Adebayo E T, Hussain N A
Military Hospital, Ikoyi, Lagos.
Niger J Clin Pract. 2009 Sep;12(3):268-72.
In many developing countries, drug costs form an important portion of government and household expenditure. Also, improper use of drugs is a major health hazard and increases treatment costs. However, while the problem of irrational use of drugs is worldwide, it has not been adequately studied especially in developing countries such as Nigeria. Military facilities provide health care services to an important segment of both the military and civil population.
The aim of this study was to evaluate drug prescribing practices at a Nigerian military hospital (Military Hospital, Ikoyi, Lagos) and to make recommendations for its improvement. Using WHO rational drug use (RDU) criteria, prescribing and facility care indicators were studied using case notes of general out patients seen between March 2006 and February 2007. Also, a knowledge, attitude and practice (KAP) study of prescribers and dispensers at the hospital to complement the study of indicators was also undertaken.
Based on systematic sample of 180 case notes collected over the study period, the average number of drugs per encounter was higher (3.0 +/- 1.5) than other African values. Also, 43.8% of drugs were prescribed using their generic names which is low. A high number of patients were prescribed antibiotics (27.8%) and injections (23.9%). From the KAP study of 29 respondents, only one (3.4%) was not aware of the existence of the Essential Drug List (EDL) while 50.0% claimed ownership of a copy of the EDL. Few (13.9%) respondents, could accurately detail the 5 steps in issuing a prescription.
This study revealed gaps between the actual level of knowledge of prescribers/dispensers about RDU and actual practice. The need for further studies and focused interventions are outlined.
在许多发展中国家，药品费用占政府和家庭支出的重要部分。此外，药物的不当使用是主要的健康危害，并增加了治疗成本。然而，尽管药物不合理使用问题在全球范围内存在，但尚未得到充分研究，尤其是在尼日利亚等发展中国家。军事设施为军队和民众的重要部分提供医疗保健服务。
本研究的目的是评估尼日利亚一家军事医院（拉各斯伊科伊军事医院）的药物处方行为，并提出改进建议。使用世界卫生组织合理用药（RDU）标准，通过2006年3月至2007年2月期间普通门诊患者的病历研究处方和设施护理指标。此外，还对该医院的开方者和配药者进行了知识、态度和行为（KAP）研究，以补充指标研究。
基于在研究期间收集的180份病历的系统样本，每次就诊的平均药物数量（3.0±1.5）高于其他非洲国家的数值。此外，43.8%的药物使用通用名开具，比例较低。大量患者被开具抗生素（27.8%）和注射剂（23.9%）。在对29名受访者的KAP研究中，只有1人（3.4%）不知道基本药物清单（EDL）的存在，而50.0%的人声称拥有一份EDL。很少有受访者（13.9%）能够准确详述开具处方的5个步骤。
本研究揭示了开方者/配药者对RDU的实际知识水平与实际行为之间的差距。概述了进一步研究和针对性干预的必要性。
