scholarly journals WHO/INRUD Core drug use indicators and commonly prescribed medicines: a National Survey from Sri Lanka

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
P. Galappatthy ◽  
P. Ranasinghe ◽  
C. K. Liyanage ◽  
M. S. Wijayabandara ◽  
S. Mythily ◽  
...  

Abstract Background Identification of internationally comparable indicators of medicines use are important for a country to implement strategies and regulations to improve usage of medicines. Sri Lanka established a new National Medicines Regulatory Authority in 2015 and this survey evaluated the medication use indicators in Sri Lanka, according to the International Network on Rational Use of Drugs (INRUD), prior to its implementation. Methods This descriptive-cross-sectional study was conducted in 80 pharmacies, representing all 25 districts of the country. Three pharmacy categories were included; privately owned pharmacies, ‘Rajya Osusala’ pharmacies operated by the State Pharmaceuticals Corporation (SPC) of Sri Lanka and SPC Franchisee pharmacy outlets. Selection of pharmacies from respective districts were done proportionate to estimated population. Data were collected to identify WHO/INRUD core drug use indicators and the commonly prescribed medicines. Results Total of 2328 prescriptions were included (‘Rajya Osusala 559; SPC Franchise 711; private pharmacies 1058). Altogether 7,255 medicines were prescribed, and the 3 most commonly prescribed medicines were atorvastatin, losartan and metformin. Average number of medicines per encounter was 3.1±1.9 (Median: 3; range 1-12) Highest average number of medicines per encounter was reported in prescriptions received at ‘Rajya Osusala’ pharmacies (3.6±2.2), significantly higher than in other categories of pharmacies (p<0.001). Percentage of medicines prescribed by generic name was only 35.5%, highest at the ‘Rajya Osusala’ pharmacies (40.6%), significantly higher than other categories of pharmacies. The overall percentage of medicines prescribed from essential medicine list (EML) was 68.8%, without any significant variation between different categories of pharmacies. The percentage of medicines actually dispensed and accurately labelled were 92.4 and 98.5% respectively. Conclusions The average number of medicines per encounter was higher than the WHO recommended value but the usage of antibiotic and injectable drugs were within recommended standards. Generic prescribing, was very much lower. The EML prescribing, labelling and percentage dispensed medicines fared much better although lower than the WHO recommended 100% compliance. This island wide study has provided national wide data before the implementation of key changes in regulation of medicines in Sri Lanka and a repeat survey will be useful to identify impact of the new legislations.

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Priyadarshani Galappatthy ◽  
Priyanga Ranasinghe ◽  
Chiranthi K. Liyanage ◽  
Maheshi Wijayabandara ◽  
Dinuka S. Warapitiya ◽  
...  

Irrational prescribing is common, especially in developing countries. It is important to identify the magnitude of irrational use, to take necessary steps to promote rational prescribing. We identified core prescribing indicators and commonly prescribed medicines at ward settings (IW) and outpatients’ clinics (OPC) in a tertiary care hospital in Sri Lanka. A descriptive cross-sectional study was carried out at IW and OPC settings. Prescriptions were obtained from 5 major specialties (Clinical Medicine (CM), Gynaecology and Obstetrics (GO), Paediatrics, Psychiatry, and Surgery). The WHO core prescribing indicators were used to describe the pattern of prescribing, and the most commonly prescribed medicines were identified. A total of 1,318 prescriptions were analyzed. The five most commonly prescribed medicines were paracetamol (31.0%), omeprazole (20.6%), folic acid (18.3%), atorvastatin (16.2%), and salbutamol (15.3%). The average number of medicines per encounter was 4.8 ± 3.6 (IW: 5.7 ± 4; OPC: 3.8 ± 2.8; p < 0.001 ), with the highest IW (7.8 ± 4.2) and OPC (7.8 ± 2.7) values were from CM, being significantly higher than all other disciplines ( p < 0.05 ). Percentage encounters with an antibiotic or an injection was 26.4% and 30.1%, respectively, with IW being significantly higher than OPC ( p < 0.001 ). Percentage of medicines prescribed by generic name and from the essential medicine list (EML) was 90.1% and 91.1%, respectively, with no significant IW and OPC difference. In conclusion, a high degree of polypharmacy was noted. The use of injectable medicines, prescribing from the EML, and generic name prescribing was satisfactory; however, overall rational prescribing needs further improvement. Further investigation into the degree of rational prescribing associating it with clinical information will be important.


