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      Drug use pattern using WHO core drug use indicators in public health centers of Dessie, North-East Ethiopia

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          Abstract

          Background

          Rational drug use requires that patients receive and take medication appropriately. Though the process of diagnosis and pharmaceutical care is complex, World Health Organization (WHO)/international network for rational use of drugs (INRUD) core drug use indicators investigate drug use to minimize the hazardous effect of the drug and enhance the wise use of scares resources. This study assessed drug use patterns in health centers of Dessie town using WHO/INRUD indicators.

          Methods

          A cross-sectional study was conducted in public health centers of Dessie town. Data were retrospectively collected from 1500 prescriptions dispensed from January 1, 2018, to December 31, 2018 using WHO data collection tool to assess prescribing indicators. For patient care and health facility indicators, 600 patients and 3 health centers were prospectively reviewed. Systematic random sampling was used to select samples. Data were analyzed using the Statistical Package for the Social Sciences version 20.

          Results

          The average number of drugs per encounter was 2.1. The percentage of encounters with antibiotics and injection was 44% and 13.9%, respectively. The percentage of drugs prescribed by generic name and from an essential drug list was 98% and 100%, respectively. On average, patients spent 4.7 min for consultation and 105 s for dispensing. From 1305 prescribed drugs, 92% were dispensed, while only 4% were labeled adequately. More than half (54.8%) of patients had adequate knowledge of their medication. None of the health centers had an essential drug list. The availability of key essential medicines was 64.10%.

          Conclusion

          This study demonstrated irrational drug use practices in all healthcare facilities. Polypharmacy, antibiotics over-prescribing, short consultation and dispensing times, inadequate labeling of medicines, inadequate level of patients' knowledge about prescribed medicines, and unavailability of key drugs in stock were found to be the major problems. Continuous refreshment trainings on rational use of drugs and WHO recommendations should be given for prescribers and pharmacists. Further, we recommend studies involving large number of facilities to estimate overall prescribing practices.

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          Most cited references33

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          Assessment of drug use pattern using WHO prescribing indicators at Hawassa University teaching and referral hospital, south Ethiopia: a cross-sectional study

          Background To promote rational drug use in developing countries, it is important to assess drug use pattern using the World Health Organization (WHO) drug use indicators. The aim of this study was to assess the drug prescription patterns at the Medical Outpatient Pharmacy of Hawassa University Teaching and Referral Hospital, using some of the WHO core drug use indicators. Methods A descriptive, quantitative, and cross-sectional survey was conducted to determine the current prescribing practices at Hawassa University Teaching and Referral Hospital. The sample was selected using systematic random sampling. 1290 patient encounters were reviewed retrospectively for a 2-year period from September 2007 to September 2009. Data were collected from prescriptions and Prescription registration books retained in the pharmacy. Result The average number of drugs prescribed per encounter or mean was 1.9 (SD 0.91) with a range between 1 and 4. The percentage of encounters in which an antibiotic or injection was prescribed was 58.1% (n = 749) and 38.1% (n = 491), respectively. The Percentage of drugs prescribed by generic name and from an essential drug list was 98.7% (n=2419) and 96.6% (n=2367), respectively. The most commonly prescribed forms of antibiotics were amoxicillin (16.4%), ampicillin (15%), gentamicin (14.9%) and chloramphenicol (11.6%). On the other hand, the most commonly prescribed injections were ampicillin (21.4%), cloxacillin (13.4%), crystalline penicillin (12.4%), ceftriaxon (9.8%) gentamicin (9.8%), diclofenac (9.4%), chloramphenicol 41 (8.4%) and furosemide 25 (5.1%). Conclusion On the basis of the finding of this study, the prescribing practices for antibiotic and injection shows deviation from the standard recommended by WHO. These two commonly overused and costly forms of drug therapy need to be regulated closely. Drug use evaluation should be done for some of the antibiotics to check whether they were appropriately prescribed or not. On the other hand, polypharmacy, generic prescribing and prescribing from EDL were not found to be a problem in this study. Teaching hospitals have a special responsibility to society to promote rational prescribing by their staff and, through them, the future generations of doctors.
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            Irrational Use of Medicines—A Summary of Key Concepts

