A Systematic Review on Evaluation of WHO Core Prescribing Indicators Across Healthcare Facilities in Low Resource Asian Setting: A Case of Nepal.

Inappropriate drug use is a significant global health issue, particularly in low-resource settings. This systematic review evaluates drug utilization across healthcare facilities in Nepal, a low-resource setting, using WHO core prescribing indicators to identify areas for improvement. A systematic r...

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Publicado en:Inquiry (00469580) Vol. 62; pp. 1 - 20
Autores principales: Agrawal, Rohit, Shrestha, Rajeev, Poudel, Ramesh Sharma, Shrestha, Shakti
Formato: meta analysis pictorial research systematic review tables/charts Journal Article
Publicado: Sage Publications Inc. 6/14/2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 6/14/2025
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      pub: Sage Publications Inc.
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        atl: A Systematic Review on Evaluation of WHO Core Prescribing Indicators Across Healthcare Facilities in Low Resource Asian Setting: A Case of Nepal.
      aug:
        au:
          Agrawal, Rohit
          Shrestha, Rajeev
          Poudel, Ramesh Sharma
          Shrestha, Shakti
        affil: Shree College of Technology, Purbanchal University, Bharatpur, Bagmati Province, Nepal
      sug:
        subj:
          Resource-Limited Settings Nepal
          Prescribing Patterns
          Inappropriate Prescribing
          Quality Improvement
          Human
          Systematic Review
          Nepal
          PubMed
          Embase
          CINAHL Database
          Descriptive Statistics
          Confidence Intervals
          Antibiotics
          Tertiary Health Care
          Injections
          Meta Analysis
      ab: Inappropriate drug use is a significant global health issue, particularly in low-resource settings. This systematic review evaluates drug utilization across healthcare facilities in Nepal, a low-resource setting, using WHO core prescribing indicators to identify areas for improvement. A systematic review was conducted by searching literature in PubMed, Embase, CINAHL, INRUD bibliography, NepJOL, NepMed, and Google Scholar. Original studies assessing at least one WHO prescribing indicator in healthcare settings of Nepal were included. Eligible studies were analyzed descriptively and through proportional meta-analysis using a random-effects model. Eighty-eight studies were identified involving 2108 healthcare facilities and 60 191 patient encounters. The average of three drugs per encounter (95% CI: 2.5-3.2) was determined. Generic prescribing occurred only in 21.8% (95% CI: 15.6%-28.8%) prescriptions, showing a decline trend. Antibiotics were prescribed in 64.4% (95% CI: 57.7%-70.8%) encounters, with higher prevalence in secondary and tertiary care settings. Injectables were prescribed in 22.9% encounters (95% CI: 12.2-35.8). Drugs prescribed from WHO and Nepal essential medicine lists accounted for 53.0% (95% CI: 41.1-64.7) and 54.4% (95% CI: 47.7-60.9), respectively. The evaluation of drug utilization in Nepal suggested that the standards for WHO core prescribing indicators were not met, including overuse of antibiotics, underuse of essential medicines, and minimal generic prescribing. Targeted interventions, including prescriber education, policy reforms, enhanced monitoring, and regular prescription audits, are essential to promote rational prescribing and improve drug-related outcomes, including an opportunity to reduce antimicrobial resistance.
      pubtype: Academic Journal
      doctype:
        meta analysis
        pictorial
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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