Abstract

BackgroundEnsuring rational drug use requires ongoing evaluation of drug prescribing, dispensing, and use by patients. Health care providers working in an emergency department face unique challenges, including making urgent decisions, patient overload, and limited resources, which contribute to inappropriate drug use. Rational medication use should be an important aspect of emergency care to improve patient outcomes. Thus, this study was conducted to assess medication utilization patterns using World Health Organization (WHO) prescribing indicators in the emergency department.MethodsA cross-sectional study design was implemented among patients presenting at the emergency department of Hiwot Fana Specialized University Hospital (HFSUH) from January to March 2018. The data were collected from the medical charts of a total of 342 patients using a pre-prepared structured format according to WHO recommendations. The data were analyzed using SPSS version 21 software and presented in tables and figures.ResultsThe most commonly reported clinical diagnosis was found to be soft tissue laceration or abrasion, in 75 patients (21.9%), followed by dyspepsia, in 50 (14.6%), and severe pneumonia, in 44 (12.9%). A total of 810 drugs were prescribed for the 342 patients. The main category of drugs prescribed were analgesics, constituting 125 (29.2%), followed by antibiotics, 120 (28.0%). Regarding WHO prescribing indicators, the average number of drugs prescribed per encounter was 2.36, the number of encounters at which antibiotics were prescribed was 127 (37.13%), and injections were prescribed at 300 (87.7%) encounters. All of the drugs prescribed were from the National Essential Medicine List (NEML) of Ethiopia, and 780 (98.1%) of the drugs were prescribed by international nonproprietary name.ConclusionOverall, there were inflated use of antibiotics and injection drugs, whereas prescribing by international nonproprietary name and prescribing from NEML were according to the recommendations. Hence, the hospital should work to ensure the judicious use of antibiotics and injection drugs.

Highlights

  • Medicines are an essential component of health care delivery

  • The average number of drugs prescribed per encounter, percentage of drugs prescribed by international nonproprietary name, percentage of drugs prescribed from the NEML, percentage of encounters at which antibiotics were prescribed, and percentage of encounters at which injections were prescribed were assessed

  • The average number of drugs prescribed per encounter was 2.36, which was slightly greater than the value indicated in the World Health Organization (WHO) guideline (1.6–1.8) (Isah AO; WHO, 1993)

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Summary

Introduction

Medicines are an essential component of health care delivery. When used rationally, they produce the desired effect of improving patients’ ailments. They produce the desired effect of improving patients’ ailments Their irrational use, on the other hand, leads to prolongation of the illness, development of adverse effects, and unnecessary expense. The health system in Ethiopia is structured into three tiers: referral, general, and primary hospitals. Health care providers working in an emergency department face unique challenges, including making urgent decisions, patient overload, and limited resources, which contribute to inappropriate drug use. Rational medication use should be an important aspect of emergency care to improve patient outcomes. This study was conducted to assess medication utilization patterns using World Health Organization (WHO) prescribing indicators in the emergency department

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