Assessment of pharmaceutical sales promotion and prescribing patterns of antibiotics at Entebbe Regional Referral Hospital

Abstract

Background: The inappropriate use of antibiotics is a major contributing factor to the widely acknowledged rise in antibiotic resistance (ABR) compromising their efficacy and posing a major threat to global health and sustainable development. This is a result of several factors among which are the prescribing patterns among prescribers in the different health facilities. Prescribing patterns are further influenced by pharmaceutical promotion activities (PPAs) directed towards prescribers. This study aimed to assess the pharmaceutical sales promotion activities and the overall prescribing patterns of antibiotics among prescribers at Entebbe Regional Referral Hospital (ERRH). Methods: A cross sectional study design was employed to identify the pharmaceutical promotion activities, prescribing practices of antibiotics as well as prescribers’ perceptions on pharmaceutical sales promotion at the outpatient Department of ERRH. Observations were employed to obtain data from a total of 351 systematically sampled prescriptions. A total of 20 responses from prescribers were collected through structured questionnaires. The data were analyzed using Jamovi 2.4.14.0 software to obtain descriptive statistics. Results: The study found out that the commonly used pharmaceutical promotion tools were calendars, pens and clinical coats while the activities included CMEs, free gifts and sponsorships. Out of the 351 prescriptions studied, 94.87% prescriptions contained antibiotics with more than half of the medicines (53.13%) prescribed being antibiotics. The average number of medicines per prescription was 3.14 with 76.07% prescribed generically and 100% from the Essential Medicines List of Uganda. Most of the prescribers (75%) admitted to being influenced by promotional activities directed towards them. Conclusion: The pharmaceutical companies employed a number of different methods collectively to promote increased drug sales while targeting prescribers at the OPD of ERRH. There was a very high rate of antibiotic prescribing as well as a higher average number of medicines per prescription as compared to both the National and WHO standards. Most of the prescribers admitted to being influenced by pharmaceutical promotion activities. Recommendation: The Ministry of Health should promote generic prescribing and compliance with the National /WHO recommendations by enforcing use of National Standard Treatment Guidelines.