Evaluation of Drug-use Pattern in a Tertiary Referral Hospital, Tripoli: A Prospective Cross-sectional Study Using WHO Core Drug-use Indicators

Abstract

Medications represent an essential component of medical treatment; however, their benefits hinge on rational use. This study evaluated the patterns of rational drug use at the University Hospital in Tripoli, Libya, using WHO prescribing and patient-care indicators. A prospective observational cross-sectional study was conducted using convenience sampling. Data from 1,200 encounters were collected from the outpatient clinics (n=600) and the central pharmacy (n=600) over seven months using standardized World Health Organization (WHO) detailed indicator forms. Additionally, 100 patient interviews were performed to assess their knowledge about the dispensed medications. Data were entered into a Microsoft Excel sheet and analyzed descriptively using frequencies, percentages, and averages. On average, three drugs were prescribed per encounter. Antibiotics and injections were identified in 24% and 18% of encounters, respectively. Generic names were used in 30% (n = 962) of the prescribed drugs (n = 3,168), and 56% of all drugs were prescribed from the Libyan Essential Medicines List (EML). On average, 6.44 minutes and 7 seconds were allocated to the patients by the physicians and the pharmacists, respectively. Actual dispensing occurred for only 28% (n = 380) of the total medications (n = 1358) requested at the central pharmacy, and only 40% (n = 153/380) of the dispensed medications were adequately labeled. Overall, only 36% of patients demonstrated adequate knowledge of their dispensed medications. Prescribing and dispensing practices at the hospital deviated significantly from the rational use standards across several indicators. Urgent interventions and policy reforms are required from all stakeholders to improve the situation.