Abstract
BackgroundIdentification of internationally comparable indicators of medicines use are important for a country to implement strategies and regulations to improve usage of medicines. Sri Lanka established a new National Medicines Regulatory Authority in 2015 and this survey evaluated the medication use indicators in Sri Lanka, according to the International Network on Rational Use of Drugs (INRUD), prior to its implementation.MethodsThis descriptive-cross-sectional study was conducted in 80 pharmacies, representing all 25 districts of the country. Three pharmacy categories were included; privately owned pharmacies, ‘Rajya Osusala’ pharmacies operated by the State Pharmaceuticals Corporation (SPC) of Sri Lanka and SPC Franchisee pharmacy outlets. Selection of pharmacies from respective districts were done proportionate to estimated population. Data were collected to identify WHO/INRUD core drug use indicators and the commonly prescribed medicines.ResultsTotal of 2328 prescriptions were included (‘Rajya Osusala 559; SPC Franchise 711; private pharmacies 1058). Altogether 7,255 medicines were prescribed, and the 3 most commonly prescribed medicines were atorvastatin, losartan and metformin. Average number of medicines per encounter was 3.1±1.9 (Median: 3; range 1-12) Highest average number of medicines per encounter was reported in prescriptions received at ‘Rajya Osusala’ pharmacies (3.6±2.2), significantly higher than in other categories of pharmacies (p<0.001). Percentage of medicines prescribed by generic name was only 35.5%, highest at the ‘Rajya Osusala’ pharmacies (40.6%), significantly higher than other categories of pharmacies. The overall percentage of medicines prescribed from essential medicine list (EML) was 68.8%, without any significant variation between different categories of pharmacies. The percentage of medicines actually dispensed and accurately labelled were 92.4 and 98.5% respectively.ConclusionsThe average number of medicines per encounter was higher than the WHO recommended value but the usage of antibiotic and injectable drugs were within recommended standards. Generic prescribing, was very much lower. The EML prescribing, labelling and percentage dispensed medicines fared much better although lower than the WHO recommended 100% compliance. This island wide study has provided national wide data before the implementation of key changes in regulation of medicines in Sri Lanka and a repeat survey will be useful to identify impact of the new legislations.
Highlights
Identification of internationally comparable indicators of medicines use are important for a country to implement strategies and regulations to improve usage of medicines
We found that average number of medicines per encounter overall was higher than the World Health Organization (WHO) recommended value with polypharmacy detected in 35% prescriptions islandwide
It was heartening to note the usage of antibiotics and injectable drugs being within the WHO recommended values and comparing favourably with the values reported from other countries
Summary
Identification of internationally comparable indicators of medicines use are important for a country to implement strategies and regulations to improve usage of medicines. Health care quality is the degree to which health care services provided by an institution improves desired outcomes. This is determined by comparison with set standard measurements and indicators. Rational use of medicines is an essential element in ensuring the quality of health care for patients and the community [1]. It is defined by the World Health Organization (WHO) as patients receiving medications appropriate for their clinical requirements, in doses that meet their individual needs for an adequate period of time, at the lowest cost to them and their community [2]. Rational use of medicines is closely aligned with effectively curing a disease, relieving the symptoms of disease, or the goal of prevention and prophylaxis through therapy based on scientific evidence and well-studied clinical guidelines [3]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
