Assessment of drug use indicators using WHO/INRUD methodology at primary health care facilities in Guilan,Iran

Introduction: The irrational use of drugs was a global problem, especially in low and lower-middle-income countries is higher. However, there are no studies available on irrational use of drugs in rural Guilan province. This study aimed to measure the drug prescribing performance of primary health care centers in Northern Province, Islamic Republic of Iran, using the WHO/International Network of Rational Use of Drugs core drug prescribing indicators. Methods: In a cross-sectional retrospective study, a total of 874,132 prescriptions were collected from 177 primary health facilities of the family physician program at Guilan University of Medical Sciences in 2018-19. Five measurements were used to assess the irrational drug use: the average number of drugs per encounter, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed, percentage of drugs prescribed by generic name and percentage of drugs prescribed from National Essential Medicines List or Formulary. Index of Rational Drug Prescribing (IRDP) was used as an indicator of rational drug use. To analyze, statistical software SPSS 16 and Chi-square test were used. Results: The average of drugs per prescription was 2/69. Drugs percent off the list 13/7% (86/3%, according to the version approved list). 18/3% of prescriptions containing at least one antibiotic and 8/1% of injection and 2.0% of prescriptions had at least one corticosteroid. Most clients are women (62%) and seniors (44/9%) were formed. In this study, the price Version 74.6% of prescriptions were priced more than 30,000 Rs (Average price of prescription=107,000 Rs). Conclusion: This study shows that the prescribing practices in the health facilities are fairly good and are not that far from the standard WHO requirements. However, there is a need to do more on some issues, including the prescribing practice of antibiotics, and patients dosage form knowledge. Continuous training of physicians can improve the quality of prescribing and subsequent monitoring be considered in evaluating a doctor s season.

Keywords:

Prescribing indicators , rational prescribing , family medicine , WHO/INRUD , Guilan , Iran