Evaluation of Prescription Practices Using WHO/INRUD Indicators and Determinants of Polypharmacy at a Kenyan County Referral Hospital

Abstract

Introduction: Improving treatment standards by auditing care quality using WHO and INRUD drug-use indicators is essential in low- and middle-income countries. This study aims to assess prescription practices at KCRH General Outpatient Clinics and identify risk factors for polypharmacy. Methods: This retrospective descriptive cross-sectional study analyzed prescriptions dispensed in 2022 at the KCRH outpatient pharmacy. Using a stratified random sampling, prescriptions were reviewed using a WHO/INRUD-based data abstraction form. Core drug-use indicators were determined, and logistic regression analyses were performed using STATA Version 14. Results: Of the 920 prescriptions, 69.2% were for adults and 57.0% for females. Analgesics (32.3%) and antibiotics (29.0%) were most frequently prescribed. Overall, 84.1% of the prescriptions contained antibiotics, 8.7% injectables, 97.6% generics, and 95.6% were from the KEML. The mean number of drugs per prescription was 2.7. Antibiotic prescribing was associated with lower odds of polypharmacy (aOR: 0.18; 95% CI: 0.10–0.42). Conclusion: Interventions to promote rational antibiotic use are necessary, including educating healthcare providers and patients about the risks of antibiotic overuse.