How to Investigate Drug Use in Health Facilites. Essential Drugs Monitor No. 014 (1993)
(1993; 2 pages)


The Action Programme on Essential Drugs (DAP) created a practical manual describing the standard methodology and indicators used to monitor drug usage and prescribing practices in health facilities. The indicators are intended to measure specifics about the behaviour of health providers and do not require specific training to measure. They have been field tested and are now the provisional standard for DAP. There are twelve core indicators divided into three general areas related to rational use: prescribing practices, patient care, and facility-specific supportive factors (Table 1). There are also seven complementary drug use indicators that are less standardized and allow local variables to be taken into account (Table 2). To use the indicators, a sample size of 20 facilities, 30 prescriptions per facility, and 100 patients per facility is recommended for study. Field testing showed that greater standardisation of core indicators is needed. Certain shortcomings of the indicators include counting combination drugs as one drug instead of multiple drugs and the exclusion of waiting time from the average consultation and dispensing time measurements. Early results from initial surveys give a general overview of the experience of different countries regarding drug use. The average number of drugs per prescription ranged from 1.3 to 2.2 and between 39% and 56% of prescriptions included an antibiotic. Based on a theoretical need for antibiotics of 22.7% in Yemen, the results suggest antibiotics may be overprescribed. Two additional studies aimed to quantify the effects of interventions by comparing data to previous studies and results from other countries. (Abstract by Flannery Bowman)

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