Quality of Drug Prescription and Dispensing Practices in a Teaching Hospital in a developing country

BackgroundThe World Health Organization recommends rational drug usage to protect patient health and quality of life. Study assessed the quality of drug prescription and dispensing in a tertiary hospital. MethodsCross-sectional study with retrospective and prospective data collection underpinned by the WHO core prescribing indicators. A cluster sample of 10 clinical units and their attached pharmacies in the hospital. Six hundred prescriptions from the pharmacy over six months were randomly selected to evaluate the prescription indicators, 330 patient encounters observed for patient care indicators, and 48 randomly selected doctors to evaluate factors influencing their prescribing practices across the 10 clinics. Descriptive analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 25 and comparison done across all indicators of rational drug use. ResultsAverage drugs per encounter was 3.4 {+/-} 1.9 drugs. Antibiotics and injections were prescribed in 40.2% and 24.8% encounters respectively. Generic names were used in 43.6% and 97.1% of prescription were from the essential medicine list. Average time for consultation was 17.5 {+/-} 8.0 minutes, dispensing time was 7.7 {+/-} 3.8 minutes, 99.8% of medications were properly labelled, and 82% of patients understood the drug doses. The pharmacies stocked 93.3% of key drugs but no consultation room had the essential drug list. Only 43.7% of physicians demonstrated accurate understanding of rational drug use. ConclusionFindings on the WHO core drug indicators showed poor quality of drug prescription. Brand prescription, polypharmacy, and antibiotic overuse observed requires intensifying training and monitoring on rational drug use.