Evaluation of drug use pattern in adults' outpatient clinics in a tertiary teaching hospital using WHO core prescribing indicators

Objectives: This study has evaluated the drug use pattern among adults attending the outpatient clinics of the Jordan University Hospital (JUH), by assessing the adherence of prescriptions to the World Health Organization (WHO) core prescribing indicators. Methods: This is a cross-sectional study that was conducted during the period from October 2011 to January 2022 at JUH. Several prescriptions from 10 different adult outpatient clinics were reviewed to evaluate hospital adherence to the five WHO core prescribing indicators. Key findings: To assess the WHO core prescribing indicators, data for 2451 prescriptions were reviewed. Around one-third of the patients (33.4%) were receiving polypharmacy (five medications or more). Results revealed that two core prescribing indicators were not following the standard values specified by the WHO; the average number of drugs prescribed per encounter (3.8 medications/prescription), and the percentage of drugs from the essential drug list (EDL) (54.1%). Endocrine clinics showed the highest average of drugs (6.3) per prescription and the highest percentage of prescriptions with injectable medicines (51.7%). On the other hand, ophthalmology clinics showed the highest percentage of prescriptions with antibiotics (29.9%) and the lowest percentage of drugs prescribed from the EDL at JUH (14.1%). Evaluating factors affecting the number of prescribed medications per encounter revealed that elderly patients (> 60 years), being female, referring to the endocrine clinic, and having insurance have a higher average number of medications per encounter compared with others (P < 0.05). Conclusion: The proper prescribing practices in a sizable tertiary hospital in Amman, Jordan, are clarified by this study. The percentage of medications from EDL and the typical number of drugs/encounters did not comply with WHO requirements. The study findings should guide the Jordanian health policymakers in designing and implementing strategies to limit irrational prescribing practices and raise awareness of and ensure physician adherence to the national EDL.