The Pattern of Medicine Use in Ethiopia Using the WHO Core Drug Use Indicators

Introduction. Rational medicine use is an appropriate prescribing, dispensing, and patient use of medicines for the diagnosis, prevention, and treatment of diseases. It is affected by several factors. Irrational use of medicine is a widespread problem at all levels of care. This review is aimed at assessing the medicine use pattern in health facilities of Ethiopia using the medicine use pattern developed by WHO/INRUD. Methods. Relevant literature was searched from Google Scholar, PubMed, Hinari, Web of Science, and Scopus using inclusion and exclusion criteria. A systematic review was used to summarize the medicine use pattern in health facilities of Ethiopia, and that WHO core drug use indicators were employed. Result. From 188 searched studies, 30 literatures were reviewed. The average number of drugs per encounter was 2.11. The percentage of encounters with antibiotics and injection was 57.16% and 22.39%, respectively. The percentage of drugs prescribed by generic name and from an essential drug list was 91.56% and 90.19%, respectively. On average, patients spent 5.14 minutes for consultation and 106.52 seconds for dispensing. From prescribed drugs, 67.79% were dispensed, while only 32.25% were labeled adequately. The availability of key essential medicines was 64.87%. The index of rational drug use value was 7.26. Moreover, the index of rational drug prescribing, index of rational patient-care drug use, and index of rational facility-specific drug use were 3.74, 2.51, and 1.01, respectively. Conclusion. Ethiopian health facilities were faced with antibiotic overprescribing, short consultation, and dispensing times, poor labeling of medicines, poor availability of key drugs, and nonadherence to the essential drug list. Routine, multidisciplinary awareness creation, and regulation should be implemented to promote rational medicine use at a national level.

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

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-021-01530-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Teklehaimanot Fentie Wendie ◽

Abdulmejid Ahmed ◽

Solomon Ahmed Mohammed

Keyword(s):

Public Health ◽

Drug Use ◽

Health Centers ◽

Essential Medicines ◽

World Health ◽

Essential Drug ◽

Rational Use ◽

North East ◽

Essential Drug List ◽

Drug List

Abstract Background Rational drug use requires that patients receive and take medication appropriately. Though the process of diagnosis and pharmaceutical care is complex, World Health Organization (WHO)/international network for rational use of drugs (INRUD) core drug use indicators investigate drug use to minimize the hazardous effect of the drug and enhance the wise use of scares resources. This study assessed drug use patterns in health centers of Dessie town using WHO/INRUD indicators. Methods A cross-sectional study was conducted in public health centers of Dessie town. Data were retrospectively collected from 1500 prescriptions dispensed from January 1, 2018, to December 31, 2018 using WHO data collection tool to assess prescribing indicators. For patient care and health facility indicators, 600 patients and 3 health centers were prospectively reviewed. Systematic random sampling was used to select samples. Data were analyzed using the Statistical Package for the Social Sciences version 20. Results The average number of drugs per encounter was 2.1. The percentage of encounters with antibiotics and injection was 44% and 13.9%, respectively. The percentage of drugs prescribed by generic name and from an essential drug list was 98% and 100%, respectively. On average, patients spent 4.7 min for consultation and 105 s for dispensing. From 1305 prescribed drugs, 92% were dispensed, while only 4% were labeled adequately. More than half (54.8%) of patients had adequate knowledge of their medication. None of the health centers had an essential drug list. The availability of key essential medicines was 64.10%. Conclusion This study demonstrated irrational drug use practices in all healthcare facilities. Polypharmacy, antibiotics over-prescribing, short consultation and dispensing times, inadequate labeling of medicines, inadequate level of patients' knowledge about prescribed medicines, and unavailability of key drugs in stock were found to be the major problems. Continuous refreshment trainings on rational use of drugs and WHO recommendations should be given for prescribers and pharmacists. Further, we recommend studies involving large number of facilities to estimate overall prescribing practices.

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Drug use pattern using WHO prescribing indicators at Sheikh Sultan Hassan Yabere Referral Hospital, Eastern Ethiopia: A cross sectional study

Journal of Drug Delivery and Therapeutics ◽

10.22270/jddt.v10i4-s.4207 ◽

2020 ◽

Vol 10 (4-s) ◽

pp. 34-38

Author(s):

Muktar Shekabdulahi Warsame

Keyword(s):

