One-day out-patient prescribing patterns at a national referral hospital in Kenya

Background : Poor prescribing habits lead to ineffective and unsafe treatment for patients, exacerbating or prolonging of illness as well as causing distress and harm to them. Drug utilization studies can help identifying gaps in prescribing and feed the results back to prescribers to enhance future rational use of medicines. Objective : Evaluate outpatient prescribing practices and patterns in a leading national Hospital in Kenya. Methods : A sample of 60 prescriptions was selected by quasi-random sampling. Data was abstracted using a pre-designed data collection form, entered into and analyzed using Excel software. Results : The average number of drugs prescribed per prescription was three with a polypharmacy rate (>4 drugs) of 20%. Only two-thirds (65%) of the prescribed drugs were actually dispensed at the hospital pharmacy due to shortages, principally shortages of originators. Slightly more than half (52%) of the drugs were prescribed by generic name. Prescribing by brand names was highest among medical interns (61%). Almost all drugs prescribed (95%) were consistent with the hospital tender list. Conclusions : There is a need to increase the rate of prescribing of generics to save costs as well as reduce stock-out levels. This can be helped by instigating a comprehensive generics policy. There is also a need to strengthen and empower drugs and therapeutic committees (DTCs) to improve selection and availability of quality generics to win the confidence of prescribers. Keywords : Drug utilisation studies, generics, prescribing patterns, prescribing indicators, polypharmacy, WHO indicators, Kenya