Assessment of Rational Prescription and the Use of Artemisinin-Based Combination Therapy among Prescribers and Patients at Bechem Government Hospital

Abstract

Background: Rational prescribing is to ensure safe and effective use of medicine. However, widespread irrational use of medicine is a problem at the various levels of health care, and leads to increased mortality, morbidity, poor health outcomes and waste of scarce resources. Objective: To assess the factors (predisposing, enabling and need) associated with rational prescription and use of Artemisinin Based Combination Therapy (ACT) among prescribers and patients at the Bechem Government Hospital. Methods: The World Health Organization core indicators of rational drug/ medicine use, prescribing tool was used to collect data from 120 outpatients’ records from January, 2018 to December, 2018. The Andersen’s behavioural model was used to investigate the use of medicines. A designed questionnaire was used to collect data on predisposing, enabling and need factors from 120 outpatients and 11 health providers/prescribers who were purposively sampled for interview. Associations between rational use of ACT among prescribers and patients (dependent variable) and prescribed or dispensed ACT, patients understanding of medicine information etc. (independent variables) were established using the Chi square test where the level of significance was set at p<0.05. Results: The rational use of ACT among patients in this study was 34.5%. This implies that 3 out of every 10 patients would have rational use of ACT. An average number of drugs per encounter was 2.8. The prescribers that followed the recommended procedure for ACT prescription was 14.2%. The predisposing factor associated with rational use of ACT was age. The enabling factors associated with rational use of ACT were recommended prescription and use of NHIS and cash for health services. The need factors associated with rational use of ACT were advice and counseling and use of RDT for malaria test. Conclusion: the rationale use of ACT among patient was very low and needs a special attention. The number of drugs prescribed per patient encounter was good, notwithstanding, prescribers that follow recommended malarial treatment protocols was very low and could have negative influence on rational use of ACT. Moreover prescribers and patients should be encouraged to adhere to the recommended ACT use and treatment guidelines.