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

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.

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Prescribing patterns and perceptions of health care professionals about rational drug use in a specialist hospital clinic.

Journal of Public Health in Africa ◽

10.4081/jphia.2014.242 ◽

2014 ◽

Vol 5 (2) ◽

Cited By ~ 2

Author(s):

Moses A. Ojo ◽

Cecilia I. Igwilo ◽

Thomas Emedoh

Keyword(s):

Health Care ◽

Drug Use ◽

Health Care Professionals ◽

Prescribing Patterns ◽

Cross Sectional ◽

Rational Drug Use ◽

Prescription Practices ◽

Rational Drug ◽

Generic Prescribing ◽

Psychiatric Facilities

Irrational drug use is associated with adverse consequences including drug resistance and avoidable adverse drug reactions. Studies of rational drug use in psychiatric facilities are scanty. This study evaluated prescription practices and perception of health care professionals regarding causes of irrational drug use. A retrospective study conducted at the outpatient clinic of Federal Neuro- psychiatric Hospital, Yaba, Lagos. Data on drug use indicators were analyzed. A cross-sectional assessment of perception of prescribers and dispensers regarding rational drug use was conducted. A total of 600 prescriptions were analyzed. Mean number of drugs per encounter was 3.5 and percentage generic prescribed was 58.5%. Poly-pharmacy (P=0.024, 95% CI=1.082-1.315) and non-generic prescribing (P=0.032, 95% CI=1.495-1.821) were significantly associated with young prescribers. Factors associated with irrational drug use include demand from patients, patients’ beliefs about injection drugs and influence of pharmaceutical sale representatives. Certain aspect of prescribers indicators are still poor in the hospital studied. Health care professionals identified possible associated factors for irrational drug use. Concerted efforts are required to ensure rational drug use especially in psychiatric facilities in Nigeria.

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Medication Review for Hospitalized Pediatric Patient: Clinical Pharmacist Interventions

Çocuk Enfeksiyon Dergisi/Journal of Pediatric Infection ◽

10.5578/ced.202067 ◽

2020 ◽

Vol 54 (4) ◽

pp. 218-224

Author(s):

Merve Nur Işık ◽

Nazan Dalgıç ◽

Betül Okuyan ◽

Zeynep Yıldız Yıldırmak ◽

Mesut Sancar

Keyword(s):

Drug Use ◽

Clinical Pharmacist ◽

Medication Review ◽

Pediatric Patients ◽

Potential Drug ◽

Drug Related Problems ◽

Cross Sectional ◽

Rational Drug Use ◽

Rational Drug

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.

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Rational and Irrational Drug Use: Factors, Impacts and Strategies to Combat Irrational Drug Use: A Narrative Review

10.47890/ijpscp/zahrahassanalqamariat/2021/24148307 ◽

2021 ◽

Vol 2 (1) ◽

pp. 6-17

Author(s):

Zahra Hassan AL Qamariat ◽

Keyword(s):

Drug Use ◽

Health System ◽

Essential Medicines ◽

World Health ◽

Local Health ◽

Rational Drug Use ◽

Inappropriate Use ◽

Rational Drug ◽

The World ◽

Health Organization

Misuse of drugs is a serious health problem all around the world. Rational drug use can be characterized as follows: patients receive drugs that meet their clinical needs, at doses that meet their requirements, promptly and at the lowest cost to themselves and their region. Drug abuse, polypharmacy, and misuse are the most prominent drug use problems today. Misuse of drugs can occur for a variety of reasons at different levels, including recommended mistakes and over-the- counter medications. Inappropriate use of income can lead to real negative benefits and financial results. There are many irrational drug mixtures available. Appropriate rational use of medicines will increase personal satisfaction and lead to better local health services. A list of essential medicines recommended by the World Health Organization (WHO) can assist the countries around the globe in rationalizing the distribution and purchasing of medicines, thus decreasing the costs to healthcare systems. Irrational drug use has been a subject of concern for years as it affects the health system and patients badly. Irrational use of drugs can result from several factors such as patient, prescriber, dispenser, health system, supply system, or regulations. Thus, diverse strategies have been used to promote rational drug use and also to tackle irrational use. Thereby the concept of rational and irrational drug use and factors that lead to either result should be identified and monitored.

