Drug prescribing indicators in village health clinics across 10 provinces of Western China.

BACKGROUND: The irrational use of drugs was a global problem, especially in developing countries. However, there are no studies available on irrational use of drugs in rural Western China. OBJECTIVE: To assess the drug prescribing patterns using World Health Organization Drug Use Indicators at village health clinics in rural areas of Western China. METHODS: A total of 20 125 prescriptions were collected from 680 primary health clinics in villages from 40 counties in 10 provinces of Western China. Five measurements were used to assess the irrational drug use: percentage of encounters with an antibiotic prescribed, average number of drugs per encounter, percentage of encounters with an injection prescribed, percentage of drugs prescribed by generic name and percentage of drugs prescribed from National Essential Medicines List or Formulary. Index of Rational Drug Prescribing (IRDP) was used as an indicator of rational drug use. RESULTS: The percentage of prescriptions containing antibiotics was 48.43%, while the average number of drugs per prescription was 2.36, and the percentage of injection prescriptions was 22.93%. The percentage of drugs prescribed by generic name was 64.12%, and the percentage of drugs prescribed from the National Essential Drug List was 67.70%. The IRDP of the present study was 3.32 with the optimal level of 5. There are also some regional variations in these measurements. CONCLUSIONS: The study provides some evidence of irrational use of drugs to a great extent in rural areas of Western China. Overuse of injection and overuse of antibiotics were the most prominent manifestations of such irrational drug prescribing.