Comparison of antibiotics included in national essential medicines lists of 138 countries using the WHO Access, Watch, Reserve (AWaRe) classification: a cross-sectional study

Author(s):  
Itunuoluwa Adekoya ◽  
Darshanand Maraj ◽  
Liane Steiner ◽  
Hannah Yaphe ◽  
Lorenzo Moja ◽  
...  
Author(s):  
Nebyu Daniel Amaha ◽  
Dawit G. Weldemariam ◽  
Nuru Abdu ◽  
Eyasu H. Tesfamariam

Abstract Background Antibiotics require more prudent prescribing, dispensing and administration than other medicines because these medicines are at a greater risk of antimicrobial resistance (AMR). Studying the current medicine use practices and factors affecting the prescribing of an antibiotic would help decision makers to draft policies that would enable a more rational use of medicines. Methods A prospective, descriptive, and cross-sectional study was conducted to assess the current prescribing practices including antibiotics use in six community pharmacies in Asmara. A total of 600 encounters were reviewed using the WHO core prescribing indicators between May 5 and May 12, 2019 using stratified random sampling technique. Descriptive statistics and logistic regression were employed using IBM SPSS® (version 22). Results The average number of medicines per prescription was 1.76 and 83.14% of the medicines were prescribed using generic names while 98.39% of the medicines were from the National Essential Medicines List (NEML). The percentage of prescriptions containing antibiotics was 53%. The number of encounters containing injections was 7.8%. Patient age, gender and number of medicines prescribed were significantly associated with antibiotic prescribing at bivariate and multivariable models. Subjects under the age of 15 were approximately three times more likely to be prescribed antibiotic compared to subjects whose age is 65 and above (Adjusted Odds Ratio (AOR): 2.93, 95%CI: 1.71–5). Similarly, males were more likely to be prescribed antibiotic than females (AOR: 1.57, 95%CI: 1.10–2.24). Subjects to whom three to four medicines prescribed were two times more likely to be prescribed an antibiotic compared to those who were to be prescribed one to two medicines per encounter (AOR: 2.17, 95%CI: 1.35–3.5). A one-unit increase in the number of medicines increased the odds of antibiotic prescribing increased by 2.02 units (COR: 2.02; 95%CI: 1.62–2.52). Conclusions This study found that the percentage of antibiotics being prescribed at the community pharmacies in Asmara was 53% which deviated significantly from the WHO recommended values (20–26.8%). Furthermore, the percentage of encounters with an injection was 7.8% lower than the WHO value of 13.4–24.0%. Patients’ age, gender and number of medicines were significantly associated with antibiotic prescribing.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e045262
Author(s):  
Michael Sergio Taglione ◽  
Nav Persaud

ObjectiveEssential medicines lists have been created and used globally in countries that range from low-income to high-income status. The aim of this paper is to compare the essential medicines list of high-income countries with each other, the WHO’s Model List of Essential Medicines and the lists of countries of other income statuses.DesignHigh-income countries were defined by World Bank classification. High-income essential medicines lists were assessed for medicine inclusion and were compared with the subset of high-income countries, the WHO’s Model List and 137 national essential medicines lists. Medicine lists were obtained from the Global Essential Medicines database. Countries were subdivided by income status, and the groups’ most common medicines were compared. Select medicines and medicine classes were assessed for inclusion among high-income country lists.ResultsThe 21 high-income countries identified were most like each other when compared with other lists. They were more like upper middle-income countries and least like low-income countries. There was significant variability in the number of medicines on each list. Less than half (48%) of high-income countries included a newer diabetes medicines in their list. Most countries (71%) included naloxone while every country including at least one opioid medicine. More than half of the lists (52%) included a medicine that has been globally withdrawn or banned.ConclusionEssential medicines lists of high-income countries are similar to each other, but significant variations in essential medicine list composition and specifically the number of medications included were noted. Effective medicines were left off several countries’ lists, and globally recalled medicines were included on over half the lists. Comparing the essential medicines lists of countries within the same income status category can provide a useful subset of lists for policymakers and essential medicine list creators to use when creating or maintaining their lists.


Author(s):  
Vedavathi Hanumaiah ◽  
Shreenivas Revankar ◽  
Abhishek C. P.

