Validity of World Health Organisation prescribing indicators in Namibia's primary health care : findings and implications

Niaz, Q and Godman, B. and Massele, A. and Campbell, S. and Kurdi, A. and Kagoya, H.R. and Kibuule, D. (2019) Validity of World Health Organisation prescribing indicators in Namibia's primary health care : findings and implications. International Journal for Quality in Health Care, 31 (5). pp. 338-345. ISSN 1464-3677 (https://doi.org/10.1093/intqhc/mzy172)

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Abstract

Objective: World Health Organization/ International Network of Rational use of Drugs (WHO/INRUD) indicators are widely used to assess medicine use. However, there is limited evidence on their validity in Namibia’s primary health care (PHC) to assess the quality of prescribing. Consequently, our aim was to address this. Design, setting, participants and interventions: An analytical cross-sectional survey design was used to examine and validate WHO/INRUD indicators in outpatient units of two PHC facilities and one hospital from 1st February 2015 to 31st July 2015. The validity of the indicators was determined using two-by-two tables against compliance to the Namibian standard treatment guidelines (NSTG). The receiver operator characteristics for the WHO/INRUD indicators were plotted to determine their accuracy as predictors of compliance to agreed standards. A multivariate logistic model was constructed to independently determine the prediction of each indicator. Main outcomes and results: Out of 1243 prescriptions; compliance to NSTG prescribing in PHCs was sub-optimal (target was >80%). Three of the four WHO/INRUD indicators did not meet Namibian or WHO targets: antibiotic prescribing, average number of medicines per prescription and generic prescribing. The majority of the indicators had low sensitivity and/or specificity. All WHO/INRUD indicators had poor accuracy in predicting rational prescribing. The antibiotic prescribing indicator was the only covariate that was a significant independent risk factor for compliance to NSTGs. Conclusion: WHO/INRUD indicators showed poor accuracy in assessing prescribing practices in PHCs in Namibia. There is need for appropriate models and/or criteria to optimize medicine use in PHCs in the future

ORCID iDs

Niaz, Q, Godman, B., Massele, A., Campbell, S., Kurdi, A. ORCID logoORCID: https://orcid.org/0000-0001-5036-1988, Kagoya, H.R. and Kibuule, D.;
  • Item type:Article
    ID code:64618
    Dates:
    Date
    Event
    30 June 2019
    Published
    28 August 2018
    Published Online
    26 July 2018
    Accepted
    Notes:This is a pre-copyedited, author-produced version of an article accepted for publication in International Journal for Quality in Health Care following peer review. The version of record Niaz, Q., Godman, B., Massele, A., Campbell, S., Kurdi, A., Kagoya, H. R., & Kibuule, D. (2018). Validity of World Health Organisation prescribing indicators in Namibia's primary health care: findings and implications. International Journal for Quality in Health Care is available online at: https://doi.org/10.1093/intqhc/mzy172
    Subjects:Medicine > Pharmacy and materia medica
    Department:Faculty of Science > Strathclyde Institute of Pharmacy and Biomedical Sciences
    Strategic Research Themes > Health and Wellbeing
    Depositing user: Pure Administrator
    Date deposited:27 Jun 2018 10:17
    Last modified:11 Nov 2024 12:02
    Related URLs:
    URI:https://strathprints.strath.ac.uk/id/eprint/64618
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