W. Mudenda, E. Chikatula, E. Chambula, B. Mwanashimbala, M. Chikuta, F. Masaninga, P Songolo, B. Vwalika, J.S. Kachimba, J. Mufunda, B. Mweetwa
Background: There is paucity of data on rational drug use studies at tertiary hospitals in Zambia. The aim of this study was to assess the extent of rational drug use at the adults and paediatrics outpatient departments of the University Teaching Hospital (UTH) using World Health Organization (WHO) standardized drug-use indicators.
Methods: Cross-sectional, descriptive, retrospective study of prescription encounters, selected using systematic random sampling methods was conducted at the adult and paediatric outpatient departments of UTH. WHO format of core and complimentary drug use indicators were used to collect prescribing indicators, patient care data which included consultation time, dispensing time and knowledge of correct dosage.
Results: A total of 1486 drugs encounters were prescribed from both adult and paediatric outpatient wings in 2015. The average number of drugs per prescription was 2.5(SD±1.58), with a range of 1 to 7 drugs per prescription. The antibiotic and injection-prescribing rate was 53.7% and 11.8%respectively. Generic prescribing was at 56.1%. Percentage of drugs prescribed from the Zambia Essential Medicines List (ZEML) was 98.1%.
Average consulting and dispensing time was 9.5 minutes and 1.3 minutes respectively. Percentage of patients with knowledge of correct dosing schedule was 78.9%. Labelling of medicines was adequate. All consultation rooms did not have Standard Treatment Guidelines (STG's) or any reference literature and were not connected to the internet.
Conclusion: Low rate of injection prescribing was rational but consultation times were shorter than recommended and therefore irrational. High rate of antibiotic prescribing was irrational going by WHO standards for health facilities and this could lead to microbial resistance. Brand name prescribing was also irrational and common. Prescribing outside the ZEML was minimal and rational.