Drug Use ◽

Referral Hospital ◽

Prescribing Pattern ◽

Eastern Ethiopia ◽

Prescribing Indicators ◽

Essential Drug List ◽

Drug List ◽

Rational Drug ◽

Use Pattern ◽

Drug Use Pattern

Introduction: In order to enhance rational drug use, it is very important to assess the prescribing pattern of the facilities using standard prescribing checklists. Hence, the aim of this study was to assess drug use pattern using WHO prescribing indicators at Sheikh Hassan Sultan Yabere Referral Hospital, Eastern Ethiopia. Objective: the objective of this study is to assess drug use pattern using WHO prescribing indicators at Sheikh Hassan Sultan Yabere Referral Hospital, Eastern Ethiopia 2019 Method: Retrospective study design was employed to assess the current drug prescribing pattern of Sheikh Hassan Sultan Yabere Referral Hospital.Six Month prescription papers from December 1, 2018 to May 31, 2019 were surveyed. A total of 600 prescriptions that were selected using systematic random sampling were reviewed. Data was collected from prescriptions at outpatient pharmacy. The data was entered to excel and analyzed and presented with tables and charts. Results: The average number of drugs prescribed per encounter or mean was 1.98 with a range between one and six drugs. The percentage of encounters in which an antibiotic or injection prescribed were 60 % (n=600) and 2.5 % (n=600) respectively. The percentage of drugs prescribed by generic name and from an essential drug list were 89.5 % (n=600) and 98.99% (n=600). The commonly prescribed forms of antibiotics were Amoxicillin (19.15%), Amoxicillin/Clavulunate (17.41) and Azithromycin (16.83%).The most commonly prescribed injection was Ceftriaxone (52.14%). Conclusion: This study revealed major deviation from standard WHO recommended rational prescribing practice with regard to antibiotic use. The study also showed deviation from WHO standard with regard to use of generic name and prescribing from national formulary/Essential drug list. Keywords: Rational drug use, prescribing pattern, WHO prescribing indicators Jigjiga, Somali Region.

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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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Assessment of Prescription Completeness and Drug Use Pattern in Tibebe-Ghion Comprehensive Specialized Hospital, Bahir Dar, Ethiopia

BioMed Research International ◽

10.1155/2020/8842515 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Zewdu Yilma ◽

Tena Mekonnen ◽

Ebrahim Abdela Siraj ◽

Zegaye Agmassie ◽

Adane Yehualaw ◽

...

Keyword(s):

Drug Use ◽

Intervention Program ◽

Inappropriate Prescribing ◽

Essential Drug List ◽

Specialized Hospital ◽

Patient Care Indicators ◽

Rational Drug ◽

Health Facility Indicators ◽

Use Pattern ◽

Drug Use Pattern

Introduction. Irrational medicine use is a global problem, and one of its manifestation is inappropriate prescribing that occurs when medicines are not prescribed in accordance with the guideline. Objective. The aim of the study was to assess prescription completeness and drug use pattern of the hospital using the WHO core drug use indicators. Methods. 1000 prescriptions were collected retrospectively from prescriptions written for 1 year from outpatient pharmacies of the hospital. Exit interview was employed to assess patient care indicators. The health facility indicators were checked by assessing the presence of drug formulary and availability of key medicines at the facility. Data were analyzed using SPSS version 20. Results. It was found that only name of the patients was filled in all the prescriptions. Other informations were below the standard. The average number of drugs per prescription was 1.65. Percentages of encounter by generic name, with antibiotic and injections, were 85.78%, 41%, and 25%, respectively. The percentage of drugs prescribed from an essential drug list was 98.48%. The mean consultation time and dispensing time were 14.49 and 2.16 minutes, respectively. More than half patients had knowledge on drug dispensed to them (68%). The percentage of drugs actually dispensed was 65%, but none of the drugs dispensed were adequately labelled. A copy of EDL and 84% of the key drugs were available in the hospital. Conclusion. From the results of our study, it can be concluded that all prescriptions were not complete, and except the average number of drugs prescribed per encounter, the other drug use pattern indicators were out of the WHO recommendation. Therefore, effective intervention program, like training, for promotion of rational drug use practice was recommended.

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Essential Drug List in a Rural Hospital

Tropical Doctor ◽

10.1177/004947558701700404 ◽

1987 ◽

Vol 17 (4) ◽

pp. 151-155 ◽

Cited By ~ 7

Author(s):

Bernt Lindtjørn

Keyword(s):

Drug Prescription ◽

Essential Drug ◽

Drug Usage ◽

Oral Rehydration ◽

Essential Drug List ◽

Southwestern Ethiopia ◽

Drug List ◽

Rational Drug ◽

Rehydration Solution ◽

One Year

An essential drug list was introduced to Gidole Hospital (Gamu Gofa Region, southwestern Ethiopia) in 1980. This study considers whether the introduction of the essential drug list improved drug prescription. Drug usage by admitted patients was examined retrospectively by drawing samples from two one-year periods (1979 and 1983/84). This study demonstrates that a change in drug prescription occurred: a significant decrease of non-essential and placebo drugs as well as vitamin injection was achieved. Oral rehydration solution (ORS) became the main treatment for diarrhoeal diseases, while other “diarrhoeal drugs” (8-hydroxyquinolines, bismuth opium and sulphaguanidine) were no longer used. Multidrug use was significantly reduced. It is concluded that the introduction of local drug lists creates an increased awareness of rational drug prescription.

