Assessment of Drug Prescribing in Jordan Using World Health Organization Indicators

Assessment of Drug Prescribing in Jordan Using World Health Organization Indicators

Alaa R.Alkhatib1, Anwar M. Batieha2, Nour M. Abdo3, Hayel M.Obeidat4, and Abdul Hakeem M. Okour5.
1.Jordan Food and Drug Administration, Shafa Badran, Amman, Jordan 11181 Jordan. 2.Professor of epidemiology and public health, Faculty of Medicine, Department of Public Health and Community Medicine,Jordan University of Science and Technology. 3.Assistant Professor of public health, Faculty of Medicine, Department of Public Health and Community Medicine, Jordan University of Science and Technology, 4.Director General of the Jordan Food and Drug Administration, ShafaBadran, Amman, Jordan 11181 Jordan.5.Associate Professor of maternal and child health, Faculty of Medicine, Department of Public Health and Community Medicine, Jordan University of Science and Technology.

 International Journal of Hospital Pharmacy

Background: Irrational drug use is a major public health problem worldwide. Patterns of prescribing of pharmaceuticals by physicians in Jordan have been scarcely studied.
Objectives: To assess the drug prescribing patterns using World Health Organization Drug Use Indicators at 7 primary health care centers in Amman, the capital of Jordan.
Methods: We prospectively evaluated 1055 prescriptions over a period of 2 months from May/2017 to July/2017, using the WHO prescribing indicators recommended protocol. Core prescribing indicators assessed in this study included the average number of drugs per prescription, the percentage of drugs prescribed by generic name, the percentage of prescriptions containing injections, the percentage of prescriptions containing antibiotics, and the percentage of drugs from the essential drugs list.
Results: Our results showed that the average number of drugs per prescription was 3.0, the percentage of drugs written by generic name was 50.3%, the percentage of drugs written from essential drug list was 97.6%, and the percentages of prescriptions that contain injections and antibiotics were 7.1%, 61.0%, respectively.
Conclusion: Three of the 5 indicators, namely, the average number of drugs per prescription, the percentage of drugs written by generic name, and the percentage of prescriptions that contain antibiotics, fell short of WHO optimal values indicating that there is a room for improvement in prescribing.

Keywords: essential drug list; generic name; prescribing behavior; rational drug use; WHO prescribing indicators.

Free Full-text PDF

How to cite this article:
Alaa R.Alkhatib, Anwar M. Batieha, Nour M. Abdo, Hayel M.Obeidat, and Abdul Hakeem M. Okour.Assessment of Drug Prescribing in Jordan Using World Health Organization Indicators. International Journal of Hospital Pharmacy, 2019,4:27.


