How Rational Are Drugs Used in Malaysian Primary Health Care Sector?

Irrational drug use is a serious health problem and causes various consequences: medical, economic and social impacts. No study in Malaysia has been conducted extensively using World Health Organization (WHO) indicators to evaluate the rational drug use status in this country. The general aim of this study is to explore the country’s pharmaceutical situations with regard to the implementation of Essential Drug List (EDL). Specifically, the objective is to assess the WHO rational drug use indicators in the pharmaceutical sector. Rational drug use is measured by examining the patterns of drug use. A survey in 20 randomly selected public health clinics in the primary health care sector was used to gather information about prescribing habits in five different areas in Malaysia. Thirty outpatient encounters at each public health clinic were sampled. The methodology used was adopted from the WHO Protocol. Significance testing was carried out using Kruskal-Wallis test with a priori significance level of 0.05. The average number of drugs prescribed per prescription was 2.79. The average percentage of antibiotic used was 23.2% and the percentage of injection used was low, with an average of 1.7%. All of the drugs prescribed to patients were listed in the EDL. The average percentage of drugs adequately labeled was 92.0%. The percentage of patients who had adequate knowledge of how to take their drugs was 74.9%. The percentage of the public health clinics who kept the Standard Treatment Guidelines (STG) in their premises was 95.0%, but none kept the EDL in their premises.