Pattern of prescription drug use in Nigerian army hospitals.

BACKGROUND Most health expenditure of developing countries is on drugs and medical sundries but inappropriate use of such resources is common. To our knowledge, only few studies have been done in Africa on this issue , with inadequate consideration of the sociological context of the knowledge, attitude and practice of the prescribers especially doctors. This study presents the pooled data of the pattern of prescription drug use from three Nigerian Army hospitals using some WHO criteria, and the knowledge and attitude underlying doctors' prescribing practices in these hospitals. METHODS Retrospective cross-sectional survey of one year (March 2006-February 2007). Systematic random sample of general out patient case notes from three hospitals were collected using WHO criteria. The knowledge, attitude and practice survey of doctors at each study site towards the concept of rational drug use (RDU) were assessed using a self-administered questionnaire. RESULTS Data collected from 660 case notes showed that average number of drugs per encounter was 2.8 while 49.3% of drugs were prescribed in the generic form. An average of 28.1% of patients encountered antibiotics. From the knowledge, attitude and practice survey, it is evident that 90.5% of 74 prescribers were aware of the existence of national essential drugs list but 58.1% of them did not use it as basis of prescriptions. In describing types of medicines preferred, 56.7% of prescribers claimed they prescribed a mixture of generic and branded drugs. Only 12.1% of prescribers could accurately detail the 5 steps of rational prescribing. CONCLUSION The pattern of prescription drug use in Nigerian Army hospitals is unsatisfactory. It is characterised by high number of drugs per prescription, high rate of antibiotic usage and unscientific prescription by doctors. There is a need for further education and research on rational drug use among prescribers in Nigerian military health facilities.