The Impact of Clinical Pharmacist Interventions on Drug and Antibiotic Prescribing in a Teaching Hospital in Cairo — Oak Academic Publishing
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The Impact of Clinical Pharmacist Interventions on Drug and Antibiotic Prescribing in a Teaching Hospital in Cairo
1 Department of Pharmacy Practice, College of Pharmacy at University of Sharjah, Sharjah, UAE; 2 Department of Clinical Pharmacy, College of Pharmacy at Cairo University, Cairo, Egypt;
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Department of Pharmaceutics and Pharmacology, College of Pharmacy at University of Sharjah, Sharjah, UAE
1 1 Department of Pharmacy Practice, College of Pharmacy at University of Sharjah, Sharjah, UAE; 2 Department of Clinical Pharmacy, College of Pharmacy at Cairo University, Cairo, Egypt;
2 Department of Pharmaceutics and Pharmacology, College of Pharmacy at University of Sharjah, Sharjah, UAE
Background: The present study was undertaken to investigate the patterns of drug and antibiotics prescribing in a teaching hospital in Cairo, Egypt. Aim: to determine the impact of interventions on such trends in an attempt to rationalize drug use. Method: 1200 prescriptions and patients' records covering the months of January to December, 2011. Prescribing patterns were analyzed using WHO guidelines with regard to prescribing, patient care and health facility indicators. The same parame-ters were again assessed after distributing antibiotic guidelines and holding workshops activities directed towards rational drug use. Results: The number of hospital visits resulting in a prescription was significantly reduced from 94% to 86% (P-value <0.05) and in both cases none of the en-counters contained a generic drug. The average number of drugs per encounter was 2.7 and did not decrease significantly after intervention. A significant reduction was achieved in the number of prescriptions with antibiotics whereas reduction in encounters with injectable drugs was not statis-tically significant. Penicillins was the most commonly prescribed class of antibiotics and amoxicillin was the most frequently prescribed antibiotic. A significant reduction was observed in both en-counters with penicillin and the total of those with antibiotics. Analysis of prescriptions with anti-biotics revealed that penicillins, cephalosporins and erythromycin comprised 94% and 97% of all antibiotics prescribed before and after interventions respectively. Conclusion: The present results clearly indicated that interventions including distribution of antibiotic guidelines and running workshops and seminars on rational drug use to prescribers can lead to significant improvement in prescribing behavior.
Sharif, SI, Al-Shaqra, Hajjar, H, Shamout, A and Wess, L. Patterns of drug prescribing in a hospital in Dubai, United Arab Emirates. Libyan J. Med. 2007; 3 (1): 221-29.
Irshaid,YM;Al Homrany,M; Hamdi, AA; Adjepon-Yamoah, KK and Mahfouz,AA. Compliance with good practice in prescription writing at outpatient clinic in Saudi Arabia East Mediterr Health J. 2005; 11(5, 6):922-28.
Yousif, E, Ahmed, AM, Abdalla, ME, Abdel-gadir, MA. Deficiencies in medical prescriptions in a Sudanese hospital. East Mediterr Health J. 2006; 12(6):915-18.
Hamadeh GN, Dickerson LM, Saab BR, Major SC. Common prescriptions in ambulatory care in Lebanon. Ann Pharmacother. 2001; 35:636-40.
Vijayakumar TM, Sathyavati D, Subhashini T, Sonika G, and Dhanaraju MD. Assessment of prescribing trends and rationality of drug prescribing. International Journal of Pharmacology, 2011; 7 (1):140-43.
International Network for Rational Use of drugs and World Health Organization. How to investigate drug use in health facilities: selected drug use indicators. EDM Research Series No. 7 [WHO/DAP/93.1]. Geneva: World Health Organization. 1993.
Hogerzeil, HV, Walker GJ, Sallami AO, Fernando G. . Impact of an essential drugs programme on availability and rational use of drugs. Lancet,1989,1 (8630):141-42
Hasan,MY, Das,M and Mourad,F. Drug utilization and antibiotic use in the primary health care centres in Sharjah. Eastern Mediterranean Health Journal, 1997,3(3):444-51
Kuyvenhoven M, de Melker R, Van der Velden K. Prescription of antibiotics and prescribers' characteristics. A study into prescription of antibiotics in upper respiratory tract infections in general practice. Family practice, 1993, 10:366-77.
Kunin CM. Evaluation of antibiotic usage: a comprehensive look at alternative approaches. Review of infectious diseases, 1981, 3:745-53.
Farrar WE. Antibiotics resistance in developing countries. Journal of infectious diseases, 1985, 152:1103-06.
Marr JJ, Moffet HL, Kunin CM. Guidelines for improving the use of antimicrobial agents in hospitals: a statement by the Infectious Diseases Society of America. Journal of infectious diseases, 1988, 157:869-76.
Zaki,A., Abdel-Fattah,M., Bassili,A, Arafa,M and Bedwani, R. The use of medication in infants in Alexandria, Egypt. Eastern Mediterranean Health Journal.1999,5(2):320-27.
Hogerzeil HV, Bimo, Ross-Degnan D, Laing RO, Ofori-Adjei D, Santoso B, Azad Chowdhury AK, Das AM, Kafle KK, Mabadeje AF, et al. Field tests for rational drug use in twelve developing countries. Lancet. 1993;342(8884):1408-10.
