Assessment of the quality of prescription and dispensing for patients attending the Diabetes Clinic at Mulago National Referral Hospital

Abstract

Objectives: This study aimed to assess prescription quality and dispensing quality at the Diabetes Mellitus (DM) Clinic of Mulago National Referral Hospital (MNRH). Methods: A quantitative, case study design was employed at the DM Clinic of MNRH. Data was collected using structured questionnaires and data extraction forms from the 150 participants to assess prescription and dispensing practices. Data analysis involved calculating percentages to evaluate average consulting and dispensing time, drug dispensing, labelling, and prescribing quality. Results: The study revealed an average consultation time of 8.3 minutes and a low average dispensing time of 88.0 seconds, but the overall percentage of prescription filling was lower (28.8%). Less than half of the dispensed medicines were adequately labelled (44.2%), while a high percentage of patients demonstrated knowledge of correct dosage (92%). Prescribing practices showed that most prescriptions had the right indications (71.4%) and contained only necessary medicines (81.2%), with a good rate of generic prescribing (77.4%) and inclusion of essential medicines (70.8%). A high percentage of patients reported knowing the reason for their medication (90%) and the number of medicines to be taken (93.3%). However, knowledge levels decreased for the times to take medicine in a day (83.3%), the duration of treatment (76.7%), and were lowest for precautions on the medicine (66.7%). A minority of patients reported not knowing this information across all categories. Patient knowledge of their medications was generally good, but satisfaction with services was mixed, with waiting times being a key area for improvement. Conclusion: The DM Clinic at MNRH demonstrates strengths in certain aspects of prescription and dispensing, but improvements are needed in medication labelling and service delivery to optimize patient care. Recommendations: The study recommends standardizing and enhancing drug labelling practices, addressing factors contributing to low overall drug dispensing rates, implementing routine audits, promoting generic prescribing, ensuring the availability of essential medicines at all times, and providing ongoing training for healthcare providers. Additionally, optimizing patient flow to reduce waiting times and establishing a formal patient feedback mechanism are recommended.