Drug, Healthcare and Patient Safety (Sep 2023)
Evaluation of Rational Drug Use Based on WHO/INRUD Core Drug Use Indicators in a Secondary Care Hospital: A Cross-Sectional Study in Western Uganda
Abstract
Narayana Goruntla,1 Joackim Ssesanga,1 Bhavana Reddy Bommireddy,2 Durga Prasad Thammisetty,3 Veerabhadrappa Kasturi Vishwanathasetty,4 Joseph Obiezu Chukwujekwu Ezeonwumelu,1 Sarad Pawar Naik Bukke5 1Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, Kampala International University, Western Campus, Ishaka, Uganda; 2Research Scholar, Department of Pharmacy Practice, Raghavendra Institute of Pharmaceutical Education and Research (RIPER) – Autonomous, Anantapur, Andhra Pradesh, India; 3Department of Pharmacy Practice, Sri Padmavathi School of Pharmacy, Tirupati, Andhra Pradesh, India; 4Department of Pharmacognosy and Pharmaceutical Chemistry, School of Pharmacy, Kampala International University, Western Campus, Ishaka, Uganda; 5Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, Kampala International University, Western Campus, Ishaka, UgandaCorrespondence: Narayana Goruntla; Joackim Ssesanga, Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, Kampala International University, Western Campus, Ishaka, Uganda, Tel +256 760060453, Email [email protected]; [email protected]; [email protected]: Rational drug use (RDU) promotes safe, efficient, and cost-effective utilization of medicines in hospital settings. The aim of this study was to assess rational drug use based on the World Health Organization (WHO) and the International Network for Rational Use of Drugs (INRUD) core drug use indicators.Patients and Methods: This prospective, descriptive, hospital-based cross-sectional study was conducted among patients attending the Outpatient Department of a secondary care hospital located in the Sheema District of Western Uganda. A total of 450 prescriptions were prospectively collected from eligible patients and subjected to evaluation by using the WHO/INRUD core drug use indicators (prescribing, patient care, and health-facility indicators).Results: The average number of drugs prescribed per encounter was found to be 3.2 (optimal value=1.6– 1.8). The percentages of drugs prescribed by their generic name (90.48%) and from the Essential Medicine List (96.23%) were close to the WHO reference (100%). The percentage of antibiotics (66.22%) and injections (25.22%) per encounter exceeded the WHO standards (antibiotics=20.0– 26.8; injections=13.4– 24.1). Among the patient-care indicators, the average consultation time (5.41 minutes), average dispensing time (131.03 seconds), percentage of medicines dispensed (76.11%), percentage of medicines adequately labeled (59.74%), and percentage of patients with dosage knowledge (49.50%) did not meet the WHO reference. Facility indicators such as the percentage of key medicines available in the stock (66.67%) did not conform to the WHO optimal value. The hospital made the EML hundred percent available to all practitioners.Conclusion: The study concludes that the prescribing, patient care, and health facility indicators at Sheema District Secondary Care Hospital deviate from the optimal values recommended by the WHO. Therefore, this study indicates a need for improvement on these indicators and a requirement for the ongoing educational initiatives focused on rational drug prescribing, dispensing, and patient use in order to comply with the standards set by the WHO.Keywords: drug use pattern, health facility, irrational, patient care, prescribing pattern, rational, Uganda, WHO drug use indicators
