Investigation and Comparison of Medicine Use in the three Central Referral Hospitals in Sierra Leone

Background: An important goal of National Medicines Policy is to ensure that sufficient quantities of essential medicines are available to health care providers and affordable to patients.Objectives: To investigate and compare the prescribing indicators, patient care indicators and facility indicators in three central referral Hospitals in Sierra Leone.Methods: This was a simple randomized retrospective and prospective study. Three groups were obtained to assess prescribing, patient care and facility indicators in the study sites. About 10% of the prescriptions encountered from January to June 2019, were observed retrospectively. Direct observation of 30 randomly selected patients in each hospital was used to assess patient care. Data collected were organized using Microsoft Excel and analyzed using SPSS version 21. Ethical considerations were observed.Results: The average number of medicines prescribed in the three teaching hospitals (Connaught, PCMH and ODCH) were 4.07, 4.3and 3.3 respectively. Percentage encounter with injections were within standard in PCMT and ODCH. Antibiotics prescribing was slightly higher that WHO recommendation of 30% in all 3 hospitals. Percentage of medicines prescribed by generics were 75.4%, 53% and 77% respectively. The average consultation time was 5.47 minutes while the average dispensing time was 79.7 seconds. Patients that receive their medications at Connaught Hospitals had very little knowledge on how they should take their medicine(s), compared to PCMH and ODCH.Conclusion: This study has shown that irrational use of medicines is a major problem in the three referral hospitals occurring majorly during the prescribing and dispensing processes.

Assessment of Prescription Completeness and Drug Use Pattern in Tibebe-Ghion Comprehensive Specialized Hospital, Bahir Dar, Ethiopia

Introduction. Irrational medicine use is a global problem, and one of its manifestation is inappropriate prescribing that occurs when medicines are not prescribed in accordance with the guideline. Objective. The aim of the study was to assess prescription completeness and drug use pattern of the hospital using the WHO core drug use indicators. Methods. 1000 prescriptions were collected retrospectively from prescriptions written for 1 year from outpatient pharmacies of the hospital. Exit interview was employed to assess patient care indicators. The health facility indicators were checked by assessing the presence of drug formulary and availability of key medicines at the facility. Data were analyzed using SPSS version 20. Results. It was found that only name of the patients was filled in all the prescriptions. Other informations were below the standard. The average number of drugs per prescription was 1.65. Percentages of encounter by generic name, with antibiotic and injections, were 85.78%, 41%, and 25%, respectively. The percentage of drugs prescribed from an essential drug list was 98.48%. The mean consultation time and dispensing time were 14.49 and 2.16 minutes, respectively. More than half patients had knowledge on drug dispensed to them (68%). The percentage of drugs actually dispensed was 65%, but none of the drugs dispensed were adequately labelled. A copy of EDL and 84% of the key drugs were available in the hospital. Conclusion. From the results of our study, it can be concluded that all prescriptions were not complete, and except the average number of drugs prescribed per encounter, the other drug use pattern indicators were out of the WHO recommendation. Therefore, effective intervention program, like training, for promotion of rational drug use practice was recommended.

Investigation of drug use at primary health centres in Nashik, Maharashtra, India

Background: By recognizing the need to promote rational utilization of medicines, the World Health Organization (WHO) in collaboration with the International Network for Rational Use of Drugs (INRUD) developed a set of core indicators. This study aimed to investigate drug use based on it.Methods: The study was performed in Primary Health Centers (PHC) in Nashik District, Maharashtra, India. Prescriptions data for the last one year from PHCs were sampled out retrospectively. Outpatients from PHCs were selected, observed and interviewed for the patient-care indicators, prospectively. Pharmacy personnel was interviewed for the facility-specific indicators. The data were analyzed; results and conclusions were drawn.Results: The average number of drugs per prescription was 3.48 (SD=0.36). The percentages of drugs prescribed by generic name and from Essential Drug List or formulary were 83.98% and 68.97% respectively. The percentages of encounters with antibiotics and injections were 60.33% and 50.83% respectively. The average consultation and dispensing times were 3.89 minutes and 58.28 seconds respectively. 98.19% of the prescribed drugs were actually dispensed. 67.27% of the dispensed drugs were labelled. The percentage of patients’ knowledge of the correct dosage was 87.78%. The percentage availability of the EDL or formulary was 100% and of the key drugs in the stock was 85.71%.Conclusions: The need for improvement in prescribing practices can be encouraged by devising strategies such as training to physicians, rewards systems, etc. There should be plans to increase staff members for a particular working period and to educate patients with healthcare, hygiene, medicines’ compliance and common diseases.

Analisis Pelayanan Kefarmasian Berdasarkan Indikator Pelayanan Pasien WHO pada Puskesmas Kecamatan yang Belum dan Sudah Terakreditasi di Kota Depok

Pharmaceutical care based on WHO patient care indicators in various developing countries, including Indonesia, have not met the requirements. Puskesmas accreditation is expected to improve pharmaceutical care that has an impact on rational drug use. The purpose of the study was to analyze pharmacy care based on WHO patient care indicators in all sub-district health centers (9 health centers not yet accredited and 2 health centers already accredited) in Depok City. This study used a cross-sectional design and was carried out in December 2016-February 2017. The sample was adult patients from general poly and accompanying patients from integrated management of sick toddlers who met the inclusion criteria, as well as all prescription drugs taken. There were 30 respondents and 30 prescriptions for each sub-district health center. Data collection was done through interviews and observation of respondents and analysis of the recipe sheets. Data analysis used Mann-Whitney and Chi-square tests. The results show that the sub-district health centers have not been accredited which meets WHO recommendations for preparation time and delivery of drugs (> 3 minutes) of 77.8% and those who are 100% accredited. None of the sub-district health centers in Depok City meet WHO recommendations for the suitability of drug delivery, adequate drug labeling and patients with correct drug knowledge (= 100%). The time of preparation and delivery of drugs at the subdistrict health centers has been accredited significantly longer than those not yet accredited (p

Assessment of drug use practices among dermatology out-patients using WHO core drug use indicators

Background: Considering the economic burden the skin diseases cause owing to its high prevalence, it is of interest to periodically monitor the drug use pattern so as to increase the therapeutic efficacy, decrease adverse effects and provide feedback to prescribers. The present study thus assessed the drug use practices among dermatology outpatients in a tertiary care teaching unit in Eastern India.Methods: The study assessed drug use practices for all prescriptions of patients attending the concerned OPD using WHO core drug use indicators which consist of mainly three domains, prescribing indicators, patient care indicators and healthcare indicators.Results: Total number of drugs in 471 prescriptions was found to be 1050. Number of drugs per prescription varied from 1 to 6 with average of 2.22. The most commonly prescribed drugs were antibiotics, followed by steroids and steroidal combinations. Prescribing indicators revealed that 2.09% drugs were generic prescribing, with about 18.78% of the drugs being prescribed from the WHO essential drug list. The proportion of encounters with at least one antibiotic prescribed was 34.82%. 13.9% drugs actually dispensed from hospital supply, of which all were adequately labelled.Conclusions: Increasing dermatological prescribing has necessitated assessment of their rational usage. Promoting rational drug use policy is recommended for effective healthcare management.