A combined strategies intervention on the world health organization prescribing indicators: a quasi-randomised trial

Simple item page
dc.contributor.authorNcube, Nondumiso B.Q.
dc.contributor.authorMukumbang, Ferdinand C
dc.contributor.authorLaing, Richard
dc.contributor.authorSchneider, Helen
dc.contributor.authorLaing, Richard
dc.date.accessioned2025-10-29T11:07:54Z
dc.date.available2025-10-29T11:07:54Z
dc.date.issued2024
dc.description.abstractBackground: Irrational medicine use is a global problem that may potentiate antimicrobial resistance. Aim: This study aims to assess prescribing practices and the effect of a prescription audit and feedback coupled with small-group education intervention on prescribing indicators. Setting: The study was conducted in public-sector healthcare facilities in Eswatini. Methods: A cluster quasi-randomised controlled study was conducted from 2016 to 2019 using the World Health Organization/International Network for Rational Use of Drugs (WHO/INRUD) prescribing indicators at baseline, post-intervention and post-follow-up. A 6-month unblinded intervention was tested in 32 healthcare facilities, randomly allocated to intervention (16) and control (16) arms. Prescribing practices were assessed post-intervention, and 6 months after the intervention, through an audit of 100 randomly selected prescriptions from each facility. Comparisons of WHO or INRUD prescribing indicators were conducted using the intention-to-treat analysis at the two times. Results: At baseline, in both arms, rational prescribing standards were met by the number of medicines per prescription and the use of injections. Antibiotic use was above 50% in both arms. After adjustment for baseline antibiotics use, region and level of care, there were no significant differences in all prescribing indicators between the two arms, post-intervention and at 6 months follow-up. Conclusion: In a lower middle-income setting with a high prevalence of irrational prescribing practices, a prescription audit, feedback and small-group education intervention had no benefits in improving rational prescribing. Contribution: Multifaceted strategies, strengthening of pharmacy and therapeutics committees, and holistic monitoring of medicine use are recommended to promote rational medicine use.
dc.identifier.citationNcube, N.B., Chivese, T., Mukumbang, F.C., Bradley, H.A., Schneider, H. and Laing, R., 2024. A combined strategies intervention on the World Health Organization prescribing indicators: A quasi-randomised trial. African Journal of Primary Health Care & Family Medicine, 16(1), p.3943.
dc.identifier.urihttps://doi.org/10.4102/PHCFM.V16I1.3943
dc.identifier.urihttps://hdl.handle.net/10566/21306
dc.language.isoen
dc.publisherAOSIS (pty) Ltd
dc.subjectAntibiotic resistance
dc.subjectEswatini
dc.subjectIntervention
dc.subjectRational drug prescribing
dc.subjectRational drug use
dc.titleA combined strategies intervention on the world health organization prescribing indicators: a quasi-randomised trial
dc.typeArticle

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
ncube_a_combine_startedies_intervention_2024.pdf
Size:
622.47 KB
Format:
Adobe Portable Document Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

Research Articles (School of Public Health)