Study On Outpatient Drug Use Practices In Urban And Rural Hospitals In Anhui Province

OBJECTIVE: The aim of this study was to describe the current drug use practices in urban and rural hospitals in Anhui Province, and gather baseline data, which can serve as a basis for designing an appropriate intervention to improve the drug use profile. METHODS: A retrospective study of outpatient prescriptions during the period of July 2002 to June 2003 was conducted. A total of 40 hospitals (20 urban and 20 township hospitals) were selected through stratified sampling in which 60 outpatient encounters per facility were observed and the information was collected on a specifically designed form. Patient care indicators were obtained through progressive study of internal department outpatients. Analyses were carried out using Excel 2000 and SPSS 11.0 software package. RESULTS: The average number of drugs per encounter in urban and rural hospitals was 2.41 and 3.52, respectively. 70.26% and 83.91% of drugs were prescribed by generic name in urban and rural hospitals, respectively. Percentage of encounters with an antibiotic prescribed in urban and rural hospitals was 35.15% and 61.33%, respectively. Percentage of encounters with an injection prescribed in urban and rural hospitals was 23.58% and 50.67%, respectively. Percentage of drugs prescribed from essential drugs list or formulary in urban and rural hospitals was 78.86% and 84.01%, respectively. The average drug cost per encounter in urban hospitals was 52.30, of which antibiotics and injections comprised 24.61% and 21.75%, respectively. The average drug cost per encounter in rural hospitals was 13.24, of which antibiotics and injections comprised 29.08% and 38.05%, respectively. Averageconsulting time and dispensing time in urban and rural hospitals was 5.69min, 14.2s and 7.09min, 25.6s. Percentage of drugs actually dispensed and drugs adequately labelled was 100%, 97.8% and 100%, 93.6%. Patients' correct knowledge of drug usage was 93.8% and 84.5%, respectively. Essential drugs lists and formularies were not seen in those facilities. CONCLUSION: Polypharmacy, over-use of antibiotics and injections, lack of enough communication between medical professionals and patients and lack of access to standard tools for rational drug use such as locally adapted essential drugs list, formularies and standard treatment guidelines were some of the problematic. Further studies are needed to explore the reasons behind those apparent irrational drug use phenomena in order to find ways to correct them.