{"title":"Rational Drug Use Evaluation Based on World Health Organization Core Drug Use Indicators in Ethiopia: A Systematic Review.","authors":"Birye Dessalegn Mekonnen, Mekuanent Zemene Ayalew, Asnakew Asres Tegegn","doi":"10.2147/DHPS.S311926","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Rational use of medicines plays a vital role in avoiding preventable adverse drug effects, maximizing therapeutic outcomes with promoting patient adherence, and minimizing the cost of drug therapy. Irrational use of drugs is often observed in countries with weak health care systems. No review has been done that systematically expresses rational drug use practice based on the three WHO core drug use indicators in Ethiopia. Thus, this study was aimed to review systematically the prescribing, health-facility, and patient-care indicators based on WHO core drug use indicators in Ethiopia.</p><p><strong>Methods: </strong>A systematic article search was conducted in different electronic databases including PubMed/ MEDLINE, the Cochrane Library, EMBASE, Web of Science, POPLINE, the Global Health, and Google scholar. Quality assessment was conducted using Newcastle-Ottawa quality assessment scale. Studies were synthesized and grouped in to prescribing, patient care and health facility indicators.</p><p><strong>Results: </strong>From a total of 6239 articles, 21 studies were found suitable for the review. The highest average number of drugs per encounter was 2.5 while the lowest was 0.98. The percentage of generic drug use was ranged from 70.5% to 100%. The highest percentage of encounters with an antibiotic was 85%. The lowest percentage of drugs prescribed from essential drugs list was 81.4%. The highest percentage of drugs actually dispensed and adequately labeled was 96.16% and 96.25%, respectively.</p><p><strong>Conclusion: </strong>This study showed that the practice of rational drug use varied across region of the country. The average number of drugs per prescription, percentage of drugs encounter with antibiotics, drugs prescribed by their generic name, average consultation time, average dispensing time, percentage of drugs adequately labeled, and availability of essential drugs showed deviation from the standard recommended by WHO. Thus, provision of regular training for prescribers and pharmacists, and ensuring the availability of essential drugs should be encouraged.</p>","PeriodicalId":11377,"journal":{"name":"Drug, Healthcare and Patient Safety","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2021-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/45/2c/dhps-13-159.PMC8326223.pdf","citationCount":"12","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug, Healthcare and Patient Safety","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2147/DHPS.S311926","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
引用次数: 12
Abstract
Background: Rational use of medicines plays a vital role in avoiding preventable adverse drug effects, maximizing therapeutic outcomes with promoting patient adherence, and minimizing the cost of drug therapy. Irrational use of drugs is often observed in countries with weak health care systems. No review has been done that systematically expresses rational drug use practice based on the three WHO core drug use indicators in Ethiopia. Thus, this study was aimed to review systematically the prescribing, health-facility, and patient-care indicators based on WHO core drug use indicators in Ethiopia.
Methods: A systematic article search was conducted in different electronic databases including PubMed/ MEDLINE, the Cochrane Library, EMBASE, Web of Science, POPLINE, the Global Health, and Google scholar. Quality assessment was conducted using Newcastle-Ottawa quality assessment scale. Studies were synthesized and grouped in to prescribing, patient care and health facility indicators.
Results: From a total of 6239 articles, 21 studies were found suitable for the review. The highest average number of drugs per encounter was 2.5 while the lowest was 0.98. The percentage of generic drug use was ranged from 70.5% to 100%. The highest percentage of encounters with an antibiotic was 85%. The lowest percentage of drugs prescribed from essential drugs list was 81.4%. The highest percentage of drugs actually dispensed and adequately labeled was 96.16% and 96.25%, respectively.
Conclusion: This study showed that the practice of rational drug use varied across region of the country. The average number of drugs per prescription, percentage of drugs encounter with antibiotics, drugs prescribed by their generic name, average consultation time, average dispensing time, percentage of drugs adequately labeled, and availability of essential drugs showed deviation from the standard recommended by WHO. Thus, provision of regular training for prescribers and pharmacists, and ensuring the availability of essential drugs should be encouraged.
背景:合理用药在避免可预防的药物不良反应、提高患者依从性、最大化治疗效果和最小化药物治疗成本方面起着至关重要的作用。在卫生保健系统薄弱的国家经常观察到不合理的药物使用。没有根据世卫组织在埃塞俄比亚的三个核心药物使用指标系统地表达合理药物使用做法的审查。因此，本研究旨在根据世卫组织在埃塞俄比亚的核心药物使用指标系统地审查处方、卫生设施和患者护理指标。方法:系统检索PubMed/ MEDLINE、Cochrane Library、EMBASE、Web of Science、POPLINE、the Global Health、Google scholar等电子数据库中的文章。采用纽卡斯尔-渥太华质量评价量表进行质量评价。对研究进行了综合，并按处方、病人护理和卫生设施指标进行了分组。结果:从总共6239篇文章中，发现21项研究适合本综述。每次接触药物的平均数量最高为2.5，最低为0.98。仿制药使用率为70.5% ~ 100%。接触抗生素的最高比例为85%。基本药物目录中药品使用比例最低，为81.4%。实际配药和充分标注的药品比例最高，分别为96.16%和96.25%。结论:本研究表明，全国各地合理用药实践存在差异。每张处方的平均药物数量、遇到抗生素的药物百分比、按其通用名开具的药物、平均咨询时间、平均调剂时间、充分贴有标签的药物百分比以及基本药物的可得性均与世卫组织建议的标准存在偏差。因此，应鼓励对开处方者和药剂师提供定期培训，并确保基本药物的供应。
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