Guyon AB, Barman A, Ahmed JU, Ahmed AU, Alam MS. A baseline survey on use of drugs at the primary health care level in Bangladesh. Bull WHO 1994; 72:265-71.
Hamadeh GN, Dickerson LM, Saab BR, Major SC. Common prescriptions in ambulatory care in Lebanon. Ann Pharmacother. 2001; 35:636-40.
Lindbaek M, Berild D, Straand J, Hjortdahl P. Influence of prescription patterns in general practice on anti-microbial resistance in Norway. Brit J Gen Pract. 1999; 49:436-40.
Bannenberg WJ, Forshaw CJ, Fresle D, Salami AO, Wahab HA. Evaluation of the Nile Province essential Drugs Project: Mission report by a WHO team, Sudan, 27 April-12 May, 1991. Geneva, WHO. 1991.
Moghadamnia AA, Mirbolooki MR, Aghili MB. General practitioner prescribing patterns in Babol city,Islamic Republic of Iran. East Mediterr Health J. 2002;8(4&5):550-55.
Majeed A, Moser K. Age- and sex-specific antibiotic prescribing patterns in general practice in England and Wales in 1996. Brit J Gen Pract. 1999; 49:735-36.
Sharif, SI, Al-Shaqra, Hajjar, H, Shamout, A and Wess, L. Patterns of drug prescribing in a hospital in Dubai, United Arab Emirates. Libyan J. Med. 2007; 3 (1): 221-29.
Irshaid,YM;Al Homrany,M; Hamdi, AA; Adjepon-Yamoah, KK and Mahfouz,AA. Compliance with good practice in prescription writing at outpatient clinic in Saudi Arabia East Mediterr Health J. 2005; 11(5, 6):922-28.
Yousif, E, Ahmed, AM, Abdalla, ME, Abdel-gadir, MA. Deficiencies in medical prescriptions in a Sudanese hospital. East Mediterr Health J. 2006; 12(6):915-18.
Hamadeh GN, Dickerson LM, Saab BR, Major SC. Common prescriptions in ambulatory care in Lebanon. Ann Pharmacother. 2001; 35:636-40.
Vijayakumar TM, Sathyavati D, Subhashini T, Sonika G, and Dhanaraju MD. Assessment of prescribing trends and rationality of drug prescribing. International Journal of Pharmacology, 2011; 7 (1):140-43.
International Network for Rational Use of drugs and World Health Organization. How to investigate drug use in health facilities: selected drug use indicators. EDM Research Series No. 7 [WHO/DAP/93.1]. Geneva: World Health Organization. 1993.
Hogerzeil, HV, Walker GJ, Sallami AO, Fernando G. . Impact of an essential drugs programme on availability and rational use of drugs. Lancet,1989,1 (8630):141-42
Hasan,MY, Das,M and Mourad,F. Drug utilization and antibiotic use in the primary health care centres in Sharjah. Eastern Mediterranean Health Journal, 1997,3(3):444-51
Kuyvenhoven M, de Melker R, Van der Velden K. Prescription of antibiotics and prescribers' characteristics. A study into prescription of antibiotics in upper respiratory tract infections in general practice. Family practice, 1993, 10:366-77.
Kunin CM. Evaluation of antibiotic usage: a comprehensive look at alternative approaches. Review of infectious diseases, 1981, 3:745-53.
Farrar WE. Antibiotics resistance in developing countries. Journal of infectious diseases, 1985, 152:1103-06.
Marr JJ, Moffet HL, Kunin CM. Guidelines for improving the use of antimicrobial agents in hospitals: a statement by the Infectious Diseases Society of America. Journal of infectious diseases, 1988, 157:869-76.
Zaki,A., Abdel-Fattah,M., Bassili,A, Arafa,M and Bedwani, R. The use of medication in infants in Alexandria, Egypt. Eastern Mediterranean Health Journal.1999,5(2):320-27.
Hogerzeil HV, Bimo, Ross-Degnan D, Laing RO, Ofori-Adjei D, Santoso B, Azad Chowdhury AK, Das AM, Kafle KK, Mabadeje AF, et al. Field tests for rational drug use in twelve developing countries. Lancet. 1993;342(8884):1408-10.
Guyon AB, Barman A, Ahmed JU, Ahmed AU, Alam MS. A baseline survey on use of drugs at the primary health care level in Bangladesh. Bull WHO 1994; 72:265-71.
Hamadeh GN, Dickerson LM, Saab BR, Major SC. Common prescriptions in ambulatory care in Lebanon. Ann Pharmacother. 2001; 35:636-40.
Lindbaek M, Berild D, Straand J, Hjortdahl P. Influence of prescription patterns in general practice on anti-microbial resistance in Norway. Brit J Gen Pract. 1999; 49:436-40.
Bannenberg WJ, Forshaw CJ, Fresle D, Salami AO, Wahab HA. Evaluation of the Nile Province essential Drugs Project: Mission report by a WHO team, Sudan, 27 April-12 May, 1991. Geneva, WHO. 1991.
Moghadamnia AA, Mirbolooki MR, Aghili MB. General practitioner prescribing patterns in Babol city,Islamic Republic of Iran. East Mediterr Health J. 2002;8(4&5):550-55.
Majeed A, Moser K. Age- and sex-specific antibiotic prescribing patterns in general practice in England and Wales in 1996. Brit J Gen Pract. 1999; 49:735-36.