Drug use patterns at a Kenyan referral hospital: A cross-sectional study using WHO core indicators

Abstract

Background Suboptimal medicine use practices remain a major global health challenge, particularly in low- and middle-income countries, where it contributes to increased healthcare costs, and the growing burden of antimicrobial resistance. This study aimed to evaluate drug use patterns at Thika Level 5 Hospital in Kenya using World Health Organization (WHO) core drug use indicators. Methods A facility-based cross-sectional study was conducted in the outpatient department. Data were collected from 600 prescriptions, 100 patient encounters, and facility-level assessments using standardized WHO/INRUD data collection tools. Descriptive and inferential analyses were performed using IBM SPSS Statistics (version 29), and findings were descriptively compared with WHO reference standards. Results The mean number of drugs per prescription was 3.18, which was higher than the WHO recommended range of 1.6–1.8. Generic prescribing was 45.86% while antibiotic prescribing was observed in 58.7% of encounters. Injection use was 13.0% and 76.86% of prescribed medicines were from the Essential Medicines List (EML). Patient-care indicators showed a mean consultation time of 4.26 minutes and a mean dispensing time of 122.8 seconds, which was below the WHO- recommended reference value. Only 30.0% of medicines were adequately labelled, and 44.0% of patients demonstrated complete knowledge of their medications. Significant associations were observed between dispensing time and patient knowledge (p = 0.001), as well as between labelling adequacy and patient understanding (p < 0.001). In contrast, all facility indicators met WHO standards, with full availability of essential medicines, treatment guidelines, and stock records. Conclusion Despite strong facility readiness, important gaps were identified in prescribing and patient-care practices. These findings highlight opportunities for interventions aimed at strengthening antimicrobial stewardship initiatives, promoting generic prescribing, improving dispensing practices, and enhancing patient counselling to support improved medicine use practices..