Published in PLOS One on 2026-02-12, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Nana Ama Buadiba Osei, Daniel Freeman Owusu Ansah, Kofi Bedu Tetteh, Angela Appiah Kuffuor, Fareeda Serwaa Brobbey, Bismark Sarfo
Source: PLOS One • DOI 10.1371/journal.pone.0341088
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
To promote rational drug use in developing countries, it is important to assess drug use patterns. This study assessed the drug prescription patterns of the family medicine clinic at the Outpatient Pharmacy of the University of Ghana Medical Centre using the World Health Organization’s drug use indicators. An analytic, cross-sectional survey with data extracted from patient’s electronic medical records was carried out. Questionnaires were given to all prescribers in the family medicine clinic to evaluate factors related to rational medicine use. Frequencies and percentages were employed for description with further analysis, including Zero-inflated Poisson regression and logistic regression, used to determine associations between variables with a 95% confidence interval. Of the 600 participants whose prescriptions were analyzed, 367 (61.17%) were male and 233 (38.83%) were female. The prescribers interviewed were 3 males and 7 females. The mean number of medications per prescription was 1.4 (SD = 1.61), with antibiotics and injections making up 12.74% (n = 107) and 4.17% (n = 35) respectively. Generic prescriptions were 34.88% (n = 293) and those from the Essential Medicines List (EML) were 72.38% (n = 608). Prescriptions with a record of diagnosis were 50.83% (n = 305). Patients with comorbidities were shown to have a 52.2% lower prevalence rate of the total number of medications prescribed compared to those without comorbidities (p-value <0.001). Female patients have 46.4% reduced odds of being prescribed an antibiotic compared to male patients (p-value 0.012). The odds of a patient with a chronic condition being prescribed an antibiotic is 93.2% more than that of a patient without a chronic condition (p-value = 0.025). Additionally, the prevalence of drugs prescribed from the EML for a patient with a chronic condition is 74.4% lower than that prescribed for patients without a chronic condition (p-value = 0.048). There was moderate adherence to rational prescribing. Three prescribing indicators met reference standards, these were: average number of medicines per encounter, percentage of prescriptions with an injectable and percentage of encounters with antibiotics. Rational drug prescribing may be enhanced through training, guidelines, EML distribution, drug and therapeutics committee support and integrated Clinical Decision Support Systems (CDSS).
Introduction
Drugs are essential in achieving good clinical outcomes in patients [1]. Therefore, rational use of medicines should be well integrated into any health system to preserve the integrity and quality of drugs provided to patients. The World Health Organization (WHO) defines rational use of medicines (RUM) as patients “receiving medications that are appropriate for their clinical needs, administered in the right dosage to meet their individual needs, for enough time, and at the most affordable price for both the patient and their community” [2]. Adherence to good prescribing practices is essential to achieve quality healthcare delivery. For this reason, the World Health Organization (WHO) has developed quality indicators for the evaluation of prescribing practices to prevent any negative consequences associated with irrational medicine use such as poor treatment outcomes, higher treatment costs and increased risk of adverse reactions [3]. Despite the efforts made by the WHO to ensure medicines are used rationally, more than 50% of prescribed drugs worldwide are utilized inappropriately and more than 50% of patients do not take their medicines as they are told to [4]. Again, about 33% of the population worldwide do not have access to essential medicines which is concerning [5]. Drug utilization studies are therefore used periodically to ensure RUM. These studies aid in the evaluation of the quality of drugs and make clinical care cost-effective [6]. Drug utilization studies involve the review of data from prescriptions. Prescriptions reflect the physician’s knowledge and how well they utilize medications in the treatment of patients [1]. Due to a myriad of factors such as lack of qualified workers, gaps in knowledge and lack of funds, underdeveloped countries continue to face challenges regarding RUM, which is of public health concern as it affects clinical outcomes in patients [7]. In a developing country like Ghana, there is a need to understand prescription patterns in order to maximize the use of the limited resources provided [6]. Prescribing practices have been assessed in many studies worldwide, highlighting different results of irrational prescribing. A 2010 study in Saudi Arabia showed that an average of 2.4 drugs were prescribed per encounter, with 61.2% prescribed by generic name and 32.2% involving antibiotics [8]. Similarly, on average, 3.4 drugs were prescribed per encounter, with 71.6% being generic prescriptions, and antibiotics and injections being involved in 48.9% and 27.1% of encounters, respectively in a study conducted in Pakistan [9]. A 2021 study in Ghana showed that on average, 3 medicines were prescribed per encounter with a patient, with generics accounting for 76% of prescriptions, and 7% of encounters including injections [10]. A further study in Northern Ghana reported an average of 3.9 medicines prescribed per encounter, with 55% and 14% of encounters involving antibiotics and injections, respectively, while prescribing by generic name was observed in 53% of cases [11]. These studies highlight areas that can be improved to enhance prescribing practices. It is therefore imperative for facilities to regularly assess prescribing practices. Results from these studies could be used to sensitize prescribers and draw attention to inappropriate medication use. Such studies are beneficial to policymakers in terms of reviewing procurement and prescribing policies within the facility. Given that University of Ghana Medical Centre, Legon (UGMC) is a relatively new healthcare facility with personnel from different backgrounds, monitoring prescription patterns is essential to the implementation of appropriate measures to reduce potential medication errors. This study assessed prescribing practices at UGMC using the WHO prescribing indicators. It was conducted to contribute to the existing body of knowledge and aid in identifying areas for improvement in prescribing practices at this quaternary healthcare facility [12].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider research & evidence desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Nana Ama Buadiba Osei, Daniel Freeman Owusu Ansah, Kofi Bedu Tetteh, Angela Appiah Kuffuor, Fareeda Serwaa Brobbey, Bismark Sarfo. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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- Evidence brief: Drug use patterns at a Kenyan referral hospital: A cross-sectional study using WHO core indicators
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- Evidence brief: Availability and affordability of essential medicines for non-communicable disease management in primary healthcare: Evidence from three municipalities in Ghana
