Curbing Polypharmacy among Primary Health Care Workers: The Impact of an Educational Intervention

Introduction: Polypharmacy, the concurrent prescription or use of multiple numbers of drugs per patient, has been identified as a significant channel of drug wastage in the health sector. Its habitual practice has been associated with lower cadres of healthcare workers, operating mainly at the grassroots or primary health care (PHC) levels.

Objective: To assess the impact of a two-phased educational intervention on the practice of polypharmacy amongst rural workers of PHC in Kaduna State, north-western Nigeria.

Methods: A quasi-experimental study design was employed in 2 Local Government Areas (LGAs)-one study and one control. A two-phase educational intervention was carried out in the study of LGA. Pre- and post-intervention audit and analysis of the prescription records of the selected facilities was done with SPSS version 20.0. A bi-variate analysis was carried out to test the relationship between the independent and outcome variables with p-value of 0.05 as the level of significance.

Results: Both study and control facilities had baseline (pre-intervention) evidence of polypharmacy, with means (averages) of 4.3±1.56 and 3.85±1.14 drugs per patient, respectively (and ranges of between 1-13 drugs per patient and 1-10, respectively). This falls by about 43.5%, to an average of 3.26±1.19 and later, to 2.43±0.29 drugs per patient in the study group, following the first and second phases of the intervention, respectively (p<0.05). No statistically significant changes were observed in the control facilities.

Conclusions: Following the intervention, a significant improvement was observed in the prescribing pattern of the health workers in the study area, with regards to polypharmacy. This evidence emphasizes the place, priority, and potential of in-service training and continuous education of healthcare workers to promote the optimum level of practice and curtail unnecessary wastage of limited resources in the health sector, particularly in developing countries.