Prescribing for Patients Seeking Maternal and Child Healthcare in Sierra Leone: A Multiregional Retrospective Cross-Sectional Assessments of Prescribing Pattern Using WHO Drug Use Indicators.
Prescribing for Patients Seeking Maternal and Child Healthcare in Sierra Leone: A Multiregional Retrospective Cross-Sectional Assessments of Prescribing Pattern Using WHO Drug Use Indicators.
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DOI：
10.2147/rmhp.s256648
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发表时间：
2020
影响因子：
3.5
通讯作者：
Fang Y
中科院分区：
文献类型：
--
作者：
Kabba JA;James PB;Li Z;Hanson C;Chang J;Kitchen C;Jiang M;Zhao M;Yang C;Fang Y
合理使用药物是增加社会上迫切需要药物的人获得药物的必要限制。在这项研究中，我们评估了塞拉利昂医疗机构对孕妇、哺乳期母亲和五岁以下儿童实施免费医疗政策的药物处方模式。使用世卫组织的药物使用指标，我们评估了四家医院药房的处方记录；塞拉利昂四个地区各一家。为了研究处方指标，我们系统地抽样了从2017年6月到2018年7月一年的1200张处方(300张/医院)。在评估患者护理指标时，我们随机抽样了120例患者(30例/医院)，前瞻性地遇到。我们使用MS Excel 2016和IMB SPSS进行数据分析，p<；0.05被认为在关联分析中具有重要意义。每个处方的平均药物总量为3.6(SD=1.3)，5岁以下儿童为3.5(1.3)，孕妇/哺乳期母亲为3.4(1.4)。87%的五岁以下儿童处方含有抗生素，而孕妇/哺乳期母亲处方的这一比例为68.4%。孕妇/哺乳期母亲每次注射的处方比5岁以下儿童多23.2%，18.1%。总体来看，仿制药和《国家基本药物目录》中的处方分别占74.9%和73.8%。在所研究的卫生机构中，没有一家提供所有处方药物。最常见的处方药是抗生素，扑热息痛是最常见的处方药。根据本研究中使用的世卫组织药物使用指标，塞拉利昂提供免费医疗的政府医院内不合理地开出了药物。免费医疗计划的可持续性将需要高效的药品供应和管理战略。因此，制定管理计划和/或积极的药物和治疗委员会可能是必要的，以优化这些医院的药物使用。
Rational use of medicines is a necessary constrict towards increasing access for those that desperately need them in society. In this study, we assess medicines prescribing patterns in healthcare facilities implementing free healthcare policy for pregnant women, lactating mothers and children under the age of five in Sierra Leone. Using WHO drug use indicators, we evaluated prescription records from the pharmacies of four hospitals; one from each of the four regions in Sierra Leone. To study prescribing indicators, we systematically sampled 1200 prescriptions overall (300/hospital) retrospectively spanning a year, from June 2017 to July 2018. In evaluating patients care indicators, we randomly sampled 120 (30/hospital) patients encounter prospectively. We used MS Excel 2016 and IMB SPSS in data analysis, and p< 0.05 was considered significant for associational analysis. The average drug per prescription was 3.6 (SD=1.3) overall, 3.5 (1.3) for children under five and 3.4 (1.4) for pregnant women/lactating mothers. Eighty-seven percent of prescriptions for under-five children contains antibiotics as opposed to 68.4% of prescriptions for pregnant women/lactating mothers. More injections were prescribed per encounter for pregnant women/lactating mothers 23.2% than for children under five 18.1%. Overall, generic prescribing and prescribing from the National Essential Medicines List were 74.9% and 73.8%, respectively. None of the studied health facilities dispensed all of the prescribed medicines. The most prescribed pharmacological class of drugs were antibiotics, and paracetamol was the most commonly prescribed drug. Following WHO drug use indicators used in this study, drugs were irrationally prescribed within government hospitals providing free healthcare in Sierra Leone. Sustainability of the free healthcare scheme will require efficient medicine supply and management strategies. Therefore, the formulation of stewardship programs and/or an active Drug and Therapeutics Committee may be necessary to optimise drug use in these hospitals.