EVALUATION OF DRUG PRESCRIBING PATTERN UNDER THE NATIONAL HEALTH INSURANCE SCHEME IN RURAL GHANA

Abstract

Inappropriate prescription and use of drugs is a major public health concern worldwide especially in developing countries and account for huge national health budgets. The objective of this study was to evaluate prescribing pattern of drugs under the national health insurance scheme in a rural and peri-urban setting using the World Health Organization prescribing indicators and to establish determinants of irrational drug prescribing patterns. A retrospective cross sectional study carried out for the whole of 2012 in the Kintampo North Municipality of the Brong-Ahafo Region of Ghana. Vetted outpatient department claim forms submitted by all facilities to the Kintampo Municipal Mutual Health Insurance Scheme were used. A total of 4238 claim forms were reviewed resulting in 12415 drugs prescribed. The average number of drugs per prescription was 2.9. Percentage of drugs: prescribed under their generic names, which contained an antibiotic, in injection form and from the essential drugs formulary were 99.8%, 36.6%, 3.8% and 100% respectively. Significant determinants of antibiotic prescription were all age groups (5-11 years p<0.0001; 12-59 years p<0.0001; ≥60 p=0.003), second (p=0.002) and fourth (p=0.003) quarters of the year and the female sex (p=0.05). There was polypharmacy and irrational prescribing of antibiotics in this setting. Significant determinants of antibiotic prescription were all age groups, second quarters and fourth quarter of the year and the female sex.