基于世界卫生组织核心药物使用指标对埃塞俄比亚东部部分公立医院合理用药情况的评估：一项横断面研究。
Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study.
作者信息
Sisay Mekonnen, Mengistu Getnet, Molla Bereket, Amare Firehiwot, Gabriel Tesfaye
机构信息
Department of Pharmacology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.
Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.
出版信息
BMC Health Serv Res. 2017 Feb 23;17(1):161. doi: 10.1186/s12913-017-2097-3.
BACKGROUND
Despite the complexity of drug use, a number of indicators have been developed, standardized and evaluated by the World Health Organization (WHO). These indicators are grouped in to three categories namely: prescribing indicators, patient care indicators and facility indicators. The study was aimed to evaluate rational drug use based on WHO-core drug use indicators in Dilchora referral hospital, Dire Dawa; Hiwot Fana specialized university hospital, Harar and Karamara general hospital, Jigjiga, eastern Ethiopia.
METHODS
Hospital based quantitative cross sectional study design was employed to evaluate rational drug use based on WHO core drug use indicators in selected hospitals. Systematic random sampling for prescribing indicators and convenient sampling for patient care indicators was employed. Taking WHO recommendations in to account, a total of 1,500 prescription papers (500 from each hospitals) were investigated. In each hospital, 200 outpatient attendants and 30 key essential drugs were also selected using the WHO recommendation. Data were collected using retrospective and prospective structured observational check list. Data were entered to EPI Data Version 3.1, exported and analyzed using SPSS version 16.0. Besides, the data were evaluated as per the WHO guidelines. Statistical significance was determined by one way analysis of variance (ANOVA) for some variables. P-value of less than 0.05 was considered statistically significant. Finally, tabular presentation was used to present the data.
RESULTS
Mean, 2.34 (±1.08) drugs were prescribed in the selected hospitals. Prescriptions containing antibiotics and that of injectables were 57.87 and 10.9% respectively. The average consultation and dispensing time were 276.5 s and 61.12 s respectively. Besides, 75.77% of the prescribed drugs were actually dispensed. Only 3.3% of prescriptions were adequately labeled and 75.7% patients know about the dosage of the prescription. Not more than, 20(66.7%) key drugs were available in stock while only 19(63.3%) of key drugs had adequate labeling. On average, selected key drugs were out of stock for 30 days per year. All of the hospitals included in the study used the national drug list, formulary and standard treatment guidelines but none of them had their own drug list or guideline.
CONCLUSION
Majority of WHO stated core drug use indicators were not met by the three hospitals included in the study.
背景
尽管药物使用情况复杂，但世界卫生组织（WHO）已制定、标准化并评估了一些指标。这些指标分为三类，即：处方指标、患者护理指标和机构指标。本研究旨在根据WHO核心药物使用指标，对埃塞俄比亚东部迪雷达瓦的迪尔乔拉转诊医院、哈勒尔的希沃特·法纳专科医院和吉吉加的卡拉马拉综合医院的合理用药情况进行评估。
方法
采用基于医院的定量横断面研究设计，根据WHO核心药物使用指标对选定医院的合理用药情况进行评估。处方指标采用系统随机抽样，患者护理指标采用方便抽样。考虑到WHO的建议，共调查了1500份处方（每家医院500份）。在每家医院，还根据WHO的建议选取了200名门诊患者和30种关键基本药物。使用回顾性和前瞻性结构化观察检查表收集数据。数据录入EPI Data 3.1版本，导出后使用SPSS 16.0版本进行分析。此外，数据按照WHO指南进行评估。部分变量的统计学显著性通过单因素方差分析（ANOVA）确定。P值小于0.05被认为具有统计学显著性。最后，用表格形式呈现数据。
结果
选定医院平均每张处方开具2.34（±1.08）种药物。含抗生素处方和注射剂处方分别占57.87%和10.9%。平均咨询时间和发药时间分别为276.5秒和61.12秒。此外，75.77%的处方药物实际配发。只有3.3%的处方标签完整，75.7%的患者知道处方剂量。库存的关键药物不超过20种（66.7%），只有19种（63.3%）关键药物标签完整。选定的关键药物平均每年缺货30天。研究中的所有医院都使用国家药品目录、处方集和标准治疗指南，但均没有自己的药品目录或指南。
结论
研究纳入的三家医院未达到WHO规定的多数核心药物使用指标。
Zotero 插件