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Indicators of quality use of medicines in South-East Asian countries: a systematic review
H T Nguyen1, V J Wirtz, F M Haaijer-Ruskamp
1Department of Clinical Pharmacy, University of Medicine and Pharmacy at Ho Chi Minh city, Ho Chi Minh city, Vietnam Department of Pharmacotherapy and Pharmaceutical Care, University of Groningen, Groningen, the Netherlands Center for Health Systems Research, National Institute of Public Health, Cuernavaca, Mexico Department of Clinical Pharmacology, University Medical Center Groningen, Groningen, the Netherlands.
Objectives:
To identify indicators of quality use of medicines used in South-East Asian region.
Methods:
A systematic review was conducted searching MEDLINE, Embase and The International Network for Rational Use of Drugs (INRUD) and The World Health Organization (WHO) website. Original studies or reports carried out in the South-East Asian region, explicitly using indicators to measure quality use of medicines, and published between January 2000 and July 2011 were included.
Results:
A total of 17 studies conducted in 7 of 11 countries in South-East Asia were included. WHO indicators focusing on general medication use in health facilities were most widely used (10 studies). Twelve studies used non-WHO indicators for measuring quality use of medicines in clinical areas (geriatrics and obstetrics) or specific diseases, such as diarrhoea and pneumonia. In five studies, WHO indicators were used along with non-WHO indicators. There was little information available about validity, reliability and feasibility of the non-WHO indicators. The majority of indicators measured process rather than structure or outcome. There were very few indicators addressing non-communicable diseases.
Conclusions:
A limited number of studies have been published explicitly using indicators of quality use of medicines across South-East Asia. Importantly, existing indicators need to be complemented with valid, reliable and feasible indicators related to non-communicable diseases, particularly those with a high financial burden to meet the current medical challenges in the region.
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