ASSESSING PRESCRIBING PATTERNS OF ESSENTIAL MEDICINES IN THREE RURAL DISTRICT HOSPITALS IN RWANDA

Remy Pacifique Ntirenganya* , Valens Mugiraneza, Bethany L. Hedt-Gauthier, Marie Paul Nisingizwe, Anicet Nyawakira, John Nyiligira, Felix Rwabukwisi Cyamatare, Isaie Nsabimana, Regis Habimana, Frederic Muhoza, Cheryl L. Amoroso

Inappropriate prescribing is a global health problem and main challenges include over prescription of antibiotics, over-use of injections, over-spending by failing to prescribe generic medicines and prescription of multiple medicines. This cross-sectional study included patient encounters at outpatient departments of three rural hospitals in Rwanda to assess prescribing patterns of essential medicines using the WHO core prescribing indicators. Patient encounters were randomly sampled. Chi-square and Kruskal-Wallis statistical tests were used to compare results. Our findings show that the average number of medicines prescribed per patient (1.8) was within WHO targets, the percentage of encounters with an antibiotic prescribed (37.2%) was above targets, while the percentage of encounters with an injection prescribed (7.2%) and percentage of medicines prescribed in generic names (75.0%) or from the National Essential Medicines List (70.5%) were below WHO targets. Clinicians, researchers, academics and policymakers should use these findings to plan for interventions like problem-based learning or Drug and Therapeutics Committees that promote good prescribing practices.