title: Evaluation of drug-prescribing patterns based on the WHO prescribing indicators at outpatient clinics of five hospitals in Jordan: a cross-sectional study .
abstract: BACKGROUND
  Irrational drug prescribing is considered one of the major challenges for the healthcare sectors worldwide, leading to negative outcomes in patients including various drug-related problems, such as polypharmacy, adverse drug events, more demands on drug monitoring, and unwanted increase in treatment cost.
  
  
  OBJECTIVE
  The main objective of this study was to evaluate the trends and issues related to prescription at outpatient hospital pharmacies in Jordan and to contrast that to the WHO rational medication list and WHO drug use indicators.
  
  
  METHODS
  This study was a cross-sectional study, conducted between January 2014 and May 2014. It involved a total number of 24,089 patient encounters from five teaching and referral hospitals in Jordan. The encounters included patients who were prescribed at least one medication during their visit to outpatient clinics in those hospitals.
  
  
  RESULTS
  The average number of drugs per prescription was 2.93. The percentage of encounters which had antibiotics or injections in the prescription was 17.7% and 8.1%, respectively. The top three most common prescribed antibiotics were amoxicillin (n = 2,129, 49.9%), ciprofloxacin (n = 609, 14.3%), and clarithromycin (n = 267, 6.3%), while the most common prescribed injections were insulin and insulin analogs (n = 766, 39.2%), cyanocobalamin (Vitamin B12) (n = 612, 31.3%), and erythropoietin (n = 80, 4.1%). The percentage of prescriptions by generic was 57.6%, whereas the prescribing from the essentials drug list (formulary) was close to optimal (99.8%).
  
  
  CONCLUSIONS
  The average number of prescribed drugs per encounter was higher than what was considered ideal according to WHO standards; the other issue found was a lower percentage of generic prescribing compared to WHO ideal value. The rest of prescribing indicators including the injections prescribing, antibiotics prescribing, and prescribing from the essential drug list were within the optimal range of values recommended by the WHO. .
authors.forename: Ahmad
authors.initials: A
authors.lastname: Al-Azayzih
authors.forename: Sayer I
authors.initials: SI
authors.lastname: Al-Azzam
authors.forename: Karem H
authors.initials: KH
authors.lastname: Alzoubi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Shawaqfeh
authors.forename: Majed M
authors.initials: MM
authors.lastname: Masadeh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D017723:Drug Utilization Review; D018954:Drugs, Essential / Q000627:therapeutic use; D016568:Drugs, Generic / Q000627:therapeutic use; D005260:Female; D019983:Guideline Adherence / Q000639:trends; D006784:Hospitals, Teaching / Q000639:trends*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D057970:Inappropriate Prescribing / Q000517:prevention & control / Q000639:trends*; D007597:Jordan; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000639:trends*; D010607:Pharmacy Service, Hospital / Q000639:trends; D019338:Polypharmacy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D013997:Time Factors; D014944:World Health Organization; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D018954:Drugs, Essential; D016568:Drugs, Generic; D007004:Hypoglycemic Agents