title: 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.
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  Majority of WHO stated core drug use indicators were not met by the three hospitals included in the study.
authors.affiliation: Department of Pharmacology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia. mekonnensisay27@yahoo.com.
authors.forename: Mekonnen
authors.identifier: 0000-0001-6611-1174
authors.initials: M
authors.lastname: Sisay
authors.affiliation: Department of Pharmacology, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.
authors.forename: Getnet
authors.initials: G
authors.lastname: Mengistu
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.
authors.forename: Bereket
authors.initials: B
authors.lastname: Molla
authors.affiliation: Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, P.O. Box 235, Harar, Ethiopia.
authors.forename: Firehiwot
authors.initials: F
authors.lastname: Amare
authors.affiliation: Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia.
authors.forename: Tesfaye
authors.initials: T
authors.lastname: Gabriel
mesh_terms: D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D018954:Drugs, Essential / Q000191:economics / Q000600:supply & distribution* / Q000627:therapeutic use; D005002:Ethiopia / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D010607:Pharmacy Service, Hospital / Q000191:economics / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D055553:Prescription Drugs / Q000191:economics / Q000627:therapeutic use*; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation; D014944:World Health Organization
chemical_list: D018954:Drugs, Essential; D055553:Prescription Drugs
keywords: Health facility indicators; Patient care indicators; Prescribing indicators; Rational drug use; World Health Organization