Medicines management and treatment outcomes:
Introduction: Poor treatment outcomes result from clinically inappropriate and inefficient use of medicines and this is an important public health problem Worldwide and more so in sub Saharan Africa where Uganda is located (WHO 2004). Availability of medicines, prescribing and dispensing practices greatly influence treatment outcomes. Irrational prescribing is a global problem (WHO 2012). Bad prescribing and dispensing practices can lead to ineffective and unsafe treatments, exacerbation or prolongation of illness, distress or harm to the patient and higher treatment costs (WHO 2012) Objective: The study assessed the influence of availability of essential medicines, prescribing and dispensing practices on treatment outcomes in health centres within Bushenyi district, Uganda. Methods: The study used a descriptive cross sectional study design in which questionnaires were administered to 26 dispensers and 27 prescribers alongside exit interviews on 295 patients in 27 randomly selected health centres. Results: The study found that average availability of drugs in all health centres was 62.5% though varying across health centres. The study found a positive but insignificant influence of the availability of drugs on treatment outcomes across health Centres (r = 0.395, Sig. = 0.302 > 5%). Average number of drugs prescribed per encounter was 2.5, overall average percentage of drugs prescribed by generic name was 77.9%, the patient encounters with an antibiotic and injection prescribed was 62.7% and 25.4% respectively, average consultation time as 11.6 minutes overall and an insignificantly positive influence of the percentage of drugs prescribed by generic name on treatment outcomes among patients across the health centres (r = 0.529, Sig = 0.236). Average dispensing time in all health centres was 129.9 seconds, overall average percentage of drugs actually dispensed was 85.9%, the overall average proportion of drugs adequately labelled was 36.4% and the proportion of patients who knew about their dosage was 52.9%. The study found that percentage of drugs actually dispensed had a positive significant influence on the treatment outcomes of patients across the health centres (r =0.907, sig = 0.047 < 5%). Conclusions: The study concluded that availability of drugs has a positive but insignificant influence on the treatment outcomes across health centres in Bushenyi district. The percentage of drugs actually dispensed had a high positive significant influence on treatment outcomes of patients. It was also concluded that availability of medicines, prescribing and dispensing practices were below the WHO recommendations and there is need to design strategies to improve availability of essential drugs and improve prescribing and dispensing practices.