Rational Drug Use to Increase Service Quality in Developing Countries: A Systematic Review

Yuliana Helena Elisabeth, Vetty Yulianty Permanasari


Hospital Administration Program, Faculty of Public of Health, Universitas Indonesia



Background: Rational drug use (RDU) generally covers appropriate prescribing, ap­pro­­priate dispensing and appropriate patient use of medicines for the diagnosis, pre­ven­tion, mitigation and treatment of diseases. To enhance RDU, the patient should re­ceive medicines appropriate to their heath care conditions, at optimum doses and suf­fi­cient time, as well as at the cost that the individual and the community can afford. This study aimed to review systematically the rational drug use to increase service quality in de­veloping countries.

Subjects and Method: A systematic review was conducted by searching the following data­bases included PubMed, Proquest and Garuda which published articles in last ten years. The keywords for this review included rational drug use, irrational drug use, drug use pattern, WHO indicator, hospital, developing country, and cross sectional. The in­clu­­­sion criteria were review, systematic review, clinical review and guidelines. After re­view process 13 articles were included in this review.

Results: The average prescription was varying in several development countries in­clu­ded India, Ethiopia, Jordan, Pakistan, Indonesia, and Sri Lanka. The highest average pres­­crip­tion generic drug was in Ethiopia (90.61%) and lowest was in India (25.37%). The average prescription antibiotics highest was in Ethiopia (58.1%) and lowest was in Indonesia (36%). The percentage of injection prescriptions that exceed WHO recom­men­dations occurs in Ethiopia (38.1%). Percentage of compliance with the List of Essential Medicines highest was in India (74.3%), and Sri Lanka (100%). Prescriptions were ade­quately labeled highest was in Pakistan (100%) otherwise lowest was in Ethio­pia (45.4%). Patients know about the dosage of the prescription highest was in Ethiopia (78.8%) and Pakistan (61.6%). All of the hospitals included in the study used the na­tio­nal drug list, formulary and standard treatment guidelines but none of them had their own drug list or guideline.

Conclusion: Rational drug use in several countries is slightly above the WHO recom­men­dation. An intervention strategy includes managerial, educational, regulatory and eco­­no­mical strategies should be designed to solve the problem on the health care sys­tem in general.

Keywords: rational drug use, prescription, WHO, developing countries.

Correspondence: Yuliana Helena Elisabeth. Hospital Administration Program, Faculty of Public of Health, Universitas Indonesia. Email: yuliana.helena@gmail.com. Mobile: 081289691597.

DOI: https://doi.org/10.26911/theicph.2019.05.23

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