Assessment of prescription patterns and cost analysis of oncology drugs used in the Paediatric Unit of Queen Elizabeth Central Hospital, Malawi

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Date
6-09-21
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Kamuzu University of Health Sciencies
Abstract
Background: Cancer is one of the global leading causes of childhood morbidity and mortality. High childhood cancer mortality rates in developing countries have been linked to irrational chemotherapy prescribing patterns. Irrational prescribing leads to ineffective treatment, occurrence of adverse events, prolonged hospitalization and increased economic burden to patients and their community. Children are more vulnerable to effects of irrational prescribing owing to their underdeveloped pharmacokinetic and pharmacodynamic profiles. Therefore, it is important to follow principles of rational prescribing as well as study prescribing patterns in order to ascertain how drugs are being used. Despite the need for periodical assessment of prescribing patterns and cost analysis, Malawi has a paucity of data on prescribing patterns and cost analysis of pediatric anticancer drugs. Objectives The objective of this study is to assess prescribing patterns and costs analysis of anticancer drugs used in paediatric cancer patients at Queen Elizabeth Central Hospital in Blantyre, Malawi. Methodology A retrospective cohort study will be conducted in pediatric oncology unit at Queen Elizabeth central hospital (QECH). The study will review and abstract data from patients’ files of children aged 0-18 diagnosed with cancer between January 2017 and December 2020. Rationality of prescribing patterns will be assessed using WHO rational prescribing indicators. The WHO indicators include: average number of drugs per encounter, percentage generic prescribing and drugs prescribed from national formulary. Quantity of drugs dispensed from the patient files will be used to compute cost of the drugs using current market prices obtained from Central 21-Aug-9 Version 6 xii Medical Stores catalogue and private wholesale supplier. Descriptive data analysis will be conducted where continuous variables will be summarized as mean and standard deviation. Frequencies and proportions will be computed for categorical variables. Regression analysis will be carried out to summarize possible relationships between anticancer prescribing patterns and predictor variables such as patient’s demographic data, cancer type and stage, and type of medications used. The level of significance will be set at 0.05. Expected findings The study is expected to shed light on rational chemotherapy prescribing patterns and cost of chemotherapy prescription in Malawi. Rational chemotherapy use improves childhood cancer clinical outcomes, reduces occurrence of adverse reactions, and optimizes health expenditure on chemotherapy drugs. Dissemination The findings of this study will be shared with University of Nairobi, Kamuzu university of Health sciences and Queen Elizabeth central hospital. The findings will also be published in peer reviewed journal.
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