NTA Level 6 • Semester 2 • PST06211

Indicators in Monitoring and Evaluation

Monitoring and Evaluation of Medicine Use • Source Session/Topic 6

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Session 6: Indicators in Monitoring and Evaluation

Medicines Use

Total Session Time: 120 minutes + 2 hours of Assignment

Prerequisites

• None

Learning Tasks

By the end of this session students are expected to be able to:

• List indicators used in monitoring and evaluation of medicines use

• Explain application of each indicator in monitoring and evaluation of medicines use

Resources Needed:

• Flip charts, marker pens, and masking tape

• Black/white board and chalk/whiteboard markers

• Computer and LCD Projector

SESSION OVERVIEW

Activity/

Step Time Content

Method

1 05 minutes Presentation Introduction, Learning Tasks

35 minutes Indicators used in Monitoring and Evaluation

Presentation

2 of Medicines use

Buzzing

65 minutes Presentation

Application of Each Indicator in Monitoring

3 Small Group

and Evaluation of Medicines use

Discussion

4 05 minutes Presentation Key Points

5 05 minutes Presentation Evaluation

PST 06211 Monitoring and Evaluation of Medicines Use NTA Level 6 Semester 2 Facilitator Guide

SESSION CONTENTS

STEP 1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing.

STEP 2: Indicators used in Monitoring and Evaluation of Medicines use

(35 minutes)

Activity: Buzzing (10 minutes)

ASK students to pair up and buzz on the following question for 5 minutes

• What are indicators used in monitoring and evaluation of medicine use?

ALLOW few pairs to respond and let other pairs add on points not mentioned

WRITE their response on the flip chart/board

CLARIFY and SUMMARIZE by using the content below

• Medicine use indicators were developed to be used as measures of performances in three

general areas related to the rational use of medicine in primary care

o Pharmaceutical prescribing practices by health providers

o Key elements of patient care covering both clinical consultation and pharmaceutical

dispensing

o Availability of facility specific factors which support rational use such as key essential

drugs and minimum pharmaceutical information

• The medicine use indicators would typically be measured within a defined geographic or

administrative area either to describe medicine use at a given point in time or to monitor

changes over time

• Usually they tend to measure the rational use of medicine measured by facilities

• The level II indicators are used to monitor and evaluate medicine uses and they can be group

into the following aspects as from the WHO operational package ;

o Prescribing Indicators

 Average number of medicines per encounter

 Percentage of medicines prescribed by generic name

 Percentage of encounters with an antibiotic prescribed

 Percentage of encounters with an injection prescribed

 Percentage of medicines prescribed which are from the essential medicines list or

formulary list

PST 06211 Monitoring and Evaluation of Medicines Use NTA Level 6 Semester 2 Facilitator Guide

o Patient Care Indicators

 Average consultation time

 Average dispensing times

 Percentage of medicines actually dispensed

 Percentage of medicines that are adequately labeled

 Percentage of patients who know how to take their medicines

o Health Facility Indicators

 Availability of essential medicine list or formulary

 Availability of key set of indicator medicines

 Availability of standard treatment guideline (STG)

 The above indicators are the minimum set of measures to be calculated during a

single medicine use indicators survey

o Complementary Indicators (this have less standardization and less experience in

actual use

 Percentage of patients treated without medicines

 Average medicine costs per encounter

 Percentage of medicine cost spent on antibiotics

 Percentage of medicine cost spent on injections

 Percentage of prescriptions in accordance with STG

 Percentage of patients satisfied with care provided

 Percentage of facilities with access to impartial information

STEP 3: Application of Each Indicator in Monitoring and Evaluation of

Medicines Use (65 minutes)

Activity: Small Group Discussion ( 30 minutes)

DIVIDE students into small manageable groups

ASK students to discuss on the following question

• What are applications of medicine use indicators?