Background: Rational use of medicines requires that the patients receive medication appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period of lime, and at the lowest cost to them and to their community. Objective of the study were like descriptive cross- sectional study was conducted to determine and identify the level of knowledge, attitude and practice regarding rational use of medicines among the interns.Methods: A validated structured questionnaire containing 19 questions regarding rational use of medicines in knowledge, attitude and practice (KAP) format was distributed in hand among 109 interns affiliated to this institution. Descriptive statistics were used to illustrate the results in the form of number and percentage.Results: Out of 109 interns, 102 completed the questionnaire and were included in the final analysis. Majority of interns who participated in study were aware of the concept of rational use of medicine but the knowledge related to EML (essential medicines list), P drugs, schedule H drugs and number of FDCs (fixed dose combination) in EML was limited.Conclusions:  As interns are future prescribers, they need to be aware of all the aspects of rational use of medicine and there is need to emphasise on learning module and training programs to ensure the interns have knowledge of rational use of medicines.


Author(s):  
Alem Endeshaw Woldeyohanins ◽  
Bezawit Meseret ◽  
Muhabawu Teka ◽  
Teshale Teshome

<p class="abstract"><strong>Background:</strong> Assessment of availability of essential medicines is a critical component of universal health coverage and important factor to address patients’ satisfaction and increase their health seeking behavior. Proper inventory management of essential drugs in the health facilities is critical in ensuring availability of essential drugs. The objectives of the study were to assess availability of essential medicines and inventory control practice in university of Gondar comprehensive specialized hospital.</p><p class="abstract"><strong>Methods:</strong> The study was conducted using institution based cross sectional study design from March 10 to April 10, 2019. The data was collected by data abstraction formats and structured observation checklist and data was analyzed by Microsoft office excel for the assessment of the essential medicine’s availability and inventory control practices in Gondar university comprehensive specialized hospital.  </p><p class="abstract"><strong>Results:</strong> The overall average availability of essential medicines during survey period in Gondar university hospital was 79.17%. The average stock out in the last six months period was 41.67%. The mean duration of stock out of essential medicines of the hospital in the last six months period was 31.7 days and average frequency of stock out was 0.7. The discrepancy between physical count and stock record count of essential medicines ranged from 0% to about 95%.</p><p class="abstract"><strong>Conclusions:</strong> The average availability of essential medicines during data collection period was fairly high. However, the facility was stock out for significant percent of essential medicines over the last six months period and stock out to lesser extent of percent at the time of survey period.</p>


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guanghui Jin ◽  
Chao Chen ◽  
Yanli Liu ◽  
Yali Zhao ◽  
Lifen Chen ◽  
...  

Abstract Background General practice clinics are the main primary care institutions providing ambulatory care in the rural areas of Beijing, rational use of medicines is crucial for the rural primary care system. This study investigated the prescribing patterns of general practice clinics in rural Beijing to provide a baseline for monitoring and promoting the rational use of medicines. Methods We performed a cross-sectional study at 14 rural community health service centers in 6 non-central districts of Beijing sampled through a multistage approach, 85 general practitioners were selected from the 14 centers. Total 8500 prescriptions were derived by recording 100 consecutive patients of each the general practitioner. The World Health Organization drug use indicators and an additional indicator were adopted to assess the prescribing patterns. Results The median number of medicines per encounter was 2.0 (1.0, 2.0); the percentage of generics and essential medicines prescribed were 97.0 and 58.2%, respectively; the percentage of encounters with antibiotics prescribed was 15.1%; the percentage of encounters with injections prescribed was 3.7%; the percentage of encounters with traditional Chinese patent medicines prescribed was 52.5%; the median duration of consultation time was 6.0 (4.0, 10.0) minutes. The most frequently prescribed medicine was aspirin (low dose, 4.6%). The prescribing indicators were influenced by different patient characteristics, patients with new cooperative rural medical scheme were less likely to be prescribed with ≥3 medicines (OR 0.865), essential medicines (OR 0.812) and traditional Chinese patent medicines (OR 0.631), but were more likely to be prescribed with injections (OR 1.551) in the encounter. Patients with ≥3 problems were more likely to be prescribed with ≥3 medicines (OR 6.753), antibiotics (OR 2.875) and traditional Chinese patent medicines (OR 2.926) in the encounter. Conclusions Most indicators in this study showed similar or fair performance in comparison with World Health Organization and domestic reports, except the percentage of medicines prescribed from the essential medicine list. Regular monitoring on the prescription quality of general practice clinics in rural Beijing should be maintained.


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