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
Authors
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Publisher
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.