Abstract
BackgroundDespite the complexity of drug use, a number of indicators have been developed, standardized and evaluated by the World Health Organization (WHO). These indicators are grouped in to three categories namely: prescribing indicators, patient care indicators and facility indicators. The study was aimed to evaluate rational drug use based on WHO-core drug use indicators in Dilchora referral hospital, Dire Dawa; Hiwot Fana specialized university hospital, Harar and Karamara general hospital, Jigjiga, eastern Ethiopia.MethodsHospital based quantitative cross sectional study design was employed to evaluate rational drug use based on WHO core drug use indicators in selected hospitals. Systematic random sampling for prescribing indicators and convenient sampling for patient care indicators was employed. Taking WHO recommendations in to account, a total of 1,500 prescription papers (500 from each hospitals) were investigated. In each hospital, 200 outpatient attendants and 30 key essential drugs were also selected using the WHO recommendation. Data were collected using retrospective and prospective structured observational check list. Data were entered to EPI Data Version 3.1, exported and analyzed using SPSS version 16.0. Besides, the data were evaluated as per the WHO guidelines. Statistical significance was determined by one way analysis of variance (ANOVA) for some variables. P-value of less than 0.05 was considered statistically significant. Finally, tabular presentation was used to present the data.ResultsMean, 2.34 (±1.08) drugs were prescribed in the selected hospitals. Prescriptions containing antibiotics and that of injectables were 57.87 and 10.9% respectively. The average consultation and dispensing time were 276.5 s and 61.12 s respectively. Besides, 75.77% of the prescribed drugs were actually dispensed. Only 3.3% of prescriptions were adequately labeled and 75.7% patients know about the dosage of the prescription. Not more than, 20(66.7%) key drugs were available in stock while only 19(63.3%) of key drugs had adequate labeling. On average, selected key drugs were out of stock for 30 days per year. All of the hospitals included in the study used the national drug list, formulary and standard treatment guidelines but none of them had their own drug list or guideline.ConclusionMajority of WHO stated core drug use indicators were not met by the three hospitals included in the study.
Highlights
Despite the complexity of drug use, a number of indicators have been developed, standardized and evaluated by the World Health Organization (WHO)
There are three major categories of core drug use indicators namely, prescribing indicators patient care indicators, and health facility indicators [6, 7]
Study design and setting Facility based quantitative cross sectional study design was employed to evaluate rational drug use based on WHO core drug use indicators in the Dilchora referral hospital (DRH), Dire Dawa; Hiwot Fana specialized University hospital (HFSUH), Harar and Karamara general hospital (KGH), Jigjiga
Summary
Despite the complexity of drug use, a number of indicators have been developed, standardized and evaluated by the World Health Organization (WHO). These indicators are grouped in to three categories namely: prescribing indicators, patient care indicators and facility indicators. Rational drug use (RDU) generally covers appropriate prescribing, appropriate dispensing and appropriate patient use of medicines for the diagnosis, prevention, mitigation and treatment of diseases. The core drug use indicators are more informative, more feasible, less likely to fluctuate over time and place as well as easier to measure drug use than the complementary indicators [4, 5]. There are three major categories of core drug use indicators namely, prescribing indicators (average number of drugs per encounter; percentage of drugs prescribed with generic name; percentage of encounters with antibiotics prescribed, percentage of encounters with injections prescribed and percentage of drugs prescribed from EDL) patient care indicators (average consultation time, average dispensing time, percentage of drugs dispensed, percentage of drugs labeled and patient knowledge of how to take the drug), and health facility indicators (availability of essential drugs, availability of STGs, formularies and EDLs) [6, 7]
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