ALLOW students to discuss for 15 minutes

ALLOW few groups to present and the rest to add points not mentioned

CLARIFY and SUMMARIZE by using the contents below

PST 06211 Monitoring and Evaluation of Medicines Use NTA Level 6 Semester 2 Facilitator Guide

Below is the description of application of each indicator for motoring and evaluation of

medicine use;

• Prescribing Indicators

o The indicators of prescribing practices measure the performance of healthcare providers

in several key dimensions related to appropriate use of medicines

 Average number of medicines per encounter

 Purpose-To determine the prevalence of polypharmacy, which is one measure of

unnecessary prescribing.

o Percentage of medicines prescribed by generic name

 Purpose -To measure the degree to which prescribing practice conforms to the

principles of generic prescribing.

o Percentage of encounters with an antibiotic prescribed

 Purpose -To determine the prevalence of antibiotic prescribing, since over-

prescribing of antibiotics is one common type of inappropriate medicine use.

o Percentage of encounters with an injection prescribed

 Purpose -To determine the prevalence of injection use, since over-prescribing of

injections is one common type of inappropriate medicine use.

o Percentage of medicines prescribed which are from the essential medicines list or

formulary list

 Purpose -To measure the degree to which prescribing practice conforms to the

national essential medicines list (EML). The essential medicines concept is one of

the main strategies being promoted in medicines policy. More and more countries

are formulating national EMLs. For most countries, this should be the basis for all

public medicines procurement and prescribing.

• Patient Care Indicators

o Patient care indicators address key aspects of what patients experience at health facilities

and how well they have been prepared to deal with the pharmaceuticals that have been

prescribed and dispensed.

o The time that prescribers and dispensers spend with limits on the potential quality of

diagnosis and treatment

o Average consultation time

 Purpose- to measure the time that medical personnel spend with patient in the

process of consultation and prescribing

o Average dispensing times

 Purpose- To measure the average time that personnel dispensing medicine spend

with patients

o Percentage of medicines actually dispensed

 Purpose -To measure the degree to which healthy facilities are able to provide the

medicine which were prescribed

o Percentage of medicines that are adequately labeled

PST 06211 Monitoring and Evaluation of Medicines Use NTA Level 6 Semester 2 Facilitator Guide

 Purpose -To assess quality of dispensing practice. If medicines are to be used

properly, they should be labelled appropriately by the person dispensing them.

o Percentage of patients who know how to take their medicines

 Purpose -To assess if patients have adequate knowledge about how to take their

medicines.

• Health Facility Indicators

o The ability to prescribe medicines rationally is influenced by many features of the

working environment. Two particularly important components are an adequate supply of

essential medicine and access to unbiased information about these medicines. Without

these it‘s difficult for health personnel to function effectively

o Availability of essential medicine list or formulary

 Purpose -To determine if prescribers and/or dispensers have access to themas key

source of pharmaceutical information that should be the basis for all

medicineprescribing and dispensing.

o Availability of key set of indicator medicines

 Purpose-to measure the availability of health facilities of key medicine

recommended for treatment of some common health problem

o Availability of standard treatment guideline (STG)

 Purpose-To determine if prescribers have available to them the key source of

therapeutic information they need in daily practice.

STEP 4: Key Points (5 minutes)

• Medicine use indicators in rational use of medicine can be group into three main categories

of indicators; prescriber indicators, patient care indicators and healthy facility indicators

• Complementary Indicators are other types of medicine use indicators with less

standardization and less experience in actual use

• Percentage of encounters with an injection prescribed is applied to determine the prevalence

of injection use, since over-prescribing of inappropriate medicine use.

• Availability of standard treatment guideline (STG) is applied to determine if prescribers

have available to them the key source of therapeutic information they need in daily practice.

• Medicine use indicators collectively measure rational use of medicine

STEP 5: Evaluation (5 minutes)

• What are the common medicine use indicators?

• What is the application of the medicine use indicators?

PST 06211 Monitoring and Evaluation of Medicines Use NTA Level 6 Semester 2 Facilitator Guide

References

Quick, J. D. (1997). Managing drug supply the selection, procurement, distribution and use of

pharmaceuticals. West Hartford, CT: KumarianPress.Bartsch, S. (2007).

The Global Fund to Fight AIDS, Tuberculosis and Malaria. Global Health Governance and the

Fight Against HIV/AIDS,146-171. doi:10.1057/9780230591349

WHO Operational package for assessing, monitoring and evaluating country pharmaceutical

situations. (2015, November 20). Retrieved from

https://www.who.int/medicines/publications/WHO_TCM_2007.2/en/

PST 06211 Monitoring and Evaluation of Medicines Use NTA Level 6 Semester 2 Facilitator Guide

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