# E-DRUG: Indicators of optimum prescribing (cont'd) **URL:** \ **Category:** e-drug\ **Created:** [February 26, 1999, 9:46pm UTC](https://talk.edrugplus.org/t/e-drug-indicators-of-optimum-prescribing-contd/4532 "1999-02-26T21:46:33Z")\ **Posts on this page:** 1\ **Page:** 1
**Author:** ![richardl1951](https://avatars.discourse-cdn.com/v4/letter/r/b3f665/32.png) [@richardl1951](https://talk.edrugplus.org/u/richardl1951)\ **Post date:** [February 26, 1999, 9:46pm UTC](https://talk.edrugplus.org/t/e-drug-indicators-of-optimum-prescribing-contd/4532/1 "1999-02-26T21:46:33Z")
E-drug: E-DRUG: Indicators of optimum prescribing (cont'd) --------------------------------------------- These contributions reflect an ongoing debate about the WHO Drug Use indicators. I have ordered the book and will comment in more detail when I have the chance to read it. It appears to me that the author used an earlier draft of the indicators when they were WHO/INRUD indicators. I say this because he mentions dropping the ORS for diarrhea indicator which was also dropped from the final set of indicators adopted by WHO. The issue remains "Are these indicators prescriptive or descriptive?" When we started work on the indicators we were challenged with the question "What is your standard?" and various very knowlegable people particularly in the WHO CDD program suggested that we should set standards of acceptable practice and then measure adherance to these standards. In the many field tests that were done we tried both approaches and found that it was too difficult to define universal standards. So we defined descriptive indicators and broke these into two groups - Core and complementary indicators. We also recognized that other indicators could be developed for specific circumstances. The 12 core indicators have been used in hundreds of surveys and except for a minor problem with the dispensing time indicator have been found to be reliable and useful. Their major value I would suggest is in comparing facilities in an area at the same time of year. What is usually found is that a few facilities are outliers and that these health units can benefit substantially from focussed interventions. The indicators have also been used very effectively to measure the impact of interventions. The complementary indicators on the other hand have not been used much and I would encourage people to try to use them. One of these indicators could have been used in India. This is the indicator "Percentage adherence to Standard Treatment Guidelines". I am pleased to hear that the indicators have been used in India and I would encourage the autors to publish their results internationally either in INRUD News or the Essential Drugs Monitor or on E-Drug. Unfortunately much of the research that is done in India is only published locally and outsiders do not get to hear about these results. To try to address this problem the next Drug Policy Issues course will be held in Mumbai, India November 28th to December 10th 1999. The course will be jointly organized by the Department of International Health, Boston University School of Public Health and the Department of Pharmacology and Therapeutics at King Edward Memorial Hospital, Mumbai in collaboration with WHO/EDM. I will post more information about this course soon, I hope that we can hear more comments on the value of the WHO Drug Use Indicators. Richard Laing Richard Laing M.B. Ch.B. M.Sc. M.D. Tel 1-617-414-1444 Associate Professor, Fax 1-617-638-4476 Department of International Health, E-mail richardl@bu.edu Boston University School of Public Health, 715 Albany Street, T4W Boston MA 02118 USA -- Send mail for the `E-Drug' conference to `e-drug@usa.healthnet.org'. Mail administrative requests to `majordomo@usa.healthnet.org'. For additional assistance, send mail to: `owner-e-drug@usa.healthnet.org'.