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Drug utilization pattern and rational drug use at orthopedics and traumatology outpatient clinics: A cross-sectional study

Joint Diseases and Related Surgery ◽

10.52312/jdrs.2021.211 ◽

2021 ◽

Vol 32 (3) ◽

pp. 759-766

Author(s):

İhsan Özdamar ◽

Emine Nur Özdamar

Keyword(s):

Drug Use ◽

Drug Utilization ◽

Cross Sectional Study ◽

Outpatient Clinics ◽

Sectional Study ◽

Utilization Pattern ◽

Cross Sectional ◽

Rational Drug Use ◽

Rational Drug

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Evaluation of Rational Drug Use based on Indicators of Diseases and Facilities at Community Health Centers in Districts in Semarang

Borneo Journal of Pharmacy ◽

10.33084/bjop.v2i2.875 ◽

2019 ◽

Vol 2 (2) ◽

pp. 119-124

Author(s):

Nisa Febrinasari ◽

Abdur Rosyid ◽

Leny Angelina

Keyword(s):

Drug Use ◽

Community Health ◽

Community Health Centers ◽

Data Retrieval ◽

Essential Medicines ◽

Homogeneity Test ◽

Cross Sectional ◽

Rational Drug Use ◽

Rational Drug ◽

The Government

Rational drug use (RDU) is an indicator to evaluates a treatment given to patients, like proper medication, precise diagnosis, precise dosing. Community Health Center (CHC) has the risk of irrational drug use. In this study, researchers selected N and BL CHC, aiming to evaluate the prescribing indicators based on three diseases which are non-pneumonia acute respiratory infection (ARI), non-specific diarrhea and myalgia, and the facility indicators with DOEN (list of essential national medicines) availability and 20 mandatory drugs. This research was a descriptive-analytical study with cross-sectional methods where the data retrieval of the prescribing is taken from January to December 2018. The study used the normality test and homogeneity test before independent sample T-test, from the third outcome of the test, the N and BL CHC could be said to differ significantly of RDU. It can be concluded that rational drug use is reviewed from a prescribing indicator based on disease and facility indicator. The results of RDU are rational in N CHC, in contrast with BL CHC which is not rational with the results of the RDU in N CHC is 101.44% and BL CHC is 89.81%. The results of N CHC is better than BL CHC, which both CHCs have fulfilled the target of the government, for 68% in 2018. In both CHCs for the facility indicator, there are a DOEN and 20 essential medicines.

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Prescribing patterns in primary and secondary level government health facilities in a district of Assam: a cross sectional study

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20191822 ◽

2019 ◽

Vol 6 (5) ◽

pp. 2077

Author(s):

Dakshadhwari Upadhyay ◽

Rashmi Ahmed ◽

Rupali Baruah ◽

Manjit Boruah

Keyword(s):

Drug Use ◽

Secondary Level ◽

Cross Sectional Study ◽

Prescribing Patterns ◽

Essential Drug ◽

Cross Sectional ◽

Essential Drug List ◽

Drug List ◽

Rational Drug ◽

Level Government

Background: Indian markets are flooded with more than 100,000 formulations, compared to approximately 350 formulations listed in the World Health Organization (WHO) essential drug list. To promote rational drug use in developing countries, assessment of drug use patterns with the WHO drug use indicators is becoming increasingly necessary. This study was conducted to study the prescribing patterns using WHO prescribing indicators in government healthcare facilities in a district of Assam.Methods: This was a cross sectional study carried out from July to September 2017. Out of total 4 blocks in Tinsukia district one (Ketetong) was randomly selected. All the primary and secondary level government health facilities were included and visited one by one. All the prescriptions on that day of visit were digitally photographed at the pharmacy of the health institution after taking written informed consent from the patient. A total of 353 prescriptions were scrutinized and analyzed using appropriate statistical tests.Results: Out of total 353 prescriptions collected, 11 were illegible and excluded from the analysis. The average number of drugs per encounter was 3.8. In 62.3% of encounters antibiotics were prescribed and injections were prescribed in 30.1% encounters. 71.8% drugs were prescribed by generic name and 56.2% drugs were prescribed from the essential drug list (EDL).Conclusions: The average number of drugs, percentage of injections and antibiotics per encounter was higher than recommended whereas prescription by generic name and from EDL or formulary was lower than recommended. Training of healthcare workers on rational drug use is need of the hour.

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Medication Review for Hospitalized Pediatric Patient: Clinical Pharmacist Interventions

Çocuk Enfeksiyon Dergisi/Journal of Pediatric Infection ◽

10.5578/ced.69774 ◽

2020 ◽

Vol 54 (4) ◽

pp. 237-243

Author(s):

Merve Nur Işık ◽

Nazan Dalgıç ◽

Betül Okuyan ◽

Zeynep Yıldız Yıldırmak ◽

Mesut Sancar

Keyword(s):

Drug Use ◽

Clinical Pharmacist ◽

Medication Review ◽

Pediatric Patients ◽

Potential Drug ◽

Drug Related Problems ◽

Cross Sectional ◽

Rational Drug Use ◽

Rational Drug

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Study on assessment of awareness about concepts in undergraduate pharmacology curriculum among clinicians in a tertiary care teaching hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20170827 ◽

