Practice towards Rational Drug Use at Finotselam and Asirade Zewudie Hospitals Based on WHO Core Drug Use Indicators, Northwest Ethiopia

Abstract

Background. The rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community with full information and with the lowest possible cost. If one of these is not met, it is referred to as irrational drug use. Many drugs have been sold or prescribed inappropriately in the world, and a significant part of the world population lacks access to essential medicine. The aim of this study was to assess practice towards rational drug use at Finoteselam and Asirade Zewudie hospitals. Methods. A cross-sectional study design was used for this study, and the study was conducted from October 11 to November 30, 2019. A total of 770 prescriptions were selected as per WHO criteria by using systematic random sampling and reviewed with the help of an observational checklist. The data were entered and processed with SPSS version 25 and evaluated using the WHO criteria. Result. The average number of drugs per prescription was 1.8 and 2.05, antibiotics encountered were 77.7% and 72.5%, injections encountered were 5.97% and 7.01%, percentage of drugs prescribed by generic names was 97% and 93.4%, counseling time was 1.6 minutes and 2.25 minutes, and dispensing time was 51.3 seconds and 62.72 seconds at Finoteselam and Asirade Zewudie hospitals, respectively. Conclusion. The majority of WHO core drug use indicators were not met in the two hospitals. The average number of drugs encountered in Asirade Zewudie hospital was slightly higher than the WHO recommended range, whereas the average number of drugs encountered in Finoteselam hospital was exactly equal. The percentage of antibiotics encountered was very high compared with WHO recommendation, but the percentage of injections encountered was below the WHO recommended range and time spent on counseling and dispensing was too short when compared with WHO recommendation. In addition to this, both hospitals had no essential drug list or formulary as well as a key drug list.

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

“…The percentage of injection use was found to be 9.5 (95% CI = 7.8, 11.1) which is comparable to the ideal value (10.1%-17.0%). 14,65 In the same way, within the WHO/INRUD optimum value or even lower results were reported by different studies done in Ethiopia (ranging from 3.6% to 23.6%), [22][23][24][25][26][27][28][29][30][31]36 and many other developing countries (ranging from 0% to 19.25%). [37][38][39][40][41][42]44,46,[48][49][50][51]53…”

“…Similarly, higher results were recorded in studies from different parts of Ethiopia (ranging from 1.9 to 3), 22,[24][25][26][27][28][29][30][31] and other developing countries (ranging from 2.30 to 3.98). 32,34,35,37,40,43,44,46,48,49,54 On the contrary, the average number of medicines per prescription within the acceptable range was reported by other studies from Ethiopia (ranging from 1.65 to 1.8).…”

“…5,14,65 This agrees with the study done at Debre Markos Referral Hospital, Northern Ethiopia (71.36%). 66 Similarly, higher values were reported by several previous studies in Ethiopia (ranging from 27.62% to 82.5%) [22][23][24][25][26][27][28][29][30][31]36 and other developing countries (ranging from 35.3% to 84.8%). 32,35,[37][38][39][40][41][47][48][49]51,54 Although the high use of antibiotics may be due to the prevalent nature of the infectious disease in developing countries, it should be given attention since it may increase the risk of antibiotic resistance.…”

“…The percentage of medicines prescribed by generic name at both HCs was 94%; it is lower than the ideal expectation which requires 100% of medicine prescription to be generic. 14,65 Similarly, prescription of medicine by generic name is below the optimal value in most of the previous studies in different parts of Ethiopia (ranging from 79.2%to 99.25%), [22][23][24][25][26][27][28][29][30][31]36 and many other developing countries (ranging from 0% to 95.4%). 32,34,37,43,44,[46][47][48][49]52,53,55 However, results per the WHO/INRUD expectation were obtained in the study done at West Shewa Zone, Oromia, Ethiopia (100%) 17 and at 4 different emirates, UAE (100%).…”

“…14,65 Consistent results with this study were reported in the studies done at West Shewa Zone, Oromia, Ethiopia (100%); 17 Ayder referral hospital, northern Ethiopia (100%), 31 and at 4 different emirates in the United Arab Emirates (UAE) (100%). 50 However, the WHO/INRUD recommendation was not achieved in the most of previous studies in different parts of Ethiopia (ranging from 79.8% to 99.5%), [22][23][24][25][26][27][28][29][30][31]36 and many previous study reports outside of Ethiopia (ranging from 22.57% to 98.80%). 32,34,37,43,44,46,47,49,52,54,55 The prescription of medicine from the essential drug list in the facilities should be preserved since it is one of the major tools for implementing RUM.…”