Trend analysis of rational medicine use and WHO indicators compliance at a tertiary referral hospital in Ghana Analyse des tendances en matière d'utilisation rationnelle des médicaments et de conformité aux indicateurs de l'OMS dans un centre hospitalier universitaire de référence au Ghana
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Background: Rational medicine use is critical to ensuring patient safety, cost-effectiveness, and optimal health outcomes. The World Health Organization (WHO) evaluates prescribing practices using key indicators, including antibiotic and injectable use, adherence to the Essential Medicines List (EML), polypharmacy, and documentation of patient vitals and diagnoses.
Objectives: This study evaluated prescribing patterns at Sunyani Teaching Hospital (STH) against WHO standards, focusing on antibiotic and injectable use, adherence to the Essential Medicines List, polypharmacy, and documentation.
Methods: A retrospective trend analysis of outpatient prescription records (2022-2024) was conducted at STH a tertiary referral facility in the Bono region of Ghana. A total of 360 cases (30 per quarter) were randomly sampled from the Lightwave Health Information Management System (LHIMS). Data were analysed using Stata version 16.
Results: Proportions of prescriptions with antibiotic use (23.3%-73.3%, mean: 45%) exceeded WHO's <20 % standard. Injectable use (0%-14.9%) remained compliant. Diagnosis documentation (92.5%-100 %) and patient vitals recording (temperature: 45.8%, weight: 49.5%, blood pressure: 51.7%) fell short of WHO's 100% standard. EML adherence (80.2%-87.6%) and generic prescribing (81.2%-95.8%) were suboptimal. Polypharmacy was prevalent (mean drugs per prescription: 2.77; WHO standard: <2).
Conclusion: Despite good injectable use compliance, antibiotic overuse, declining documentation of vital signs, and polypharmacy require attention. Strengthening antibiotic stewardship, improving patient assessment protocols, and implementing medication reviews are critical for optimizing prescribing practices at STH.
FRENCH
Contexte: L'usage rationnel des médicaments est essentiel pour garantir la sécurité des patients, la rentabilité et des résultats optimaux en matière de santé. L'Organisation mondiale de la Santé (OMS) évalue les pratiques de prescription à l'aide d'indicateurs clés, notamment l'utilisation d'antibiotiques et de médicaments injectables, le respect de la Liste des médicaments essentiels (LME), la polypharmacie et la documentation des signes vitaux et des diagnostics des patients.
Objectifs: Cette étude a évalué les habitudes de prescription au centre hospitalier universitaire de Sunyani (STH) par rapport aux normes de l'OMS, en se concentrant sur l'utilisation d'antibiotiques et d'injectables, le respect de la liste des médicaments essentiels, la polypharmacie et la documentation.
Méthodes: Une analyse rétrospective des tendances des dossiers de prescriptions ambulatoires (2022-2024) a été menée au STH, un établissement de soins tertiaires de référence dans la région de Bono au Ghana. Au total, 360 cas (30 par trimestre) ont été prélevé de manière aléatoire à partir du système de gestion des informations de santé Lightwave (LHIMS). Les données ont été analyséesà l'aide du logiciel Stata version 16.
Résultats: Les proportions d'ordonnances comportant des antibiotiques (23,3 %-73,3 %, moyenne : 45 %) dépassaient la norme <20 % de l'OMS. L'utilisation d'injectables (0 % -14,9 %) est restée conforme. La documentation des diagnostics (92,5 %-100 %) et l'enregistrement des signes vitaux des patients (température : 45,8 %, poids : 49,5 %, tension artérielle : 51,7 %) n'atteignaient pas la norme de 100 % de l'OMS. L'adhésion à la LME (80,2 %-87,6 %) et la prescription de génériques (81,2 %-95,8 %) étaient sous-optimales. La polypharmacie était répandue (moyenne de médicaments par ordonnance : 2,77 ; norme OMS : < 2).
Conclusion: Malgré une bonne conformité à l'utilisation des injectables, la surconsommation d'antibiotiques, la diminution de la documentation des signes vitaux et la polypharmacie nécessitent une attention particulière. Le renforcement de la gestion des antibiotiques, l'amélioration des protocoles d'évaluation des patients et la mise en œuvre d'examen de médicaments sont essentiels pour optimiser les pratiques de prescription à STH.
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