Abstract:
Irrational use of drugs is a major health problem whose consequences include
ineffective treatment, unnecessary prescription, development of resistance to
antimicrobials, adverse effects and economic burden to the patients. The rational use
of antibacterial agents is being increasingly recognized as an important contribution
to control the worldwide emergence of bacterial resistance, to minimize the side
effects and to reduce the cost of the treatment. A study of prescription patterns is an
important tool to determine rational drug therapy and maximize utilization of
resources. Despite the grave consequences about the irrational use of medicines in
public facilities, there is limited data available about the appropriate or inappropriate
prescription practices in government hospitals in Kenya. The general objective of
this study therefore was to assess medicine use practices by health care workers by
using World Health Organization prescribing and patient care indicators in Mbagathi
District Hospital outpatient department. Specific objectives were to determine the
number of medicines per prescription, to determine what proportions were
antibiotics, injectables, prescribed using their generic names and from the essential
medicine list. The study also determined what proportion of the prescribed drugs
were actually dispensed to the patient. This was a hospital based cross sectional
retrospective study involving the review of prescriptions from the outpatient
department from January 1
st
2012 to June 30
th
2012. A standard data collection tool
developed by WHO was used for assessing prescribing indicators. Total number of
drugs prescribed was 1,506. On average, each patient was prescribed 3.85 types of
drugs. A total of 835 drugs were prescribed by generic name, accounting for 55.4%
of total number of drugs prescribed (1,506). Out of 391 sampled prescriptions, 266
had antibiotics accounting for 68%. A relatively small proportion of the prescriptions
(9.5%) had an injection prescribed. A total of 1,087 drugs were prescribed according
to the essential medicine list (EML) accounting for 72.2%. Only 55.2% of total
medicines prescribed were actually dispensed. This study revealed that prescribing
practices were unacceptable as depicted by poly-pharmacy and prescription by brand
names. Medicines were also not available in 44.8% of the cases. It is necessary to
make prescribers aware about the appropriate use of drugs and importance of
