TY - JOUR
T1 - Assessment of medicine use among outpatients at healthcare facilities in ethiopia using the who's prescribing indicators with a focus on antibiotics
T2 - A systematic review and meta-analysis
AU - Teni, Fitsum Sebsibe
AU - Wubishet, Befikadu Legesse
AU - Yimenu, Dawit Kumilachew
N1 - Publisher Copyright:
© The Author(s) 2020.
PY - 2021
Y1 - 2021
N2 - Objectives: To summarize studies on prescribing medicine to general outpatients through the WHO/ International Network for Rational Use of Drugs (INRUD) prescribing indicators with a focus on antibiotic prescription. Methods: A systematic review and random-effects meta-analysis of studies on the WHO prescribing indicators with a focus on the percentage of encounters with antibiotics prescribed (PEAP) was performed. The databases PubMed, Web of Science, EMBASE and Global Index Medicus were searched. Results: Twenty-six studies with a total of over 34 000 prescription encounters were included in the systematic review, showing a mean of two medicines per encounter. In each meta-analysis, a range of 19 to 25 studies was included. The percentages of medicines prescribed with an international non-proprietary name (INN) and from the essential medicines list (EML) were 91% and 96% of the total number of medicines, respectively, while 19% of encounters contained injections. Studies with over 25 000 prescription encounters reported an average PEAP of 58% and PEAP showed an increasing trend over the years included in this review. Multivariable metaregression showed that PEAP increased with the average number of medicines per encounter (estimate = 0.83, P value = 0.0005). The number of medicines, study design and year of prescription explained over 40% of the variation in PEAP across studies. Conclusions: Patterns of medicine use within and close to the WHO reference values were reported for the number of medicines, INN prescribing, prescription of injections and compliance with the EML, on average. Prescription of antibiotics requires attention as amounts much higher than the reference values were prescribed, which were even higher with polypharmacy and increasing over the years included in this review.
AB - Objectives: To summarize studies on prescribing medicine to general outpatients through the WHO/ International Network for Rational Use of Drugs (INRUD) prescribing indicators with a focus on antibiotic prescription. Methods: A systematic review and random-effects meta-analysis of studies on the WHO prescribing indicators with a focus on the percentage of encounters with antibiotics prescribed (PEAP) was performed. The databases PubMed, Web of Science, EMBASE and Global Index Medicus were searched. Results: Twenty-six studies with a total of over 34 000 prescription encounters were included in the systematic review, showing a mean of two medicines per encounter. In each meta-analysis, a range of 19 to 25 studies was included. The percentages of medicines prescribed with an international non-proprietary name (INN) and from the essential medicines list (EML) were 91% and 96% of the total number of medicines, respectively, while 19% of encounters contained injections. Studies with over 25 000 prescription encounters reported an average PEAP of 58% and PEAP showed an increasing trend over the years included in this review. Multivariable metaregression showed that PEAP increased with the average number of medicines per encounter (estimate = 0.83, P value = 0.0005). The number of medicines, study design and year of prescription explained over 40% of the variation in PEAP across studies. Conclusions: Patterns of medicine use within and close to the WHO reference values were reported for the number of medicines, INN prescribing, prescription of injections and compliance with the EML, on average. Prescription of antibiotics requires attention as amounts much higher than the reference values were prescribed, which were even higher with polypharmacy and increasing over the years included in this review.
UR - http://www.scopus.com/inward/record.url?scp=85088278869&partnerID=8YFLogxK
U2 - 10.1093/jac/dkaa124
DO - 10.1093/jac/dkaa124
M3 - Review article
C2 - 32437516
SN - 0305-7453
VL - 75
SP - 2044
EP - 2058
JO - Journal of Antimicrobial Chemotherapy
JF - Journal of Antimicrobial Chemotherapy
IS - 8
ER -