Evaluation of Rational Drug Use Based on WHO/INRUD Core Drug Use Indicators in a Secondary Care Hospital: A Cross-Sectional Study in Western Uganda

Figures & data

Table 1 WHO/INRUD Prescribing Indicators in Health Centre III of Western Uganda (n=450)

Prescribing Indicators	Average/Percentage	Optimal Value
Average number of drugs prescribed per encounter (Average)	3.2	1.6–1.8
Percentage of drugs prescribed by generic name	90.48	100
Percentage of encounters with an antibiotic prescribed	66.22	20.0–26.8
Percentage of encounters with an injection prescribed	25.22	13.4–24.1
Percentage of drugs prescribed from the EML	96.23	100

Abbreviation: EML, Essential Medicine List.

Table 2 WHO/INRUD Patient-Care and Health-Facility Indicators in Health Centre III of Western Uganda (n=450)

Patient-Care Indicators	Average/Percentage	Optimal Values
Average consultation time in minutes (mins)	5.41	≥10 mins
Average dispensing time in seconds (secs)	131.03	≥180 secs
Percentage of medicine dispensed	76.11	100
Percentage of medicine adequately labeled	59.74	100
Patient’s knowledge of correct dosage	49.50	100
Percentage availability of a copy of the EDL or formulary to practitioners	100	100
Percentage of key medicines available	66.67	100

Abbreviation: EDL, Essential Drug List.

Table 3 Drug Use Performance Indicators in Health Centre III of Western Uganda (n=450)

Performance Indicators	Observed Value (A)	WHO Optimal Value (B)	Observed Index (A/B)	WHO Optimal Index
Prescribing indicators
Non-polypharmacy index	3.2	1.6–1.8	0.50^$	1.00
Generic name index	90.48	100	0.90	1.00
Rational antibiotic index	66.22	20.0–26.8	0.40^$	1.00
Injection safety index	25.22	13.4–24.1	0.95^$	1.00
Essential drug list index	96.23	100	0.96	1.00
IRDP			3.71	5.00
Patient-care indicators
Consultation time index	5.41	≥10 mins	0.54	1.00
Dispensing time index	131.03	≥180 secs	0.73	1.00
Dispensing drug index	76.11	100	0.76	1.00
Labeled drug index	59.74	100	0.59	1.00
Patients’ knowledge index	49.50	100	0.49	1.00
IRPCDU			3.11	5.00
Health-facility indicators
Index of EDL	100	100	1.00	1.00
Index of key drugs availability	66.67	100	0.67	1.00
IRFSDU			1.67	2.00
IRDS			8.49	12.00

Note: ^$B/A.

Abbreviations: IDRP, Index of Rational Drug Prescribing; IRPCDU, Index of Rational Patient-care Drug Use; IRFSDU, Index of Rational Facility-Specific Drug Use; IRDS, Index of Rational Drug Supply.

Table 4 Comparison of WHO/INRUD Indicators with Different Countries

WHO/INRUD Indicator	Current Study	Ethiopia^Citation19	Kenya^Citation20	Nigeria^Citation21	Eritrea^Citation22	Egypt^Citation23	Saudi Arabia^Citation24	Pakistan^Citation13	Sudan^Citation25	India^Citation26	UAE^Citation27
Prescribing indicators
Average number of drugs prescribed	3.20	1.69	2.90	2.76	1.78	2.5	2.4	3.4	2.5	3.2	4.9
Percentage of drugs prescribed by generic name	90.48	95.60	27.70	78.02	94.86	95.4	61.2	71.6	44.1	74.6	100.0
Percentage of antibiotics prescribed	66.22	58.20	84.80	33.33	54.50	39.2	32.2	48.9	54.7	36.6	43.0
Percentage of injections prescribed	25.22	15.90	24.90	1.67	6.60	9.9	2.0	27.1	12.0	11.4	16.9
Percentage of drugs prescribed from the EML	96.23	90.40	96.70	0	94.73	95.4	99.2	93.4	95.2	93.3	100
Patient-care indicators
Average consultation time in minutes	5.41	6.60	4.10	17.5	5.46	7.1	7.3	2.2	2.9	3.9	14.0
Average dispensing time in seconds	131.03	22.80	131.50	92.1	36.49	47.4	100	38.0	99.5	49.3	576
Percentage of drugs dispensed	76.11	81.20	76.30	76.97	87.32	95.9	99.6	90.9	72.5	98.5	99.0
Percentage of drugs labeled	59.74	32.70	22.60	100	68.24	65.4	64.0	100.0	49.0	61.6	-
Patient’s knowledge of correct dosage	49.50	56.90	54.70	60.0	78.88	94.0	79.3	62.1	22.5	76.7	-
Health-facility indicators
Percentage availability of a copy of the EDL or formulary	100.0	100.0	20.00	00	100.0	80.0	100	100	66.7	100	100
Percentage of key drugs available	66.67	77.50	80.00	100	80.0	78.3	59.2	82.0	75.3	73.4	-

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