Prescribing pattern of medications prescribed to outpatients based on WHO prescribing indicators in Ethiopia: A systematic review and meta-analysis of observational studies

Abstract

Poor prescribing pattern is observed and become a serious problem in the world including developing countries. In Ethiopia, several studies showed that health care institutions did not meet WHO prescribing indicators and the prescribing pattern is not satisfactory in the health care institutions. This study aimsto review the prescribing pattern of medications prescribed to outpatients based on WHO prescribing indicators in Ethiopia. Literature search was performed through PubMed/MEDLINE, Google Scholar, and Research Gate from July 5-30, 2019. A standard data extraction format was used to collect important data from the included studies. Open meta analyst advanced software was used for analyses of the pooled estimate of outcome measures and subgroup analysis. Der Simonian and Laird’s random-effect models were applied for the analyses at 95% confidence level. I2 statistics were used to assess heterogeneity of studies. The presence of publication bias was assessed with comprehensive meta-analysis version 3 software and presented with a funnel plot. P-value of less than 0.05 was considered as statistically significant. The results revealed that a total of 13 studies with 33,567 drugs from 15,305 prescriptions were included for systematic review and meta-analysis. The results of prescribing indicators were 1.96, 93.0, 36.2, 18.3 and 94.8% for average number of drugs per prescription, percentage of drugs prescribed by generic name, percentage of drugs encounter with antibiotics, percentage of drugs encounter with injection and for the percentage of medicines prescribed from essential drug list respectively. Therefore, the prescribing pattern of Ethiopia is below WHO standard level. Key words: Prescribing pattern, prescribing indicators, Ethiopia.