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ASSESSMENT OF DRUG USAGE PATTERN IN PATIENTS OF ASTHMA: A CROSSSECTIONAL STUDY IN A TERTIARY CARE TEACHING HOSPITAL IN EASTERN INDIA

10.36106/ijsr/5425635 ◽

2020 ◽

pp. 1-4

Author(s):

Shambo Samrat Samajdar ◽

Ritabrata Mitra ◽

Manotosh Sutradhar ◽

Debasish Ghosh ◽

Mrinal Pal ◽

...

Keyword(s):

Tertiary Care ◽

Usage Pattern ◽

Utilization Pattern ◽

Eastern India ◽

Essential Drug ◽

Drug Usage ◽

Essential Drug List ◽

Drug List ◽

Rational Drug ◽

Gina Guidelines

Background: In India, asthma imposes a substantial burden; though the disease still remains under-recognized, underestimated and under-treated in masses.With a global need of promoting rational drug use in healthcare, drug utilization pattern studies could provide feedback to prescribers and help in fostering rational drug usage. The present study was planned to study the drug utilization pattern in patients of asthma in a tertiary care set-up in eastern India and to evaluate it with respect to GINA guidelines. Materials and Methods: The study was carried out over a period of one year where cases with confirmed diagnosis of asthma, who gave informed consent to participate were included.Drug usage pattern was determined in the light of drugs prescribed, mean drugs per prescription, percentage of drugs prescribed in generic name and having conformation to national essential drug list. Percentage of inhalational, injectable, fixed dose combination and antibiotics per prescription were noted. Data were checked for completeness and statistically analysed. Results: The present study included 370 participants. A total of 1514 drugs were prescribed, with 4.09 drugs per prescription. 12.55% of drugs prescribed were from national essential drug list. A total of 1031 anti-asthma drugs were prescribed with 2.8 anti-asthma drugs per prescription. Among the various classes of anti-asthma drugs, maximum prescribed were inhalational corticosteroids, followed by long acting inhalational beta 2 agonist and anti-leukotriene drugs. 96.5% of total patients were on inhalational drugs, with budesonide and formeterol being majorly prescribed. Conclusion: The usage pattern as assessed in our study was in conformation to GINA guidelines. Guidelines like GINA have enlightened physicians about the rational prescribing in asthmatic patients.

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DRUG UTILIZATION PATTERN IN PAEDIATRIC PATIENTS IN A SECONDARY CARE HOSPITAL

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2019v11i4.30746 ◽

2019 ◽

pp. 69-74 ◽

Cited By ~ 1

Author(s):

R. SENTHILSELVI ◽

M. BOOPANA ◽

Linta Sathyan ◽

PRIYA VISUVASAM ◽

V. GANESAN

Keyword(s):

World Health Organization ◽

Drug Utilization ◽

World Health ◽

Drug Prescribing ◽

Essential Drug ◽

Essential Drug List ◽

Drug List ◽

Rational Drug ◽

The World ◽

Health Organization

Objective: The study was carried out to generate research on drug utilization pattern in paediatric patients in government headquarters hospital, Tiruppur, Tamilnadu, India using world health organization (WHO) and international network for rational use of drugs (INRUD) core indicator. Methods: The core prescribing indicators of the world health organization was used to assess the appropriate use of drugs. Index of rational drug prescribing (IRDP) developed by Zhang and Zhi was also used to find out the performance of a health care system in terms of drug utilization. Results: Out of 859 drugs in 200 cases the highest prescribed drug class is antibiotics 304(35.39%) and the majority of drugs were administered in injectable form 412(47.94%). It was analysed that a majority of prescriptions 117(58.5%) were discharged in between 4-7 d. 161(80.5%) patients were dismissed after completion of treatment. On analysing world health organization (WHO) prescribing core indicators, the average number of drugs per prescription was 4.29 which is higher than double the average number (i.e., 2). This indicates poly-pharmacy practice. 97.78% of drugs were prescribed were the generic name and percentage of encounters with antibiotic prescribed was 90.5% which is thrice greater than world health organization (WHO) standard<30%. Prescribing of injections is not within the world health organization (WHO) recommended range<20% and it was far higher showing 97.5% which is essential for paediatric inpatients. The prescribing practice in paediatric ward is in complete adherence to national essential drug list (EDL) or formulary. The mean value of the index of rational drug prescribing (IRDP) obtained was 3.09 which is very similar to that of optimal value world health organization (WHO). Conclusion: Prescription by generic name, prescribing drugs from essential drug list (EDL) and free government supply are encouraging findings in this hospital. The result shows poly-pharmacy and overuse of antibiotics are the areas to be concerned. The better clinical outcome shows rational prescribing is practised well.

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