A baseline study of drug prescribing practices in a Nigerian military hospital

In many developing countries, drug costs form an important portion of government and household expenditure. Also, improper use of drugs is a major health hazard and increases treatment costs. However, while the problem of irrational use of drugs is worldwide, it has not been adequately studied especially in developing countries such as Nigeria. Military facilities provide health care services to an important segment of both the military and civil population.

The aim of this study was to evaluate drug prescribing practices at a Nigerian military hospital (Military Hospital, Ikoyi, Lagos) and to make recommendations for its improvement. Using WHO rational drug use (RDU) criteria, prescribing and facility care indicators were studied using case notes of general out patients seen between March 2006 and February 2007. Also, a knowledge, attitude and practice (KAP) study of prescribers and dispensers at the hospital to complement the study of indicators was also undertaken.

Based on systematic sample of 180 case notes collected over the study period, the average number of drugs per encounter was higher (3.0 +/- 1.5) than other African values. Also, 43.8% of drugs were prescribed using their generic names which is low. A high number of patients were prescribed antibiotics (27.8%) and injections (23.9%). From the KAP study of 29 respondents, only one (3.4%) was not aware of the existence of the Essential Drug List (EDL) while 50.0% claimed ownership of a copy of the EDL. Few (13.9%) respondents, could accurately detail the 5 steps in issuing a prescription.

This study revealed gaps between the actual level of knowledge of prescribers/dispensers about RDU and actual practice. The need for further studies and focused interventions are outlined.