at a 95% confidence level. The prescribing indicators used in this review to measure drug use patterns in health care facilities include; Average number of medicines per encounter; Percentage of antibiotic prescriptions; Percentage of injection prescriptions; Percentage of generic drugs prescribed; and Percentage of prescribed drugs from the essential drug list [ 12 ].…”

Drug prescribing patterns in pediatric urinary tract infections: A retrospective drug utilization analysis in an urban tertiary care hospital

“…[ 12 ] Drug utilization is defined as “the marketing, distribution, prescription and use of drugs on society with special emphasis on the resulting medical and social consequences.” [ 13 ] Drug utilization studies empower rational therapeutics in identification of errors in implementing therapy and find appropriate remedies and solutions to rectify them. Rational drug prescribing is defined as “the use of the least number of drugs to obtain the best possible effect in the shortest period and at a reasonable cost.”[ 14 15 16 ] Prescription monitoring and drug utilization studies focus on determining the causes and associated problems and also offer actionable feedback to the prescriber so as to increase their perceptions and familiarize them about the irrationality in their use of drugs. [ 17 18 19 ] These studies ascertain and evaluate the efficacy, safety, convenience, and economic aspects of the use of drugs all levels in the chain of use of drugs.…”