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

## TL;DR

This study evaluates prescription practices at a Kenyan hospital using WHO/INRUD indicators and finds high antibiotic use and factors linked to polypharmacy.

## Contribution

The study provides insights into prescription patterns and risk factors for polypharmacy in a Kenyan hospital setting.

## Key findings

- Analgesics and antibiotics were the most frequently prescribed drug classes.
- Antibiotic prescribing was associated with lower odds of polypharmacy.
- Most prescriptions contained generic drugs from the KEML.

## Abstract

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.

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.

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).

Interventions to promote rational antibiotic use are necessary, including educating healthcare providers and patients about the risks of antibiotic overuse.