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Evaluating Rational Drug Use in Developing Countries: A Cross-Sectional Analysis of Prescribing Patterns Against WHO
Amjad Khan1,2,3, Ali Mohammed Ahmed Al-Subari3, Saima Mushtaq1,2
1Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Pharmacology Research & Perspectives
|November 19, 2025
Summary
Prescribing patterns in Pakistan and Yemen show polypharmacy and high rates of antibiotic and injectable use, deviating from World Health Organization (WHO) guidelines. These practices risk patient safety and fuel antimicrobial resistance.
Area of Science:
- Pharmacology
- Global Health
- Health Services Research
Background:
- Rational medication use is crucial for effective healthcare, particularly in developing nations.
- Deviations from World Health Organization (WHO) prescribing indicators can compromise patient safety and treatment outcomes.
- Understanding prescribing patterns is key to identifying areas for improvement in medication management.
Purpose of the Study:
- To evaluate prescribing patterns in Pakistan and Yemen against WHO prescribing indicators.
- To identify deviations from recommended practices in medication use.
- To assess the prevalence of polypharmacy, generic prescribing, and the use of antibiotics and injectable medications.
Main Methods:
- A cross-sectional study was conducted involving 400 prescriptions from hospital outpatient departments in Pakistan and Yemen.
- Data collected included demographic details and prescription information aligned with WHO prescribing indicators.
- Key indicators analyzed were: average number of drugs per encounter, generic prescribing percentage, essential drug list prescribing percentage, and antibiotic/injectable prescription prevalence.
Main Results:
- Polypharmacy was prevalent, with an average of 5.44 drugs per encounter in Pakistan and 6.18 in Yemen.
- Irrational antibiotic use was high: 65% of encounters in Pakistan and 72.5% in Yemen.
- Injectable medication use was significant, with 57% in Pakistan and 68% in Yemen.
- Generic prescribing was 74.18% in Pakistan and 78.24% in Yemen.
- Prescribing from the essential drug list was high (98.24% in Pakistan, 97.87% in Yemen).
Conclusions:
- Significant deviations from WHO prescribing indicators were observed in both Pakistan and Yemen.
- High rates of polypharmacy, antibiotic, and injectable use pose risks to patient safety.
- These prescribing patterns contribute to the growing threat of antimicrobial resistance.
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