Salud Mental ◽  
2019 ◽  
Vol 42 (1) ◽  
pp. 5-12
Author(s):  
Solveig E. Rodríguez-Kuri ◽  
Raúl García-Aurrecoechea ◽  
José Luis Benítez-Villa ◽  
Carmen Fernández-Cáceres

Introduction. Factors associated with drug use are defined in terms of their proximity to the phenomenon and can be classified as individual, microsocial, and macrosocial. Macrosocial factors include variables of a geographic, economic, demographic, and social nature, which can be compiled from population censuses and surveys. Objective. To determine the levels of risk for drug use in municipalities in Mexico based on macro-social indicators. Method. Retrospective cross-sectional study, based on the analysis of population data, weighted by the Delphi method. Results. Sixty-four municipalities with a high or very high risk of drug use were identified. Factors such as the volume of drug seizures, prevalence of student use, alcohol supply, and inequality among the population were weighted as the factors with greatest risk for drug use. Discussion and conclusion. These data serve as a benchmark for guiding the efficient, rational administration of resources assigned for dealing with the problem of addictions, since they make it possible to identify localities with a greater need for care services.


2020 ◽  
Vol 15 ◽  
Author(s):  
Solomon Hambisa ◽  
Rediet Feleke ◽  
Ameha Zewudie ◽  
Mohammed Yimam

Background:: Rational drug use comprises aspects of prescribing, dispensing and patient use of medicines for different health problems. This study is aimed to assess drug prescribing practice based on the world health organization prescribing indicators in Mizan-Tepi University teaching hospital. Methods:: An institutional based retrospective cross sectional study was conducted to evaluate prescribing practices in Mizan-Tepi University teaching hospital. Data were collected based on World health organization drug use indicators using prescription papers. 600 prescriptions dispensed through the general outpatient pharmacy of the hospital were collected by systematic random sampling method from prescriptions written for a 1-year time in Mizan-Tepi University teaching hospital. Results:: The present study found that the average number of drugs per prescription was 2.04 ± 0.87 in Mizan-Tepi University teaching hospital with a range between 1 and 5. Prescribing by generic name was 97.6 % and 47.8% of prescriptions contained antibiotics in the hospital. 27.7% of prescriptions contained at least one injectable medication in Mizan-Tepi University teaching hospital. From prescribed drugs, 96.7% of them were prescribed from Ethiopian essential drug list. Conclusion:: Present study indicated that the average number of drugs prescribed per encounter, the percentage of generic prescribing and prescribing from the EDL were close to optimal value. However, the percentage of encounters with antibiotics and injections prescribed were found be very high. Thus, the study highlights some improvements in prescribing habits, particularly by focusing on the inappropriate consumption of antibiotics and injections.


2021 ◽  
Vol 9 ◽  
pp. 205031212110343
Author(s):  
Ayele Mamo ◽  
Mesud M Hassen ◽  
Ahmednur Adem ◽  
Zinash Teferu ◽  
Musa Kumbi ◽  
...  

Background: Coronavirus disease is a highly transmittable and pathogenic viral infection caused by severe acute respiratory syndrome coronavirus 2, which poses therapeutic dilemmas. Some suggestions for drug treatment seem problematic. Beliefs about the causes of health problems are determinants of treatment seeking decisions. Hence, one of the alternatives for the solution of health problems is employing traditional medicine to prevent coronavirus disease 19. Objective: To assess the knowledge, attitude, and utilization of drugs toward the coronavirus disease 19 pandemic among Bale zone residents. Methods: Community-based cross-sectional study was conducted among the Bale Zone population from May 30 to June 30, 2020. Eight hundred fifty-four participants were selected using a single population formula, and a multistage sampling technique was employed. Data were analyzed using SPSS version 25.0. Descriptive and binary logistic regression was used to analyze the outcomes. A p value ⩽ 0.05 was considered statistically significant. Results: Out of the total 854 respondents, about 534 (62.5%) got information about coronavirus disease 19 from TV/radio. More than two-thirds (71.9%) of the respondents have known that severe acute respiratory syndrome coronavirus 2 has no curative drugs, and 65.4% had a more appropriate attitude toward overall drug use in coronavirus disease 19. Level of education and, attitude towards drug use were singnificantly associated with knowledge of drugs, source of information about coronavirus disease 19 and having good practice were significantly associated with atittude toward drug utilization. Conclusion: One out of two study participants have good knowledge regarding drugs to the coronavirus disease 19 pandemic. Illiterate people in the community were identified to have poor knowledge about drugs, hence community educuation program is important to improve the knowledge about drugs towards the coronavirus disease 19 pandemic.


