Evaluation of Prescribing Practices at Thika Level 5 Hospital Outpatient Department
This study assesses prescribing practices at Thika Level 5 Hospital's outpatient department using WHO prescribing indicators. It identifies areas of concern to enhance appropriate medicine use and aid future research strategies. Findings will guide feedback to prescribers for improved rational prescribing.
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EVALUATION OF PRESCRIBING PRACTICES AT THIKA LEVEL 5 HOSPITAL OUTPATIENT DEPARTMENT USING THE WORLD HEALTH ORGANIZATION PRESCRIBING INDICATORS Allan Tulienge, BPharm, JKUAT 26/11/2021
INTRODUCTION What is rational use of drugs? WHO: > half of all medicines in the world are prescribed/dispensed/sold inappropriately. Over-use & inappropriate use of medicines wastes resources and also results in significant patient harm. A study of prescribing practices: important tool for monitoring of drug use.
PROBLEM STATEMENT In Kenya & other developing and transitional countries, routine monitoring of medicine use is often lacking. Data on prescribing practices at Thika Level 5 Hospital and other government hospitals in Kenya? An evident gap exists. Kisengi (2013): Irrational use of drugs at Thika Level 5 Hospital. Constant monitoring of drug use at the hospital is a prerequisite for promotion of rational use of medicines.
JUSTIFICATION This study aimed to provide this much-needed data. Aiding in identifying areas of concern and providing feedback to prescribers at the hospital, in order to enhance the appropriate use of medicines. The findings of this study will help in the development of future research strategies and initiatives to improve the rationality of prescribing at the hospital.
OBJECTIVES Broad objective: To evaluate prescribing practices at TL5H outpatient department between 19thApril 2021 and 27thMay 2021 using WHO prescribing indicators. Specific objectives: 1.To determine average number of drugs per encounter. 2.To determine percentage of drugs prescribed by generic name. 3.To determine percentage of encounters with an antibiotic prescribed. 4.To determine percentage of encounters with an injection prescribed. 5.To determine percentage of drugs prescribed from the Kenya Essential Medicines List 2019..
METHODOLOGY Study Site : Thika Level 5 Hospital, Thika town, Kiambu County, Kenya. Study Design: descriptive, cross-sectional study as per WHO prescribing indicators for primary healthcare facilities. Retrospective analysis of all the prescriptions retained at the outpatient pharmacy from the period 19thApril 2021 to 27thMay 2021 was done.
CONCLUSION All but one of the indicators showed deviation from the optimal values recommended by WHO. This indicated irrational prescribing of drugs at the hospital, particularly evidenced by polypharmacy, failure to prescribe drugs by their international non-proprietary names, overprescribing of antibiotics and prescribing of drugs not contained in the Kenya Essential Medicines List 2019. Prescribing of injections was however acceptable.
RECOMMENDATIONS Further studies to identify the reasons for the observed practices. Relevant interventions subsequently implemented to address any irrational prescribing practices identified. CME on rational prescribing of medicines to the prescribers. Systems of supervision, audit and feedback on prescribing at TL5H. Investigation of drug use in the inpatient department as well.
