The Effect of Educational Intervention on Rational Prescribing in Public Health Facilities in Selected Local Government Areas of Rivers State: An Interventional Study

Abstract
Background: Despite progress made so far in identifying intervention models to improve drug use, irrational use of drugs has remained a serious global health problem. The study intends to determine the effectiveness of an educational intervention on rational prescribing among prescribers in selected local government areas of Rivers State. Methods: This was a quasi-experimental study that measured the effect of educational intervention on rational prescribing of drugs among prescribers in public health facilities in two selected Local Government Areas (LGA) of Rivers State: Ikwerre LGA (KELGA) which served as the control and Port Harcourt LGA (PHALGA) which served as the intervention by using cluster sampling with randomization. Paired data were analysed using McNemar’s Chi-square test and the paired t-test. The level of significance was set at P≤ 0.05. The EPI-INFO version 7.02 statistical software was used in the analysis. Results: Findings showed that the largest category of prescribers was nurse/midwives representing 48.61% and 44.4% in the intervention and control LGA respectively. There was an improvement in the knowledge and attitude of respondents in the facilities in the intervention LGA at one month and three months post-intervention (P<0.05). The average number of drugs per encounter (ANDPE), the percentage encounters with an antibiotic (PEA), the percentage encounters with an injection (PEI) were lower for the interventions group compared to the control (P<0.05). Percentage generic drug prescription (PGD) was higher in the intervention group compared to the control (P=0.001). Conclusion: Educational intervention was an effective and sustainable means of improving rational prescribing in the state. Update courses and continuing medical education on rational drug use should be held periodically for health care professionals by the State and National Primary Health Care Development Agency as well as other interested stakeholders.