RESUMO
Purpose: Rational drug use (RDU) promotes safe, efficient, and cost-effective utilization of medicines in hospital settings. The aim of this study was to assess rational drug use based on the World Health Organization (WHO) and the International Network for Rational Use of Drugs (INRUD) core drug use indicators. Patients and Methods: This prospective, descriptive, hospital-based cross-sectional study was conducted among patients attending the Outpatient Department of a secondary care hospital located in the Sheema District of Western Uganda. A total of 450 prescriptions were prospectively collected from eligible patients and subjected to evaluation by using the WHO/INRUD core drug use indicators (prescribing, patient care, and health-facility indicators). Results: The average number of drugs prescribed per encounter was found to be 3.2 (optimal value=1.6-1.8). The percentages of drugs prescribed by their generic name (90.48%) and from the Essential Medicine List (96.23%) were close to the WHO reference (100%). The percentage of antibiotics (66.22%) and injections (25.22%) per encounter exceeded the WHO standards (antibiotics=20.0-26.8; injections=13.4-24.1). Among the patient-care indicators, the average consultation time (5.41 minutes), average dispensing time (131.03 seconds), percentage of medicines dispensed (76.11%), percentage of medicines adequately labeled (59.74%), and percentage of patients with dosage knowledge (49.50%) did not meet the WHO reference. Facility indicators such as the percentage of key medicines available in the stock (66.67%) did not conform to the WHO optimal value. The hospital made the EML hundred percent available to all practitioners. Conclusion: The study concludes that the prescribing, patient care, and health facility indicators at Sheema District Secondary Care Hospital deviate from the optimal values recommended by the WHO. Therefore, this study indicates a need for improvement on these indicators and a requirement for the ongoing educational initiatives focused on rational drug prescribing, dispensing, and patient use in order to comply with the standards set by the WHO.
RESUMO
Objective: To determine the predictors of acceptance and willingness to pay (WTP) for the COVID-19 vaccine among the Indian public and to provide insights for future demand forecasts and pricing considerations. Methods: A nationwide, web-based, self-administered, cross-sectional survey was conducted from 5 to 20 October 2020. The health belief model (HBM) approach was used as a theoretical framework to assess the predictors of acceptance of and WTP for the COVID-19 vaccine. Results: Of 2 480 respondents, 2 451 completed the online survey, yielding a response rate of 98.8%. Participants who participated in the survey had diverse demographics in terms of their location, educational level, occupation type, and family income. Among 2 451 respondents, the majority (89.3%) intended to receive the COVID-19 vaccine. Respondents with high perceived benefits of COVID-19 vaccination, such as reduction in worry (OR 5.87; 95% CI 4.39-7.96) and sickness (OR 4.31; 95% CI 3.31-5.62), showed higher intention to receive the vaccine. However, respondents with a high perception of the side effects and barriers to vaccination (OR 0.36; 95% CI 0.25-0.54) and vaccine shortage (OR 0.58; 95% CI 0.41-0.81) showed lower intention to receive the vaccine. The majority (2 162, 88.21%) of respondents were willing to pay an amount of INR: 500-1 000 or USD: 6.81-13.62 for a dose of COVID-19 vaccine, with a median (Q1, Q3) of INR: 500 (500, 1 000) or USD: 6.81 (6.81, 13.62). The higher marginal WTP for the COVID-19 vaccine was influenced by advanced age, marital status, female sex, intermediate educational background, high family income, fair or poor perceived health status, and no affordable barriers. Conclusions: The majority of respondents intended to receive the COVID-19 vaccine. Healthcare interventions focusing on HBM constructs and demographic predictors associated with low intention to receive the vaccine can be effective in enhancing the coverage of the COVID-19 vaccine. The findings of this study provide guidance for the future price considerations of the COVID-19 vaccine.
