Abstract
Background The rational use of drugs requires that patients receive 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 with full information and with the lowest possible cost. If one of these is not met, it is referred to as irrational drug use. Many drugs have been sold or prescribed inappropriately in the world, and a significant part of the world population lacks access to essential medicine. The aim of this study was to assess practice towards rational drug use at Finoteselam and Asirade Zewudie hospitals. Methods A cross-sectional study design was used for this study, and the study was conducted from October 11 to November 30, 2019. A total of 770 prescriptions were selected as per WHO criteria by using systematic random sampling and reviewed with the help of an observational checklist. The data were entered and processed with SPSS version 25 and evaluated using the WHO criteria. Result The average number of drugs per prescription was 1.8 and 2.05, antibiotics encountered were 77.7% and 72.5%, injections encountered were 5.97% and 7.01%, percentage of drugs prescribed by generic names was 97% and 93.4%, counseling time was 1.6 minutes and 2.25 minutes, and dispensing time was 51.3 seconds and 62.72 seconds at Finoteselam and Asirade Zewudie hospitals, respectively. Conclusion The majority of WHO core drug use indicators were not met in the two hospitals. The average number of drugs encountered in Asirade Zewudie hospital was slightly higher than the WHO recommended range, whereas the average number of drugs encountered in Finoteselam hospital was exactly equal. The percentage of antibiotics encountered was very high compared with WHO recommendation, but the percentage of injections encountered was below the WHO recommended range and time spent on counseling and dispensing was too short when compared with WHO recommendation. In addition to this, both hospitals had no essential drug list or formulary as well as a key drug list.
Highlights
Rational drug use is defined as giving an appropriate drug for the appropriate patient that must meet their clinical need, for an appropriate period of time, dose, and with the lowest possible cost [1,2,3].World Health Organization (WHO) recommends three core drug use indicators
Prescribing indicators include the following parameters: average number of drugs prescribed, which is used to measure the number of drugs prescribed in a single prescription; percentage of drugs prescribed by generic names, which is used to measure the number of drugs prescribed by generic name; percentage of antibiotics encountered, which is used to assess antibiotic utilization; and percentage of injections encountered, which is important to measure prescriber attitude to injectable drugs
770 (385 from each hospital) prescriptions were selected and analyzed. e average number of drugs encountered per prescription was 1.82 and 2.05 at FSH and AZH, respectively
Summary
World Health Organization (WHO) recommends three core drug use indicators. Health facility indicators are important to measure the availability of formulary and key drug list in the facilities and include the availability of key drug and copy of essential drug list or formulary in the facility [4]. 30–50% of drugs have been prescribed and sold inappropriately; one-third of the world population lacks access to essential medicine and the effect of antibiotic is compromised by the rapid escalation of antibiotic resistance combined with lack of novel antibiotics, and it is considered as global major health threats [5]. In addition to consuming a majority of health expenditure costs, resistance to microbials is becoming prevalent in the world due to irrational use of medications [4, 6]
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