2017 ◽

Vol 6 (3) ◽

pp. 633

Author(s):

Rekha M. B. ◽

Hemamalini M. B. ◽

Basavaraj Bhandare

Keyword(s):

Drug Use ◽

Tertiary Care ◽

Successful Implementation ◽

Essential Drug ◽

Text Book ◽

Rational Drug Use ◽

Essential Drugs ◽

Essential Drug List ◽

Drug List ◽

Rational Drug

Background: Rational prescribing forms the corner stone of successful implementation of rational drug use. To boost the cause of rational use of Medicine, the P-drug concept was given in late nineties. The idea was to make Physicians familiar with few personal drugs chosen from National Essential drug list based on efficacy, safety, suitability and cost. The present study was conducted to assess the awareness of clinicians about basic pharmacological concepts.Methods: It is a cross sectional study with a study population of 100, conducted in RRMCH for a period of one month. It is a questionnaire based study involving clinicians and post graduates working in this hospital. Descriptive statistical analysis has been carried out in the present study.Results: In our study, 38% of physicians were aware of the term Essential drugs and 26% of doctors prescribed drugs from National Essential drug list. 56% of respondents were aware of term rational drug use but only 1/3 of them were aware of adverse effects, drug interactions of the drugs they prescribed. Majority of physicians (85%) used standard text book as the source of drug information.Conclusions: Lack of knowledge among physicians about new concepts like p-drug, rational drug use and essential drugs points towards need for having more CMEs on basic pharmacological concepts.

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Rational drug use habits of patients with chronic diseases: a cross‐sectional examination focusing on the use of technological devices

International Journal of Clinical Practice ◽

10.1111/ijcp.14222 ◽

2021 ◽

Author(s):

Mustafa Kahraman ◽

Mehmet Akif Karan ◽

Meliha Nalcaci

Keyword(s):

Drug Use ◽

Chronic Diseases ◽

Cross Sectional ◽

Rational Drug Use ◽

Rational Drug

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Antibacterial prescription and the associated factors among outpatients diagnosed with respiratory tract infections in Mbarara Municipality, Uganda

BMC Pulmonary Medicine ◽

10.1186/s12890-021-01739-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Timothy Eria Muwanguzi ◽

Tadele Mekuriya Yadesa ◽

Amon Ganafa Agaba

Keyword(s):

Drug Use ◽

Respiratory Tract ◽

Associated Factors ◽

Respiratory Tract Infections ◽

Essential Medicine ◽

Prescribing Pattern ◽

Rational Drug Use ◽

Essential Medicine List ◽

Rational Drug ◽

Tract Infections

Abstract Background Respiratory tract infections (RTI) are the second most frequent diagnosis after Malaria amongst Outpatients in Uganda. Majority are Non pneumonia cough and flu which are self-limiting and often do not require antibacterials. However, antibiotics are continuously prescribed for these conditions and are a major contributor to antimicrobial resistance and wastage of health resources. Little is known about this problem in Uganda hence the impetus for the study. Objectives To determine the antibacterial prescribing rate and associated factors among RTI outpatients in Mbarara municipality Methodology This was a retrospective cross-sectional study on records of RTI outpatients from 1st April 2019 to 31st March 2020 (prior to the novel corona virus disease pandemic) in four selected public health facilities within Mbarara municipality. A pretested data caption tool was used to capture prescribing patterns using WHO/INRUD prescribing indicators. We used logistic regression to determine factors associated to antibacterial prescribing. Results A total of 780 encounters were studied with adults (18-59 years) forming the largest proportion of age categories at (337, 43.15%) and more females (444, 56.85%) than men (337, 43.15%). The antibacterial prescribing rate was 77.6% (606) with Amoxicillin the most prescribed 80.4% (503). The prescribing pattern showed an average of 2.47 (sd 0.72) drugs per encounter and the percentage of encounters with injection at 1.5% (24). Drugs prescribed by generic (1557, 79%) and drugs prescribed from essential medicine list (1650, 84%) both not conforming to WHO/INRUD standard; an indicator of possible irrational prescribing. Female gender (adjusted odds ratio [aOR] = 1.51, 95% confidence interval [CI]: (1.06–2.16); 18–59 years age group (aOR = 1.66, 95% CI: 1.09–2.33) and Individuals prescribed at least three drugs were significantly more likely to have an antibacterial prescribed (aOR= 2.72, 95% CI: 1.86–3.98). Conclusion The study found a high antibacterial prescribing rate especially among patients with URTI, polypharmacy and non-conformity to both essential medicine list and generic name prescribing. This prescribing pattern does not comply with rational drug use policy and needs to be addressed through antimicrobial stewardship interventions, prescriber education on rational drug use and carrying out more research to determine the appropriateness of antibacterial prescribed.

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