1. Hogerzeil, Hans V. Promoting rational prescribing: an international perspective. British journal of clinical pharmacology, 1995, 39.1: 125 6.doi:10.1111/j.1365-2125.1995.tb04402.x
2. Le Grand, A., Hogerzeil, H. V., & Haaijer-Ruskamp, F. M. Intervention research 30 in rational use of drugs: a review. Health policy and planning, (1999).14(2), 89-102. doi:10.1093/heapol/14.2.89
3. World Health Organization.Action Programme on Essential Drugs and Vaccines. (1993). How to investigate drug use in health facilities: selected drug use indicators. Geneva: World Health Organization. WHO/DAP/93.1
4. Laing, R. O., Hogerzeil, H. V., & Ross-Degnan, D. Ten recommendations to improve use of medicines in developing countries. Health policy and planning, (2001).16(1), 13-20. doi:10.1093/heapol/16.1.13
5. Otoom S, Batieha A, Hadidi H, Hasan M, Al-Saudi K. Evaluation of drug use in Jordan using WHO prescribing indicators. East Mediterr Health J. 2002 Jul- Sep;8(4-5):537-43.
6. Al-Azayzih A, Al-Azzam SI, Alzoubi KH, Shawaqfeh M, Masadeh MM. Evaluation of drug-prescribing patterns based on the WHO prescribing indicators at outpatient clinics of five hospitals in Jordan: a cross-sectional study. Int J Clin Pharmacol Ther. 2017 May; 55(5):425-432. doi: 10.5414/CP202733
7. Atif, M., Sarwar, M. R., Azeem, M., Umer, D., Rauf, A., Rasool, A, et al. Assessment of WHO/INRUD core drug use indicators in two tertiary care hospitals of Bahawalpur, Punjab, Pakistan.J Pharm Policy Pract. 2016; 9(1): 27. doi: 10.1186/s40545-016-0076-4
8. Robert L Maher, Joseph Hanlon & Emily R Hajjar (2013) Clinical consequences of polypharmacy in elderly, Expert Opinion on Drug Safety, 13:1, 57-65, doi. 10. 1517 /14740338.2013.827660.
9. Sharif, S., Al-Shaqra, M., Hajjar, H., Shamout, A., & Wess, L. Patterns Of Drug Prescribing In A Hospital In Dubai, United Arab Emirates.Libyan J Med. 2008; 3(1): 10–12. doi: 10.3402/ljm.v3i1.4744.
10. El Mahalli, A. A. WHO/INRUD drug prescribing indicators at primary health care centres in Eastern province, Saudi Arabia. Eastern Mediterranean Health Journal, (2012).18(11), 1091. doi:10.26719/2012.18.11.1091
11. Pervin, L. Polypharmacy and aging: Is there cause for concern. ARN Network. 2008; 25(1):6-7.
12. Ajlouni, K., Khader, Y. S., Batieha, A., Ajlouni, H., & El-Khateeb, M. (2008). An increase in prevalence of diabetes mellitus in Jordan over 10 years. Journal of Diabetes and its Complications, 22(5), 317-324. DOI:10.1016/j.jdiacomp.2007.01.004
13. Jaddou HY, Batieha AM, Khader YS, Kanaan AH, El-Khateeb MS, Ajlouni KM. Hypertension Prevalence, Awareness, Treatment and Control, and Associated factors: Results from a National Survey, Jordan. International Journal o Hypertension. 2011; 2011:828797. doi:10.4061/2011/828797.
14. Flegel, Ken. “The adverse effects of brand-name drug prescribing.” Canadian Medical Association Journal 184.5 (2012): 616-616, doi: 10.1503/cmaj.112160
15. El-Dahiyat F, Kayyali R. Evaluating patients’ perceptions regarding generic
16. medicines in Jordan. Journal of Pharmaceutical Policy and Practice. 2013;6:3. doi :10.1186/2052-3211-6-3.
17. Patel V, Vaidya R, Naik D, Borker P. Irrational drug use in India: a prescription survey from Goa. J Postgrad Med. 2005; 51(1):9–12.
18. Desalegn AA. Assessment of drug use pattern using WHO prescribing indicators at Hawassa University teaching and referral hospital, South Ethiopia: a cross sectional study. BMC Health Serv Res. 2013,13(1):170. doi: 10.1186/1472-6963-13-170 .
19. Electronic Health Records and Health Care in Jordan. Jordan; 2016 24 October 2017.
20. Costelloe Céire, Metcalfe Chris, Lovering Andrew, Mant David, Hay Alastair D. Effect of antibiotic prescribing in primary care on antimicrobial resistance in individual patients: systematic review and meta-analysis BMJ 2010; 340 :c209. doi: 10.1136/bmj.c2096.
21. Mansour NO, El-Hefnawy ME. Rational Use of Drugs in Egypt According to the Standard WHO Prescribing Indicators: Pilot Baseline Situational Analysis RRJHCP. 2017;3(1):48–53.
22. Ofori-Asenso R, Brhlikova P, Pollock AM. Prescribing indicators at primary health 15 care centers within the WHO African region: a systematic analysis (1995–2015). BMC Public Health.2016; 16:724. doi: 10.1186/s12889-016-3428-8.
23. Laing RO. Rational Drug Use: An Unsolved Problem. Trop Doct. 1990; 20(3):101-103. doi: 10.1177/004947559002000303
24. Thong BY, Tan T. Epidemiology and risk factors for drug allergy.Br J Clin Pharmacol. May;71(5):684-700

Terms of Use/Privacy Policy/ Disclaimer/ Other Policies:
You agree that by using our site, you have read, understood, and agreed to be bound by all of our terms of use/privacy policy/ disclaimer/ other policies (click here for details).

This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.