Analysis of rational prescription of medicines by village clinics: a repeated cross-sectional study of a province in eastern China.

Abstract

To analyse the rational prescription of medicines by village clinics following China's implementation of the New Healthcare System Reform (NHCSR). Retrospective study. Village clinics in a province in eastern China. Our evaluation was based on the core drug use indicators reported in the study 'How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators'. The level of rational use of medicines (RUMs) in village clinics improved in 2018 compared with 2009; the average number of drugs per prescription decreased from 3.66 to 2.77, the percentage of prescriptions including antibiotics decreased from 65.40% to 46.00%, and the percentage of prescriptions including injections decreased from 55.75% to 37.48% (all p<0.01), whereas the percentage of drugs prescribed from the list of essential medicines increased from 66.50% to 80.34%, and the percentage of drugs prescribed by generic names increased from 61.29% to 70.65% (all p<0.01). The level of RUMs improved after the implementation of the NHCSR, however, it was found that there was still a gap between the level of RUMs in 2018 and the international reference value. Financial investments, electronic prescription systems, improved supervision and regular training are essential actions that must be implemented.