WHO/INRUD Drug Prescribing Indicators in the Emergency Ward of a Teaching Hospital, South East of Iran
Abstract
Background: Rational drug use is an important issue in all healthcare settings. Core drug use indicators have been developed by World Health Organization/ International Network for Rational Use of Drugs (WHO/INRUD). The prescribing indicators measure healthcare providers’ performance in five key areas of drug usage. The aim of this study was to evaluate WHO/INRUD indicators of prescribing in emergency ward of a teaching hospital.
Methods: This descriptive cross-sectional study was carried out in Emergency Ward of teaching hospital from March 2022 – March 2023. A standard prescribing indicators form was utilized to collect the required data using WHO drug prescribing indicators. Besides the rate of intravenous fluids and narcotic analgesics administration was evaluated. Index of rational drug prescribing (IRDP) was also calculated for each month and the mean of 12 IRDPs represent the emergency ward IRDP. Descriptive statistics were used for analysis.
Results: Antibiotics were prescribed in 34% of studied prescriptions and ceftriaxone was the most widely used antibiotic (33.8%). Index of rational drug prescribing (IRDP) was 0.73 for polypharmacy, 0.93 for generic name prescribing, 0.88 for antibiotic prescribing, 0.1 for injectable drug use and 1 for formulary-based drug prescription. Total IRDP for the emergency ward was 3.64 (from optimal value of 5). IV fluids and narcotics were prescribed in 61.1% and 8.3% of studied prescription respectively.
Conclusion: We concluded that although our overall IRDP value is below the WHO standard but it is about other neighbor countries. Our condition regarding IV drug administration showed a huge difference with WHO standards. It shows we need more input and regulations in this regard.
2. Medicines: rational use of medicines. Fact sheet No. 338. World Health Organization [online] (http://www.who.int/mediacentre/factsheets/fs338/en/, accessed 16 September 201
3. Zarmba S. Uganda national communication strategy for promoting rational use of medicine. Kampala, Uganda, Ministry of Health, 2009 (http://apps.who.int/medicinedocs/documents/s16511e/s16511e.pdf, accessed 16 September 2012)
4. Rational use of medicines by prescribers and patients. Geneva, World Health Organization, 2005.
5. Bhartiy SS, Shinde M, Nandeshwar S, Tiwari SC. Pattern of prescribing practices in the Madhya Pradesh, India. Kathmandu Univ Med J (KUMJ). 2008;6(1):55-9.
6. Asif I. Irrational use of medicine: a threat to patient community. Ezine [online article] (http://ezinearticles. com/?Irrational-Use-of-Medicines---A-Threat-to-PatienCommunity&id=3144554, accessed 16 September 2012).
7. El Mahalli AA. WHO/INRUD drug prescribing indicators at primary health care centres in Eastern province, Saudi Arabia. East Mediterr Health J. 2012;18(11):1091-6.
8. 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.
9. Ahmadi F, Zarei E. Prescribing patterns of rural family physicians: a study in Kermanshah Province, Iran. BMC Public Health. 2017;17(1):908.
10. Safaeian L, Mahdanian AR, Hashemi-Fesharaki M, Salami S, Kebriaee-Zadeh J, Sadeghian GH. General physicians and prescribing pattern in Isfahan, Iran. Oman Med J. 2011;26(3):205-6.
11. Bimo. Report on Nigeria field test. INRUD News.1992;3:9–10.
12. Fattouh R, Abu Hamad B. Impact of using essential drug list: analysis of drug use indicators in Gaza Strip. East Mediterr Health J. 2010;16(8):886-92.
13. Guidelines on the use of international nonproprietary names (INNs) for pharmaceutical substances. Geneva, World Health Organization, 1997 (http://apps.who.int/medicinedocs/en/d/Jh1806e/, accessed 18 September 2012).
14. 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(1):684
15. Ofori-Asenso R, Brhlikova P, Pollock AM. Prescribing indicators at primary health care centers within the WHO African region: a systematic analysis (1995-2015). BMC Public Health. 2016; 16:724.
16. Karimi A, Haerizadeh M, Soleymani F, Haerizadeh M, Taheri F. Evaluation of medicine prescription pattern using World Health Organization prescribing indicators in Iran: A cross-sectional study. J Res Pharm Pract. 2014;3(2):39-45.
17. Hossain MJ, Jabin N, Ahmmed F, Sultana A, Abdur Rahman SM, Islam MR. Irrational use of antibiotics and factors associated with antibiotic resistance: Findings from a cross-sectional study in Bangladesh. Health Sci Rep. 2023;6(8):e1465.
18. Awad A, Al-Saffar N. Evaluation of drug use practices at primary healthcare centers of Kuwait. Eur J Clin Pharmacol. 2010;66(12):1247-55.
19. Naseeb TA, Nasser MA. Drug prescribing indicators in primary health care centers in Bahrain. Saudi Med J. 2005;26(9):1436-8.
20. Atif M, Azeem M, Sarwar MR, et al. WHO/INRUD prescribing indicators and prescribing trends of antibiotics in the Accident and Emergency Department of Bahawal Victoria Hospital, Pakistan. Springerplus. 2016;5(1):1-7.
21. Kim J, De Jesus O. Medication Routes of Administration. 2023 Aug 23. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–.
22. Vlahovic-Palcevski V, Morovic M, Palcevski G. Antibiotic utilization at the university hospital after introducing an antibiotic policy. Eur J Clin Pharmacol. 2000;56(1):97-101.
23. Mahendrakumar BJ, Sowmya M, Uma Maheswari D, Hymavathi R, Ramesh S. Hospital Formulary: An Overview Indian Journal of Pharmacy Practice. 2013; 6(1).
24. 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;142(2):216-9.
| Files | ||
| Issue | Vol 12, No 2 (Spring 2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/jpc.v12i2.16186 | |
| Keywords | ||
| Prescribing Indicators Emergency Drug Use Evaluation | ||
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