Evaluation of the prescribing practice using WHO core prescribing indicators in Hiwot Fana Specialized University Hospital, Harar, eastern Ethiopia
Background: Drugs are important component of health care and play a critical role in saving life. Drug use in health facility is a complex subject involving physician, patient and dispenser and hence is directly affected by prescribing, dispensing and patient use of drugs. Â The study is, therefore, aimed to evaluate drug prescribing practice using WHO prescribing indicators in Hiwot Fana Specialized University Hospital (HFSUH), Harar, Ethiopia.
Method: A retrospective cross sectional study was carried out to determine current prescribing practice in HFSUH outpatient pharmacy department, Harar, from January 20-February 20, 2016. As per the WHO guidelines, 600 prescription papers were selected using systematic random sampling and reviewed with the help of observational checklist. The data were entered and processed with SPSS version 16. Finally, the data were evaluated using WHO criteria.Â
Result: The average number of drugs prescribed per encounter was 1.7. The percentage of encounters in which an antibiotic or injection was prescribed was 343 (57.2%) and 354 (59%), respectively. The percentage of drugs prescribed by generic name and from an essential drug list (EDL) was found to be 954 (92.1%) and 708 (68.94%), respectively.
Conclusion: On the basis of the findings, the prescribing practices for antibiotic use; injection use; and prescribing from EDL showed a great deviation from the standards recommended by WHO. These two commonly overused and costly forms of drug therapy need to be regulated closely. In addition, prescribing practice should be limited to EDL of the country.
Key words: WHO, core prescribing indicators, prescribing practice, HFSUH
2. Vooss AT, Diefenthaeler HS. Evaluation of prescription indicators established by the WHO in GetÃºlio Vargas-RS. Braz J Pharm Sci. 2011;47 (2): 385-90.
3. WHO (2000). Medicines Strategy: Framework for action Essential drugs and Medicines policy 2000â€“2003. Geneva (WHO/EDM/2000.1).
4. WHO (1995). The use of Essential Drugs. 6th Report of the Expert Committee. Geneva. WHO Technical Report Series 850.3. Available at whqlibdoc.who.int/trs/WHOTRS_850.pdf
5. FMHACA of Ethiopia (2012). Manual for Medicines Good Prescribing Practice: 2nd edition. Addis Ababa. Available at www.fmhaca.gov.et/documents/Medcines
6. Sosola AG. An assessment of prescribing and dispensing practices in public health facilities of Southern Malawi, Malawi University. 2007 available at apps.who.int/medicinedocs/documents/s21439en/s21439en.pdf
7. Ministry of Health (1994). Master plan for the Ethiopian national drugs programme, Addis Ababa.
8. DACA (2009). Antimicrobials use, resistance and containment baseline survey syntheses of findings, Addis Ababa, Ethiopia.
9. Laing RO, Hogerzeil HV, Ross-Degnan D. Ten recommendations to improve use of medicines in developing countries. Health policy and planning. 2001;16(1):13-20.
10. WHO. Promoting Rational Use of Medicines: Core Components - WHO Policy Perspectives on Medicines, No. 005, September 2002 at http://apps.who.int/medicinedocs/en/d/Jh3011e/
11. Mallet HP, Njikam A, Scouflaire SM. Evaluation of prescription practices and of the rational use of medicines in Niger. Sante (Montrouge, France). 2000;11(3):185-93.
12. Desalegn AA. Assessment of drug use pattern using WHO prescribing indicators at Hawassa University teaching and referral hospital, south Ethiopia: a cross-sectional study. BMC health services research. 2013;13(1):1.
13. Berhanu D, Molla F, Assen A, Melkam W, Abrha S, Masresha B, et al. Evaluation of drugs utilization pattern using WHO prescribing indicators in Ayder referral hospital, Northern Ethiopia. IJPSR. 2015; 6 (2): 343-347.
14. Desta Z, Abula T, Gebre-Yohannes A, Worku A. Prescribing patter for outpatients in three hospitals in north-west Ethiopia. J.Health Dev. 2002;16(2): 183-189.
15. WHO and MOH. Assessment of the Pharmaceutical Sector in Ethiopia. Addis Ababa.2003. Available at http://www.who.int/medicines/areas/coordination/ethiopia_pharmaceutical.pdf.
16. Lenjisa JL, Fereja TH. A Retrospective Analysis of Prescribing Practice Based on WHO Prescribing Indicators at Four Selected Hospitals of West Ethiopia: Policy Implication. East and Central African Journal of Pharmaceutical Sciences. 2013;16(3):69-74.
17. Adebayo ET and Hussain NA. Pattern of prescription drug use in Nigerian army hospitals. Annals of African Medicine. 2010; 9 (3):152-8
18. Prasad PS, Rudra JT, P Vasanthi, Sushitha U. Assessment of drug use pattern using World Health Organization core drug use indicators at Secondary Care Referral Hospital of South India. CHRISMED Journal of Health and Research 2015; 2(3): 223-8
19. Abdulahi M, Shiferaw T. Pattern of prescription in Jimma Hosptial. Ethiop J Health Dev.1997; 11(3): 263â€“267.
20. Reddy PV., Ravichandran V and Shanmugasundaram P. evaluation of drug use pattern in gynecology department using WHO prescribing indicators, Int J Pharm Bio Sci 2015; 6(4): 83 - 88
21. Ministry of Health/Zimbabwe Essential Drugs Action Programme: Essential Drugs Survey. In How to investigate drug use in health facilities. WHO:Geneva; 1993. 74(WHO/DAP/93.1)
22. Dilbato DD, Kuma ZG, and T/Mariam S. A base line survey on prescribing indicators and the underlying factors influencing prescribing in southern Ethiopia. Ethiopian Journal Health Development. 1998; 12(2): 87-93.
23. Admassie E, Begashaw B and Hailu W. Assessment of drug use practices and completeness of prescriptions in Gondar University Teaching Referral Hospital. International journal of pharmaceutical sciences and research. 2013; 4 (1): 265-275.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).