1995 ◽  
Vol 29 (6) ◽  
pp. 566-572 ◽  
Author(s):  
Kerstin Al Bingefors ◽  
Dag Gl Isacson ◽  
Lars Von Knorring ◽  
Björn Smedby

Objective: To analyze healthcare and prescription drug use among patients taking and those not taking antidepressant drugs in a Swedish community. Design: Cross-sectional study. Setting: General population of the rural Swedish municipality Tierp of approximately 20 000 inhabitants. Participants: All residents of Tierp aged 25 years or older during 1988. Main Outcome Measures: Mean number of ambulatory care visits, hospital bed days, and prescriptions per person; proportion of those taking prescription drugs in different pharmacologic classes. Results: Patients treated with antidepressant drugs had a significantly (p < 0.05) greater use of ambulatory care, hospital care, and prescription drugs than those who did not take antidepressants in the study population. They also had an increased frequency of use of prescription drugs from virtually all pharmacologic classes. Furthermore, the risk for polypharmacy was high in patients treated with antidepressant medications. Conclusions: Those who took antidepressant drugs consumed more health services and prescription drugs than did those not taking an antidepressant. Patients receiving antidepressant treatment may be at serious risk for iatrogenic disease and should be evaluated carefully with respect to concomitant drug use.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chandrani Nirmala Wijekoon ◽  
Indika Wettasinghe ◽  
Dinithi Fernando ◽  
Arosha Sampath Dissanayake ◽  
Malinda Gunawardana ◽  
...  

Abstract Background Early recognition and the optimal management of anaphylaxis saves lives but studies from different countries have demonstrated gaps in knowledge and practices between healthcare workers. There is a paucity of such data from Sri Lanka. We assessed knowledge, perception and self-confidence in the diagnosis and management of anaphylaxis amongst pre-intern medical graduates who would soon become first-contact doctors attending emergencies. Methods This cross-sectional study included pre-interns who graduated with Bachelor of Medicine, Bachelor of Surgery (MBBS) degrees in 2019 from three Sri Lankan universities with differing undergraduate curricula. Using consecutive sampling data were collected within four months of the final-MBBS examinations with a self-administered questionnaire and the answers on case diagnosis and management were used as the basis of outcome scores. Results 385 participants responded (response rate: 91.5%). 16.4% correctly identified all anaphylaxis triggers. Only 7.3% correctly diagnosed all ten case scenarios and 34.5% all seven cases of anaphylaxis. 98.2 and 97.9% correctly identified 1:1000 adrenaline as the first-line treatment and the intramuscular route. 9.9% would preferentially but incorrectly use the intravenous route if access was available. Only 79.2 and 55.6% knew the correct adult and paediatric doses of adrenaline and 50% agreed that follow-up care was needed. The mean scores for case diagnosis and management of anaphylaxis were 7.7/10 ± 1.4 and 16.9/20 ± 1.9, respectively. Multiple linear regression indicated that the final MBBS results classification (class of degree or no class indicated) was a positive predictor of case diagnosis score [class vs no class: B = 0.662 (95% CI 0.347–0.978), p < 0.001] and being a graduate of University 2 [B = 1.568 (95% CI 1.182–1.953), p < 0.001] and passing with a class at final MBBS [B = 0.716 (95% CI 0.319–1.113), p < 0.001] were positive predictors of management score. Self confidence in diagnosing and managing anaphylaxis were rated as 79.7 and 62.1% and there was a positive correlation between knowledge and perception scores and self-confidence (case-diagnosis: rpb = 0.111, p = 0.03; management: rpb = 0.164, p = 0.001). Conclusions Knowledge, perception and self confidence in the diagnosis and management of anaphylaxis was sub optimal amongst pre-interns and we identified areas that need improvement. A higher MBBS qualification classification was a predictor for correct diagnosis and management and confidence in diagnosis and management positively correlated with knowledge and perception scores. Further and enhanced educational and training strategies are needed for this life threatening emergency condition.


2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Janaka Weragoda ◽  
Rohini Seneviratne ◽  
Manuj C. Weerasinghe ◽  
Mandika Wijeyaratne ◽  
Anil Samaranayaka

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Moses A. Ojo ◽  
Cecilia I. Igwilo ◽  
Thomas Emedoh

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.


2009 ◽  
Vol 17 (2) ◽  
pp. 246-252 ◽  
Author(s):  
Lourdes Jordán Jinez ◽  
José Roberto Molina de Souza ◽  
Sandra Cristina Pillon

Adolescence is a phase of exposure to several risk behaviors, especially the experimental use of drugs and its associated problems. The study aims to identify risk factors and drug use among secondary students in Comonfort, Guanajuato, Mexico. This is a cross-sectional study, using a version of the Drug User Screening Inventory (DUSI) adapted from Portuguese to Spanish. The sample was composed of 695 (42.9%) students, 52.8% women. Drug use was present in 20.3%, predominantly alcohol and tobacco. Risk factors are related to the male gender, older than 13 years, second and third grades, living with relatives, poor relationships, curiosity, family conflicts, peer pressure and solidarity. CONCLUSION: alcohol and tobacco are the most used drugs and are associated to curiosity and peer pressure.


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