Abstract
Poor prescribing pattern is observed and become a serious problem in the world including developing countries. In Ethiopia, several studies showed that health care institutions did not meet WHO prescribing indicators and the prescribing pattern is not satisfactory in the health care institutions. This study aimsto review the prescribing pattern of medications prescribed to outpatients based on WHO prescribing indicators in Ethiopia. Literature search was performed through PubMed/MEDLINE, Google Scholar, and Research Gate from July 5-30, 2019. A standard data extraction format was used to collect important data from the included studies. Open meta analyst advanced software was used for analyses of the pooled estimate of outcome measures and subgroup analysis. Der Simonian and Laird’s random-effect models were applied for the analyses at 95% confidence level. I2 statistics were used to assess heterogeneity of studies. The presence of publication bias was assessed with comprehensive meta-analysis version 3 software and presented with a funnel plot. P-value of less than 0.05 was considered as statistically significant. The results revealed that a total of 13 studies with 33,567 drugs from 15,305 prescriptions were included for systematic review and meta-analysis. The results of prescribing indicators were 1.96, 93.0, 36.2, 18.3 and 94.8% for average number of drugs per prescription, percentage of drugs prescribed by generic name, percentage of drugs encounter with antibiotics, percentage of drugs encounter with injection and for the percentage of medicines prescribed from essential drug list respectively. Therefore, the prescribing pattern of Ethiopia is below WHO standard level. Key words: Prescribing pattern, prescribing indicators, Ethiopia.
Highlights
“Rational drug use is a condition of appropriate drug utilization in which patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period
It sets the standard level of prescribing indicators as: the average number of per prescription to be ≤2, the percentage of drugs prescribed by generic name to be 100%, the percentage of prescriptions with an antibiotic encountered to be 25%, the percentage of prescriptions with an injection encountered to be between 13.4 and 24.1%, and the percentage of drugs from essential drug list to be 100%(World Health Organization, 2006)
This review showed that the average number of drugs per prescription was lower than a review done in African region which was done in 11 African countries primary health care centers including Ethiopia (Ofori-Asenso et al.,2016).Drugs that were prescribed by their generic name in this study were 93.3% which is lower than that recommended by the WHO (100%) (World Health Organization, 2006)
Summary
“Rational drug use is a condition of appropriate drug utilization in which patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements for an adequate period. WHO developed medication use indicators to promote rational drug use and to evaluate drug prescribing pattern, including prescribing indicators in order to evaluate medication-related services provided to the population. It sets the standard level of prescribing indicators as: the average number of per prescription to be ≤2, the percentage of drugs prescribed by generic name to be 100%, the percentage of prescriptions with an antibiotic encountered to be 25%, the percentage of prescriptions with an injection encountered to be between 13.4 and 24.1%, and the percentage of drugs from essential drug list to be 100%(World Health Organization, 2006). These indicators enable the investigator to identify the prescription profile and quality of services offered to the population(Vooss and Diefenthaeler, 2011).In Ethiopia, several studies showed health care institutions didnot meet WHO prescribing indicators and the prescribing pattern isnot satisfactory in the health care institutions(Desalegn, 2013; Sisay et al, 2017).this systematic review and metaanalysis aim to review the prescribing pattern of medications prescribed to outpatients based on WHO prescribing indicators in Ethiopia
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