            Medicines play an integral part of healthcare delivery. However, they are expensive commodities and account for a significant proportion of overall health expenditure in most countries. Irrational use of medicines is a major challenge facing many health systems across the world. Such practices are likely to lead to poor health delivery that may put patients at risk and result in wastage of scarce resources that could have been used to tackle other pressing health needs. The concept of “rational use of medicine” can at times be confusing and not easily appreciated by patients, healthcare providers, policy makers, or the public, all of whom need to collaborate effectively to address this challenge. In this article, we summarize basic concepts such as rational medicine use, good prescribing and dispensing, and explore some of the factors that contribute to irrational use of medicines as well as potential impacts of such practices. This article has been written with the intention of offering a clear, concise, and easy to understand explanation of basic medicine use concepts for health professionals, patients, policy makers, and the public.
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              Evolution of the Global Burden of Viral Infections from Unsafe Medical Injections, 2000–2010

              Background In 2000, the World Health Organization estimated that, in developing and transitional countries, unsafe injections accounted for respectively 5%, 32% and 40% of new infections with HIV, hepatitis B virus (HBV) and hepatitis C virus (HCV). Safe injection campaigns were organized worldwide. The present study sought to measure the progress in reducing the transmission of these viruses through unsafe injections over the subsequent decade. Methods A mass action model was updated, to recalculate the number of injection-related HIV, HCV and HBV infections acquired in 2000 and provide estimates for 2010. Data about the annual number of unsafe injections were updated. HIV prevalence in various regions in 2000 and 2010 were calculated from UNAIDS data. The ratio of HIV prevalence in healthcare settings compared to the general population was estimated from a literature review. Improved regional estimates of the prevalence of HCV seropositivity, HBsAg and HBeAg antigenemia were used for 2000 and 2010. For HIV and HCV, revised estimates of the probability of transmission per episode of unsafe injection were used, with low and high values allowing sensitivity analyses. Results Despite a 13% population growth, there was a reduction of respectively 87% and 83% in the absolute numbers of HIV and HCV infections transmitted through injections. For HBV, the reduction was more marked (91%) due to the additional impact of vaccination. While injections-related cases had accounted for 4.6%–9.1% of newly acquired HIV infections in 2000, this proportion decreased to 0.7%–1.3% in 2010, when unsafe injections caused between 16,939 and 33,877 HIV infections, between 157,592 and 315,120 HCV infections, and 1,679,745 HBV infections. Conclusion From 2000 to 2010, substantial progress was made in reducing the burden of HIV, HCV and HBV infections transmitted through injections. In some regions, their elimination might become a reasonable public health goal.
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                Author and article information

                Contributors
                ahmedsolomon21@gmail.com
                Journal
                BMC Med Inform Decis Mak
                BMC Med Inform Decis Mak
                BMC Medical Informatics and Decision Making
                BioMed Central (London )
                1472-6947
                25 June 2021
                25 June 2021
                2021
                : 21
                : 197
                Affiliations
                [1 ]GRID grid.467130.7, ISNI 0000 0004 0515 5212, Department of Pharmacy, College of Health Science, , Wollo University, ; Dessie, Ethiopia
                [2 ]GRID grid.467130.7, ISNI 0000 0004 0515 5212, Pharmacy Student, , Wollo University, ; Dessie, Ethiopia
                Author information
                http://orcid.org/0000-0002-6498-8455
                Article
                1530
                10.1186/s12911-021-01530-w
                8228957
                34172067
                1827cf00-9204-4b38-a4d8-20a98d37b6fd
                © The Author(s) 2021

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 14 October 2020
                : 16 May 2021
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2021

                Bioinformatics & Computational biology
                prescribing indicator,patient care indicator,health facility indicator,ethiopia

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