Evaluation of Drug Prescription Pattern Using WHO Prescribing Indicators in Libya: A Cross-Sectional Study
DOI:
https://doi.org/10.31351/vol32iss1pp266-273Keywords:
Antibiotic, Rationality, Prescription, PatternAbstract
Background and aims. The improper use of drugs due to irrational prescriptions is a common problem in Libya. This study aimed to investigate the prescribing pattern and predictors of antibiotic prescription in primary health care facilities in three districts (east, west, and south) in Libya. Methods. In this retrospective study, 484 prescriptions were examined. World Health Organization-recommended indicators for rational use were examined (WHO): e.g., the percentage of prescriptions covering antibiotics, prescription of injections, and prescription of drugs by a generic name and from a national essential drug list, as well as the average number of drugs per prescription, were all considered. Results. The average number of drugs per prescription was 4.72, with a maximum of 7 drugs in a prescription, and the percentage of prescriptions involving antibiotics and injections was 30.4% and 10.5%, respectively. There were 28.6% drugs prescribed by their generic name and 82.8% were retrieved from the essential drugs list. The most common category of medicines were 18.9% antibiotics, 18.3% antihypertensives, and 15.7% multivitamins and minerals. While the lowest consumed drugs were steroids 2.5%. Conclusion. There was some irrational drug prescribing, particularly with regard to injections and antibiotics. It is suggested that physicians participate in continuing education programs on rational prescribing for various medical indications.
References
Bakassas I, lunde P. National drug policies: the need for drug utilization studies. Trends pharmacol sci. 1986;7:331-4
Nehru M, Kohli K, Kapoor B, Sadhotra P, Chopra V, Sharma R. Drug utilization study in outpatient ophthalmology department of government medical college Jammu. JK Sciences. 2005;7:149-51
WHO publication. What is drug utilization research and why is it needed? Introduction to drug utilization research. 2003;8
Desalegn A. Assessment of drug use pattern using WHO prescribing indicators at Hawassa University teaching and referral hospital, south Ethiopia: a cross-sectional study. BMC Health Serv Res. 2017;13(178):1–6
WHO. World Health Organization Promoting Rational Use of Medicines: Core Components. WHO Policy and Perspectives on Medicine No. 5 Document WHO/EDM/2002.3. Geneva: WHO; 2002.
Ofori-asenso R, Brhlikova P, Pollock AM. Harvard Medical School and Harvard Pilgrim Health, World Health Organization. Using indicators to measure country pharmaceutical situations Fact Book on WHO Level I and Level II monitoring indicators. BMC Public Health. 2016;16(724):1–14
Sharif S, Al-Shaqra M, Hajjar H, Shamout A, Wess L. Patterns of drug prescribing in a hospital in dubai, United arab emirates. Libyan J Med. 2008 Mar 1;3(1):10-2. doi: 10.4176/070928.
Meyer TA. Improving the quality of the order-writing process of inpatient orders and outpatient prescriptions. Am J Health System Pharmacy. 2000; 57(Suppl.4):S18-2
Safe Writing. In: Lacy CF, Armstrong LL, Goldman, MP, Lance, LL, Eds. Drug information handbook, 9th ed. Cleveland, Ohio, Lexi-Comp. 2001:12
Atia A. Prescribing errors and the need for prescription separation in Libya. Libyan J Med Sci 2018;2:1-2.
Atia A. Physician trends of drug prescription in Libya: A pharmacoepidemiological study. Pharmacophore 2019;10(3):33-38.
World Health Organization. How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators. EDM Research series No. 007. WHO, Geneva Switzerland. WHO/DAP/93.1. 1993.
Sherif F. An Evaluation of the Prescribing Patterns of Drugs in Libya. Jam. Med. J, 2008;8(3):203-206.
Bosu WK, Ofori-Adjei D. An audit of prescribing practices in health care facilities of the Wassa West district of Ghana. West Afr J Med. 2000;19(4):298-303.
Mengistu G, Misganaw D, Tsehay T, Alemu BK, Bogale K. Assessment of Drug Use Pattern Using WHO Core Prescribing Indicators at Outpatient Settings of Governmental Hospitals in Dessie Town. Drug Healthc Patient Saf. 2020;12:237-244. doi: 10.2147/DHPS.S266749.
Holloway K, Ivanovska V, Wagner A, Vialle-Valentin C, Ross-Degnan D. Have we improved use of medicines in developing and transitional countries and do we know how to? Two decades of evidence. Tropical Med Int Health. 2013;18(6):656–64.
Banerjee I, Bhadury T. Prescribing pattern of interns in a primary health center in India. J Basic Clin Pharm. 2014;5(2):40–3.
Yousif BME, Supakankunti S. General practitioners’ prescribing patterns at primary healthcare centers in National Health Insurance, Gezira, Sudan. Drugs Real World Outcomes. 2016;3(3):327–32.
