ASSESSING DRUG USE PRACTICES IN FREE MEDICAL CAMPS IN KENYA - II

1. ASSESSING DRUG USE PRACTICESIN FREE MEDICAL CAMPS IN KENYA - II Orwa J, Ombogo J, Ojoo M, Oluka M, Ogaja E, Wanyanga W, Thuo M, All authors: INRUD KENYA, P.O. Box 8700, Nairobi 00100, Kenya

3. Introduction Individual drug use problems take place within a c system of drug supply and within a network of beliefs and motivations. To change a problem behaviour we must learn c about the behaviour itself and also about the determinants which underline it. Evaluation of drug use practices at free medical c camps is necessary to monitor and design changes in public - private roles that can promote drug accessibility and rational drug use at these camps .

4. Study goal The goal of this study was to obtain baseline c information on current treatment practices encountered in free medical camps, so appropriate interventions to improve drug use may be defined. Study objectives To asses prescribing practices at Free Medical c Camps in Kenya. To asses dispensing practices at Free Medical c Camps. To asses patient drug use practices at the Free c Medical Camps.

5. Methodology This was a cross - sectional study. c Data was collected using structured questionnaires. c Prescribing encounters were sampled c retrospectively by drawing random encounters from historical medical records of Kenya Medical Association. 30 encounters from 20 camps covering Nyanza , Western, Central and Rift Valley provinces, were sampled giving a total of 600 encounters. Drug use indicators were also obtained c prospectively (200 encounters) from free medical camps in Nairobi.

6. Results Table 1 shows a summary of the results of the drug c use indicator study The average patient received 2 - 3 drugs, with an c average of 46 % of patients receiving antibiotics. Prescribing in accordance with Kenya EDL was c found to be about 77 % and generic prescribing was 32 %. Adequacy of labelling was 65%. c Patient knowledge on how to take their medicines c was 74 %. The percentage of drugs prescribed actually c dispensed was 79 %.

7. Results The variability on the overall level of use of c antibiotics at different medical camps is shown on Fig. 1. There is a general tendency to over prescribe c antibiotics. There is a low tendency to prescribe by generic c name in most medical camps (Fig.2). In most cases however, most medicines prescribed c are from Kenya EDL (Fig. 3). Injection was only prescribed for chronic c conditions.

8. Results Observational evaluation of donated drugs revealed c presence of: medicines not on Kenya EDL c medicines for alternative therapy c short expiry (1 month) c non - essential medicines donated in large c quantities This is an indication of violation of guidelines for drug c donations.

9. VARIABLE VALUE Prospective Retrospective Average Av. no. of drugs prescribed 2.1 2.9 2.5 Drugs prescribed by INN (%) 32 31 31.5 Encounters with antibiotics 52 40 46.0 (%) Encounters with inj. (%) 0 1 0.5 Drugs on Kenya EDL (%) 79 76 77.5 Drugs actually dispensed (%) 79 - 79 Drugs adequately labelled (%) 65 - 65 Adequate patient knowledge 74 - 74 (%) Table 1. Information on patient care at free medical camps in Kenya

13. Conclusion This preliminary study has provided meaningful c insights into drug use pattern and prescribing behaviour at free medical camps in Kenya. However, more prospective evaluation are to be c carried out to be able to have representative measure of patient care practices at free medical camps. Though free medical camps provide important c mechanism for improving access to essential medical care, there is need to enforce standards for drug donation in order to promote rational drug use.