Evaluating Rational Drug Use in Developing Countries: A Cross-Sectional Analysis of Prescribing Patterns Against WHO Indicators in Pakistan and Yemen.

The rational use of medications is essential for optimal healthcare delivery, especially in developing countries. This research delves into prescribing patterns within the healthcare system of Pakistan and Yemen against World Health Organization (WHO) prescribing indicators to uncover variances from recommended practices. A cross-sectional study was conducted in the outpatient department of different hospitals in Pakistan and Yemen, including 400 prescriptions. Demographic details and prescription data were collected, focusing on WHO prescribing indicators including the average number of drugs per encounter, the percentage of drugs prescribed by generic name, the percentage of drugs prescribed from the essential drug list, and the prevalence of antibiotic and injectable prescriptions. The mean age of patients was 43.54 ± 16.92 and 38.81 ± 18.67 years in Pakistan and Yemen, respectively. Polypharmacy was observed in both populations, with an average of 5.44 ± 1.16 drugs per encounter in Pakistan and 6.18 ± 1.09 in Yemen. Irrational antibiotic use was observed, with rates of 65% and 72.5% encounters in Pakistan and Yemen, respectively. The mean injectable medications per hospital were 28.5 (57%) and 34 (68%) in Pakistan and Yemen, respectively. In Pakistan, the mean percentage of generic prescribing was 74.18%, while in Yemen, it was 78.24%. The total percentage of drugs prescribed from the essential drug list was 98.24% in Pakistan, whereas 97.87% in Yemen. The findings reveal significant deviations from WHO prescribing indicators marked by polypharmacy and excessive antimicrobial and injectable utilization, which pose risks to patient safety and contribute to antimicrobial resistance.