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. 2025 Jun 30;18(1):2519140.
doi: 10.1080/20523211.2025.2519140. eCollection 2025.

Comparative assessment of rational use of drugs in public and private hospital pharmacies: a multicenter cross-sectional study using INRUD/WHO prescribing indicators

Adil A Mahmoud  1 , Asim Ahmed Elnour  2   3 , Ali Awadallah Saeed  4 , Vineetha Menon  5 , Shereen A M Elhag  6 , Omkalthoum Fathi G  6 , Mohamed Ayoup M  6 , Hussam Abdulhadi M A  6 , Ahmed Sameer E  6 , Mohamed Tahaa E  6 , Semira Abdi Beshir  7 , Nadia Al Mazrouei  8 , Sami Fatehi Abdalla  9 , Fahad T Alsulami  10 , Yousef Saeed Alqarni  11 , Abuelnor Mohammed  12   13
Affiliations

Comparative assessment of rational use of drugs in public and private hospital pharmacies: a multicenter cross-sectional study using INRUD/WHO prescribing indicators

Adil A Mahmoud et al. J Pharm Policy Pract. .

Abstract

Background: Specific actions to promote the RUD in public and private hospitals are highly needed. The current study aimed to assess RUD based on World Health Organization (WHO) prescribing indicators in selected public and private hospitals in Khartoum state-Sudan.

Methods: A multicenter cross-sectional study was conducted in six public and three private hospitals. After ethics approval, a consecutive random sample of 2880 patient encounter prescriptions was selected. The IRDP indicates adherence to RUD.

Results: The average number of drugs per patient encounter prescription was 1.7 ± 0.2 and 2.5 ± 0.2 (overall 2.1) in public and private hospitals, respectively. Drugs prescribed generically were 61% (index 0.61) in public hospitals and 24% (index 0.24) in private hospitals. The index of injection prescribing was 0.1 for public and 0.85 for private hospitals. Drugs on the EDL accounted for 94% of prescriptions in public hospitals and 70% in private hospitals. The EDL prescribing index was 0.94 for public and 0.7 for private hospitals. The overall mean IRDP for public and private hospitals was 3.11.

Conclusion: Inadequate prescribing patterns in public and private hospitals significantly deviate from WHO standards across most prescribing indicators. Consequently, public and private hospitals should strive to promote the RUD.

Keywords: Essential Drug List (EDL); Index of Rational Drug Prescribing (IRDP); Polypharmacy; Prescription rationality; Rational Use of Drugs (RUD); World Health Organization (WHO) prescribing indicators; hospital pharmacies.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s). Abbreviations AMRAntimicrobial ResistanceEDLEssential Drug ListINRUDInternational Network of Rational Use of Drugs IRDPIndex of Rational Drug PrescribingRUDRational use of DrugsWHOWorld Health Organization

Figures

Figure 1.
Figure 1.
The average number of drugs per prescription in public and private hospitals compared to the WHO optimum value.
Figure 2.
Figure 2.
Percentage of drugs written generically in public and private hospitals compared to the WHO optimum value.
Figure 3.
Figure 3.
Percentage of antibiotics prescribed in public and private hospitals compared to the WHO optimum value.
Figure 4.
Figure 4.
Percentage of drugs prescribed as injections in public and private hospitals compared to the WHO optimum value.
Figure 5.
Figure 5.
Percentage of drugs prescribed found on the Essential Drug List (EDL) in public and private hospitals compared to the WHO optimum value.
See this image and copyright information in PMC

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