Public sector management of essential medicines: an evaluation of the system in Papua New Guinea

Abstract

Objective: The management of essential medicines in PNG was evaluated using the standard treatment guidelines and essential medicines list as the basis to determine appropriateness of drug prescribing. Study design: A prospective study was carried out at Losuia Health Centre, Alotau Provincial Hospital, and Port Moresby General Hospital. At each setting >300 consecutive prescriptions were evaluated in 2010. In all analyses, a P-value <0.05 was taken to indicate a statistically significant association. The overall prescribing quality was evaluated and additional analyses were performed on antibiotics and antimalarial drugs.Results: A total of 1090 patients enrolled in the study and 2495 medicines were prescribed. The most common was amoxicillin products. The average number of drugs prescribed per patient was 2.3. The most common disease treated was malaria. There were statistically significant differences observed (P< 0.0001) for the level of inappropriate prescribing by prescriber category on drug selection, dosage, and duration. The overall inappropriate prescribing of antibiotics and antimalarial drugs based upon drug selection, dosage, frequency, and duration indicated a significant differences. An analysis of concordance of the STGs with the MDC for ten diseases states showed marked inconsistencies. Conclusion: The level of inappropriate prescribing was as high as 53.8% in the selected locations in PNG which is of great concern with respect to the quality of health care delivery.