Evaluation of Drug Use Practices Using WHO Core Drug Use Indicators at Pediatric Health Facilities, Kabul, Afghanistan

Abstract

Background: Irrational medicine use is a global problem. It can lead to increased morbidity and mortality and increased costs of drug therapy, thus imposing an adverse impact on the overall quality of the pharmaceutical care system. Objective: To evaluate drug use practices based on WHO core drug use indicators at pediatric health facilities of Kabul, Afghanistan.
Methods: A cross-sectional study was conducted at outpatient departments of the three pediatric health facilities at samples that were collected using a systematic random sampling method. The sample size included 600 outpatient prescriptions. Data were evaluated as per the WHO guidelines.
Results: On average 2.795, 2.745, and 4.2 drugs per prescription were prescribed in 001, 002, and 003 health facilities respectively (WHO standard is 1.6-1.8). 37.03% of drugs in 001, 42.62% in 002, and 42.64% of drugs in 003 were prescribed by the generic name (WHO standard is 100%). Antibiotics were prescribed in 79% prescriptions of the 001, 88% of the 002, and 52% of the 003 health facilities (WHO standard value is 20-26.8%). Injections were prescribed in 6% of the 001, 32% of the 002, and 19.5% of the 003 prescriptions (WHO standard is 13.4-24.1%). 65.47% of drugs in 001, 67.94% of drugs in 002, and 73.1% of drugs in 003 health facilities were prescribed from the Afghanistan national essential medicines list (WHO standard is 100%).
Conclusion: Most of the core drug use indicators were not met with WHO standards in these pediatric health facilities. However, in 001 and 003 health facilities the prescribing patterns may be more complex because they are tertiary health care centers.