Background Despite medicines are a major contributor to the health and well-being of the community, irrational use of medicines is being a serious public health crisis with significant harmful implications for patients, healthcare systems, and communities as a whole. Objective This study was aimed at evaluating the rational use of medicine using the World Health Organization/Network of Rational Use of Drugs (WHO/INRUD) core drug use indicators at Teda and Azezo health centers of Gondar town, northwest Ethiopia. Methods A cross-sectional study was conducted among 1200 prescription papers retrospectively, and 60 patients prospectively at two health centers of Gondar town, northwest Ethiopia from May 01/2019 to April 30/2020. The data were collected using a standard data collection checklist. Data were analyzed using SPSS® version 24. The data were analyzed descriptively by using mean, frequency, and proportion. Results Prescribing indicators: From a total of 2595 prescribed medicines, 94% of them were prescribed by generic name; percent encounters with injection was 9.5±0.28%, percent encounters with antibiotics was 73.85±0.35%, and 100% of medicines were prescribed from the essential medicine list of Ethiopia. Patient care indicators: Only 16.7% of the patients knew the correct dosage of their medications, and 17.5% of dispensed medicines were adequately labeled. From the prescribed medications, only 77.17% were actually dispensed. Average consultation and dispensing time were 5.35 minutes and 40.24 seconds, respectively. Facility-specific indicators: Only 83.5% of key medicines were available in the health centers. Conclusion According to the WHO/INRUD core drug use indicators, rational medicine use is not achieved in terms of most components of the prescribing, patient care, and facility-specific indicators. Therefore, both health centers should work towards promoting the rational use of medicines.

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Evaluation of Rational Use of Medicine Using WHO/INRUD Core Drug Use Indicators at Teda and Azezo Health Centers, Gondar Town, Northwest Ethiopia

Aim: The prescribing pattern of furosemide helps the prescribers in the monitoring and evaluation of the drugs and helps them in recommending the necessary modifications. So the aim of the present study is to demonstrate the outpatient use of furosemide in a public hospital.
Methodology: This is a retrospective study was conducted in a public hospital in Alkharj city. The outpatient prescriptions were reviewed to demonstrate the prescription patterns of furosemide. The study included all outpatient prescriptions that contains furosemide in 2018.
Results: Furosemide was prescribed in 46.27% of diuretics prescriptions in the outpatient setting. The majority of the patients were female patients. Most of the patients were more than 39 years old. Most of the furosemide prescriptions were prescribed mainly by resident prescribers, mainly in the cardiology department.
Conclusion: Furosemide is an important medication for treating cardiovascular diseases specially in the presence of edema. It is important to increase the awareness of health care professionals and patients regarding the use of furosemide. Moreover, it is important to increase the awareness of the public regarding the importance of adherence to furosemide.

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The Outpatient Use of Furosemide in a Public Hospital

The main objective of this study is to analyze the prescribing pattern of medicine in outpatient departments of tertiary care centre in Kathmandu using World Health Organization (WHO) drug use prescribing indicators. As per WHO consideration, 100 prescriptions were taken from each outpatient departments (OPD) of Nepal medical college including Orthopedics, Obstetrics and Gynecology, Surgery, Medicine, Ophthalmology, Otorhinolaryngology, Pediatrics, Dermatology and Psychiatry. Analysis of variance (ANOVA) was used to assess the statistical significance between means between all departments. Among a total of 900, 47.7% were male and 52.3% were female. Average medicine per prescription was 2.43±0.039. Number of Medicines by generic name 76 (3.4%), antibiotics 416 (19.0%), Injection 34 (1.5%), from Essential Medicine List (EML) 1,312 (60.1%), Fixed Dose Combination (FDC) 468 (21.4%) and the polypharmacy (≥4) was 129 (14.3%). The average cost was NPR 404.72±19.3 (3.69$; 1$=109.41NPR) and duration of treatment was 16.43±0.73 days. Patient’s age had positive correlation with number of medicines (p=0.002) and negative correlation with antibiotics (p=0.988). Cost of treatment had positive correlation with number of medicines (p=0.00), EML (p=0.00), duration of treatment (p=0.00) and antibiotics (p=0.33). Average medicines, from EML, and antibiotic use were high in Otorhinolaryngology with statistical significance of difference between mean. Prescription with FDC and intravenous were significantly high in Obstetrics and Gynecology. Cost and treatment duration were significantly high in Psychiatry. Tertiary healthcares need to develop and implement specific guidelines for prescriptions writing and also should develop a system to record them.

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R. Thapa

Papers

A Study on Medicine Utilization Pattern in Outpatient Departments of Tertiary Care Centre in Kathmandu