Drug use practices at pediatric hospitals of Khartoum State, Sudan

Abstract

Background: Irrational drug utilization is a major concern in developing countries. The World Health Organization (WHO) has developed first-level informative indicators in assessing drug use practices and encouraging improvement in the quality of patient care.

Objective: To assess the current drug use practices in 4 pediatric teaching hospitals in Khartoum State, and to compare the results with studies conducted in Sudan and other developing countries.

Methods: A descriptive, quantitative, and cross-sectional study using the WHO drug use indicators methodology was conducted in the outpatient settings of 4 pediatric hospitals. The study sample was selected using systematic random sampling. In each hospital, prescribing was assessed through a collection of 150 prescriptions, determination of consultation time and dispensing time for 150 patients, and by interview of 150 patients for the evaluation of dispensing practices and parents' knowledge.

Results: The mean number of drugs prescribed per prescription was 2.0 (95% CI 1.9 to 2.1); 49.3% (95% CI 46.3 to 52.4) were prescribed by generic name, 81.3% (95% CI 77.9 to 84.3) of prescriptions involved an antibiotic, and 3.5% (95% CI 2.2 to 5.4) of prescriptions were in injection form. The mean consultation and dispensing times were 4.7 minutes (95% CI 4.4 to 5.1) and 28.2 seconds (95% CI 26.5 to 29.9), respectively. The percentage of drugs actually dispensed was 80.1% (95% CI 77.9 to 82.2), 55.7% (95% CI 52.0 to 59.4) of drugs were adequately labeled, and 83.5% (95% CI 80.2 to 86.3) of parents knew the correct dosage of all drugs dispensed for their children. The percentage of availability of key drugs was 81.3% (95% CI 77.1 to 84.9). The essential medicines list was not available at the 4 hospitals.

Conclusions: Our findings reveal problem areas in prescribing and dispensing practices in pediatric hospitals. Further in-depth quantitative research to answer the shortcomings of this study and cost-effective multifaceted interventions to improve current drug use practices are highly needed to secure the quality of medical care in pediatric hospitals.