Abstract
Introduction: Prevention of irrational use of medicines may reduce healthcare costs and potentially save lives. Aim: The aim of this study was to assess rational drug prescribing using World Health Organization (WHO) and International Network of Rational Use of Drugs (INRUD) indicators on prescribing in the General Outpatient Department of Kampala International University Teaching Hospital, Ishaka-Bushenyi, Western Uganda. Methodology: The study design was retrospective, descriptive and cross-sectional. A total of 884 prescriptions were selected by systematic sampling using an interval of 27 from 23,868 prescriptions available in the medical records of the General Out-Patient Department (GOPD) of Kampala International University Teaching Hospital (KIUTH) from April, 2016 to March, 2017. The selected samples were analyzed using Microsoft Excel 2013, to assess for conformity with the prescribing indicators. Results: The results showed that the percentage of recording of diagnosis was 90.72% (index of diagnosis—0.91). The average number of drugs per encounter was 2.6 (index of non-polypharmacy—0.77), and the percentage of drugs prescribed with the generic name was 90.21% (index of generics—0.9). Percentages of encounters with antibiotics and injectable drugs prescribed were 61.88% (index of antibiotics—0.48) and 5.43% (index of injectable drugs—1) respectively. Only 78.96% (index of EMSLU—0.79) of the medicines prescribed were from the Essential Medicines Supplies List of Uganda (EMSLU) or Uganda Clinical Guidelines 2016. The index of rational drug prescribing (IRDP) was found to be 4.85. Conclusion: The findings showed that only the percentage of encounters with injectable drugs was in line with WHO/INRUD prescribing indicators. On the over all, the index of rational drug prescribing (IRDP) was poor (observed 4.85 versus optimum 6). The authors recommended continuous sensitization, counselling and education of prescribers in KIUTH in order to achieve rational prescribing.
Highlights
Prevention of irrational use of medicines may reduce healthcare costs and potentially save lives
That is average number of medicines prescribed per encounter, percentage of medicines prescribed by generic name, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed and percentage of medicines prescribed from Essential Medicines List
The five core prescribing indicators include: average number of medicines per encounter, percentage of medicines prescribed by generic name, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed, and percentage of medicines from the Essential Medicines Supplies List of Uganda (EMSLU) or Uganda Clinical Guidelines 2016 (UCG)
Summary
Prevention of irrational use of medicines may reduce healthcare costs and potentially save lives. Aim: The aim of this study was to assess rational drug prescribing using World Health Organization (WHO) and International Network of Rational Use of Drugs (INRUD) indicators on prescribing in the General Outpatient Department of Kampala International University Teaching Hospital, Ishaka-Bushenyi, Western Uganda. According to [3], the World Health Organization (WHO) defined rational use of drugs as patients receiving 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. According to the report of baseline studies, all levels of health care facilities in Uganda recorded polypharmacy, low use of generic names, over-use of antibiotics and low adherence to standard treatment guidelines. The report concluded that there was poor medicines management in more than 1000 public health care facilities in Uganda [7]
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