The Quality of Prescribing and Dispensing In Public and Private Health Care Facilities in South West Cameroon

Abstract

Medicines are an integral part of patient care, but their inappropriate use by clients can have serious medical, economic, and social consequences. Previous studies in public health services report multiple medicine prescription and misuse of antibiotics and injections. This study investigated the quality of prescribing and dispensing by public and private health providers. Methods: A Simulated client study to assess the quality of prescribing for diarrhoea, malaria and URTI,; a cross sectional descriptive study of actual prescribing and dispensing in health care settings; and a comparative analysis of the quality of prescribing and dispensing between public and private health care providers. Results Simulated Client Study: Less than 50% of the cases (diarrhoea, malaria and upper respiratory tract infection in that order) were accurately diagnosed by health staff (45 .5 vs. 47.3 vs. 42, respectively, p=O.O IS); less than 30% received the recommended treatment (14 vS.24 vs. 12.7 respectively, p=O.OO I); and less than 40% received the appropriate advice (16 .3 vs.39.3 vs. 39.3 respectively, p=O.OO]). The quality of prescribing was poor. No significant differences were found between public and private care providers. Actual Prescribing and Dispensing Study: The quality of actual prescribing was below acceptable standards, but the quality of dispensing was within acceptable limits. An average of 3.4 products per encounter was noted; and high rates of antibiotics prescribed. No significant differences in prescribing patterns between public and private care providers, but there were significant differences in dispensing patterns, with private providers dispensing a higher proportion of prescribed drugs (p=O.OO I). Conclusion: The quality of prescribing and dispensing in South West Cameroon is poor. No best practices were observed. Health Staff demonstrated low knowledge levels of prescribing and dispensing. There is need to improve drug prescribing and dispensing in this region of Cameroon.