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AuthorNcube, Nondumiso B Q
AuthorChivese, Tawanda
AuthorMukumbang, Ferdinand C
AuthorBradley, Hazel A
AuthorSchneider, Helen
AuthorLaing, Richard
Available date2024-04-28T05:39:35Z
Publication Date2024-02-28
Publication NameAfrican Journal of Primary Health Care and Family Medicine
Identifier10.4102/phcfm.v16i1.3943
CitationNcube NBQ, Chivese T, Mukumbang FC, Bradley HA, Schneider H, Laing R. A combined strategies intervention on the World Health Organization prescribing indicators: A quasi-randomised trial. Afr J Prm Health Care Fam Med. 2024;16(1), a3943. https://doi.org/10.4102/phcfm.v16i1.3943
ISSN2071-2928
URIhttp://hdl.handle.net/10576/54287
AbstractIrrational medicine use is a global problem that may potentiate antimicrobial resistance. 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. The study was conducted in public-sector healthcare facilities in Eswatini. 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. 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. 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.
Languageen
PublisherAOSIS Publishing
SubjectEswatini
antibiotic resistance
intervention
rational drug prescribing
rational drug use.
rational medicine use
TitleA combined strategies intervention on the World Health Organization prescribing indicators: A quasi-randomised trial.
TypeArticle
Issue Number1
Volume Number16
ESSN2071-2936
dc.accessType Open Access


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