Adherence to WHO/INRUD prescription indicators in public hospitals: evidence from the Ashanti Region, Ghana.

IF 3.4 3区医学 Q2 PHARMACOLOGY & PHARMACY

Therapeutic Advances in Drug Safety Pub Date : 2025-06-08 eCollection Date: 2025-01-01 DOI:10.1177/20420986251346321

Richard Delali Agbeko Djochie, Rita Owusu-Donkor, Elizabeth Modupe d'Almeida, Francis Kwadwo Gyamfi Akwah, Emmanuel Kyeremateng, Samuel Opoku-Afriyie, Cecilia Akosua Tabiri, Francis Kyei-Frimpong, Samuel Dwomoh, Francis Fordjour, Jonathan Boakye-Yiadom

{"title":"Adherence to WHO/INRUD prescription indicators in public hospitals: evidence from the Ashanti Region, Ghana.","authors":"Richard Delali Agbeko Djochie, Rita Owusu-Donkor, Elizabeth Modupe d'Almeida, Francis Kwadwo Gyamfi Akwah, Emmanuel Kyeremateng, Samuel Opoku-Afriyie, Cecilia Akosua Tabiri, Francis Kyei-Frimpong, Samuel Dwomoh, Francis Fordjour, Jonathan Boakye-Yiadom","doi":"10.1177/20420986251346321","DOIUrl":null,"url":null,"abstract":"Background: Rational prescribing optimizes medicine use, reduces costs, and improves patient outcomes. However, adherence to rational prescribing practices varies, particularly in low- and middle-income countries like Ghana, where healthcare systems differ across urban, peri-urban, and rural settings.Objectives: This study assessed adherence to WHO/INRUD prescribing indicators in public hospitals and determined each hospital's Index of Rational Drug Prescribing (IRDP).Design: A retrospective descriptive study was conducted in 25 public hospitals across rural, peri-urban, and urban settings in the Ashanti Region of Ghana.Methods: Data from 5091 patient encounters were analyzed to assess prescribing indicators, including the average number of medicines per encounter, generic prescribing, adherence to the Essential Medicines List (EML), antibiotic use, and injection prescribing. IRDP scores were calculated, and geographic comparisons were performed using analysis of variance (ANOVA), with p < 0.05 considered statistically significant.Results: No hospital met the WHO target of <2 medicines per encounter (regional average: 3.63 ± 0.62). Generic prescribing averaged 72.26%, and EML adherence was 91.85%, with no hospital achieving 100%. Antibiotic prescribing exceeded the <30% target, averaging 60.84%. Injection use aligned best with WHO standards (average: 13.42%), with 22 of 25 hospitals meeting the <20% threshold. The regional IRDP was 3.67, with rural hospitals scoring lowest (3.63), followed by peri-urban (3.64) and urban hospitals (3.81). No significant geographic differences in IRDP scores were observed (p > 0.05).Conclusion: While injection use aligns with WHO standards, gaps remain in generic prescribing, antibiotic use, and EML adherence. Strengthening prescriber training, antimicrobial stewardship programs, and policy enforcement is essential to improving prescribing practices and patient outcomes in public hospitals in the Ashanti Region.","PeriodicalId":23012,"journal":{"name":"Therapeutic Advances in Drug Safety","volume":"16 ","pages":"20420986251346321"},"PeriodicalIF":3.4000,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12146595/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Therapeutic Advances in Drug Safety","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/20420986251346321","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Rational prescribing optimizes medicine use, reduces costs, and improves patient outcomes. However, adherence to rational prescribing practices varies, particularly in low- and middle-income countries like Ghana, where healthcare systems differ across urban, peri-urban, and rural settings.

Objectives: This study assessed adherence to WHO/INRUD prescribing indicators in public hospitals and determined each hospital's Index of Rational Drug Prescribing (IRDP).

Design: A retrospective descriptive study was conducted in 25 public hospitals across rural, peri-urban, and urban settings in the Ashanti Region of Ghana.

Methods: Data from 5091 patient encounters were analyzed to assess prescribing indicators, including the average number of medicines per encounter, generic prescribing, adherence to the Essential Medicines List (EML), antibiotic use, and injection prescribing. IRDP scores were calculated, and geographic comparisons were performed using analysis of variance (ANOVA), with p < 0.05 considered statistically significant.

Results: No hospital met the WHO target of <2 medicines per encounter (regional average: 3.63 ± 0.62). Generic prescribing averaged 72.26%, and EML adherence was 91.85%, with no hospital achieving 100%. Antibiotic prescribing exceeded the <30% target, averaging 60.84%. Injection use aligned best with WHO standards (average: 13.42%), with 22 of 25 hospitals meeting the <20% threshold. The regional IRDP was 3.67, with rural hospitals scoring lowest (3.63), followed by peri-urban (3.64) and urban hospitals (3.81). No significant geographic differences in IRDP scores were observed (p > 0.05).

Conclusion: While injection use aligns with WHO standards, gaps remain in generic prescribing, antibiotic use, and EML adherence. Strengthening prescriber training, antimicrobial stewardship programs, and policy enforcement is essential to improving prescribing practices and patient outcomes in public hospitals in the Ashanti Region.

查看原文本刊更多论文

公立医院遵守世卫组织/INRUD处方指标：来自加纳阿散蒂地区的证据。

背景：合理处方优化药物使用，降低成本，改善患者预后。然而，对合理处方做法的坚持程度各不相同，特别是在加纳等低收入和中等收入国家，这些国家的医疗保健系统在城市、城郊和农村环境中存在差异。目的：本研究评估公立医院对WHO/INRUD处方指标的依从性，确定各医院合理用药指数（IRDP）。设计：在加纳阿散蒂地区农村、城郊和城市环境中的25家公立医院进行了一项回顾性描述性研究。方法：分析5091例就诊患者的数据，评估处方指标，包括每次就诊的平均药物数量、仿制药处方、对《基本药物清单》（EML）的依从性、抗生素使用和注射处方。计算IRDP评分，并采用方差分析（ANOVA）进行地理比较，p值为p。结果：没有医院达到WHO的目标（p < 0.05）。结论：虽然注射使用符合世卫组织标准，但在仿制药处方、抗生素使用和EML依从性方面仍存在差距。加强开处方者培训、抗微生物药物管理规划和政策执行对于改善阿散蒂地区公立医院的处方做法和患者治疗效果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Therapeutic Advances in Drug Safety Medicine-Pharmacology (medical)

CiteScore

6.70

自引率

4.50%

发文量

审稿时长

9 weeks

期刊介绍： Therapeutic Advances in Drug Safety delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies pertaining to the safe use of drugs in patients. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in drug safety, providing a forum in print and online for publishing the highest quality articles in this area. The editors welcome articles of current interest on research across all areas of drug safety, including therapeutic drug monitoring, pharmacoepidemiology, adverse drug reactions, drug interactions, pharmacokinetics, pharmacovigilance, medication/prescribing errors, risk management, ethics and regulation.