Abstract
Background: Rational use of Medicines (RUM) plays an important role in avoiding possible adverse drug reactions, maximizing therapeutic outcomes with patient adherence, and minimizing the cost of drug therapy. In Sierra Leone, no review has been done on RUM based on the three World Health Organization (WHO) core drug use indicators.
Objective: To assess the rational use of essential medicine in selected public hospitals in Freetown.
Method: Prospective cross-sectional study involving 250 health professionals and 150 outpatients at three public hospitals in Freetown, Sierra Leone. In each hospital, 30 key essential medicines were selected using the WHO prescribing indicators. A standard data collection checklist was used. Data obtained were organized using Microsoft Excel spreadsheets to obtain frequencies and percentages. Core drug use indicators were analysed using the WHO guidelines.
Results: About 69.9% of medicines were prescribed by generic name (Reference value=100%), the percentage encounters with injection were 68.9%, and 76.5% for antibiotics (Reference values=<20% and <30% respectively). In all 3 hospitals, 100% of medicines were prescribed from the Essential Medicine List of Sierra Leone. Patient care indicators showed that 81% of the patients knew the correct dosage of their medications, and 61.4% knew how long the drugs dispensed should be taken. Only 70.6% understood the instructions given by health providers about drug administration. Average consultation and dispensing time were 4 minutes and 1 minute, respectively. All the public hospitals had copies of the Essential Drug List and Standard Treatment Guidelines. Conclusion: Rational Medicine Use was not fully observed in this study. Therefore, these public hospitals should work towards comprehensive implementation of the WHO guidelines.
Keywords: Rational Use of Medicine, Prescribing indicators, Freetown, Essential medicines.