A combined strategies intervention on the World Health Organization prescribing indicators: A quasi-randomised trial
African Journal of Primary Health Care & Family Medicine
| Field | Value | |
| Title | A combined strategies intervention on the World Health Organization prescribing indicators: A quasi-randomised trial | |
| Creator | Ncube, Nondumiso B.Q. Chivese, Tawanda Mukumbang, Ferdinand C. Bradley, Hazel A. Schneider, Helen Laing, Richard | |
| Description | Background: Irrational medicine use is a global problem that may potentiate antimicrobial resistance.Aim: This study aims to assess prescribing practices and the effect of a prescription audit and feedback coupled with small-group education intervention on prescribing indicators.Setting: The study was conducted in public-sector healthcare facilities in Eswatini.Methods: A cluster quasi-randomised controlled study was conducted from 2016 to 2019 using the World Health Organization/ International Network for Rational Use of Drugs (WHO/INRUD) prescribing indicators at baseline, post-intervention and post-follow-up. A 6-month unblinded intervention was tested in 32 healthcare facilities, randomly allocated to intervention (16) and control (16) arms. Prescribing practices were assessed post-intervention, and 6 months after the intervention, through an audit of 100 randomly selected prescriptions from each facility. Comparisons of WHO or INRUD prescribing indicators were conducted using the intention-to-treat analysis at the two times.Results: At baseline, in both arms, rational prescribing standards were met by the number of medicines per prescription and the use of injections. Antibiotic use was above 50% in both arms. After adjustment for baseline antibiotics use, region and level of care, there were no significant differences in all prescribing indicators between the two arms, post-intervention and at 6 months follow-up.Conclusion: In a lower middle-income setting with a high prevalence of irrational prescribing practices, a prescription audit, feedback and small-group education intervention had no benefits in improving rational prescribing.Contribution: Multifaceted strategies, strengthening of pharmacy and therapeutics committees, and holistic monitoring of medicine use are recommended to promote rational medicine use. | |
| Publisher | AOSIS | |
| Date | 2024-02-28 | |
| Identifier | 10.4102/phcfm.v16i1.3943 | |
| Source | African Journal of Primary Health Care & Family Medicine; Vol 16, No 1 (2024); 8 pages 2071-2936 2071-2928 | |
| Language | eng | |
| Relation |
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:
https://phcfm.org/index.php/phcfm/article/view/3943/6885
https://phcfm.org/index.php/phcfm/article/view/3943/6886
https://phcfm.org/index.php/phcfm/article/view/3943/6887
https://phcfm.org/index.php/phcfm/article/view/3943/6889
https://phcfm.org/index.php/phcfm/article/view/3943/6890
https://phcfm.org/index.php/phcfm/article/view/3943/6888
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