Akl OA, El Mahalli AA, Elkahky AA, Salem AM. WHO/INRUD drug use indicators at primary healthcare centers in Alexandria, Egypt. Journal of Taibah University Medical Sciences. 2014;9(1):54–64.
El Mahalli A. WHO/INRUD drug prescribing indicators at primary health care centres in eastern province. Saudi Arabia East Mediterr Health J. 2012;18(11):1091–6.
Isah A, Ross-Degnan D, Quick J, Laing R, Mabadeje A. The development of standard values for the WHO drug use prescribing indicators ICUM/EDM/ WHOhttp:/ /archives.who.int/ prduc2004 /rducd/ ICIUM_Posters /1a2_txt.htm
Mulwa, Nicholas C., George O. Osanjo, Stanley Ndwigah, Albert N. Kaburi and Gichuru Muriuki. “Patterns of Prescribing Practices in Makueni County Referral Hospital, Kenya. African J Pharm Therap. 2015;4(4):161-168.
Lgbisks T, Joseph O. Drug prescription pattern in a Nigerian Tertiary Hospital,” Tropical J Pharm Res. 2012;11(1):146-152.
Bodenschatz C, Talaat M, Kandeel A, Lohiniva A, Radwan E, Mahoney F. Injection prescribing patterns in public health care facilities in Egypt. East Med health J. 2009;15(6):1440-1448.
Jahan S, Al-Saigul AM, Hamdelsseed SA. Primary health care physicians' prescribing patterns for children under five in Qassim, Saudi Arabia. Prim Health Care Res Dev. 2019 Jun 25;20:e89. doi: 10.1017/S1463423619000148.
Atif M, Sarwar MR, Azeem M, Naz M, Amir S, Nazir K. Assessment of core drug use indicators using WHO/INRUD methodology at primary healthcare centers in Bahawalpur, Pakistan. BMC Health Serv Res. 2016;16:684.
Adebayo E, Hussain N. Pattern of prescription drug use in Nigerian army hospitals. Ann Afr Med. 2010;9(3):152-158.
Cheraghali A, Solemani F, Behmanesh Y, Habibipour F, Ismaeilzadeh A, Nikfar S, Rahimi W. Physicians' attitude toward injectable medicines. J Pharmacol Toxicol. 2006;1(1):33–9.
Cole CP, James PB, Kargbo AT. An evaluation of the prescribing patterns for under-five patients at a Tertiary Paediatric Hospital in Sierra Leone. J Basic Clin Pharm. 2015 Sep;6(4):109-14. doi: 10.4103/0976-0105.168051.
Mansour N, El-Hefnawy M. Rational Use of Drugs in Egypt According to the Standard WHO Prescribing Indicators: Pilot Baseline Situational Analysis. Rese Rev J Hosp Clin Pharmacy. 2017;3(1):48–53.
Otoom S, Culligan K, Al-Assoomi B, Al-Ansari T. Analysis of drug prescriptions in primary health care centres in Bahrain. East Mediterr Health J. 2010;16(5):511-5.
Dong L, Yan H, Wang D. Drug prescribing indicators in village health clinics across 10 provinces of western China. Fam Pract. 2011;28(1):63–7.
Atia, A.; Gismallah, M.; Almogadmi, E. Influence of Medical Representatives on Prescribing Practices in Tripoli. J. Adv. Pharm. Res. 2022, 6 (1), 28-33. DOI: 10.21608/aprh.2021.95357.114
Bilal AI, Osman ED, Mulugeta A. Assessment of medicines use pattern using World Health Organization's Prescribing, Patient Care and Health facility indicators in selected health facilities in eastern Ethiopia. BMC Health Serv Res. 2016;16:144. doi: 10.1186/s12913-016-1414-6.
Kasabi GS, Subramanian T, Allam RR, Grace CA, Reddy S, Murhekar MV. Prescription practices & use of essential medicines in the primary health care system, Shimoga district, Karnataka, India. Indian J Med Res. 2015 Aug;142(2):216-9. doi: 10.4103/0971-5916.164261.
Mahmood A, Elnour AA, Ali AA, Hassan NA, Shehab A, Bhagavathula AS. Evaluation of rational use of medicines (RUM) in four government hospitals in UAE. Saudi Pharm J. 2016;24(2):189-96.
Al-Azayzih A, Al-Azzam SI, Alzoubi KH, Shawaqfeh M, Masadeh MM. Evaluation of drug-prescribing patterns based on the WHO prescribing indicators at outpatient clinics of five hospitals in Jordan: a cross-sectional study . Int J Clin Pharmacol Ther. 2017;55(5):425-432. doi: 10.5414/CP202733.
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Iraqi Journal of Pharmaceutical Sciences ( P-ISSN 1683 - 3597 E-ISSN 2521 - 3512)
This work is licensed under a Creative Commons Attribution 4.0 International License.
