Have we improved use of medicines in developing and transitional countries and do we know how to? Two decades of evidence

• Published in: Tropical medicine & international health 2013-06, Vol.18 (6), p.656-664
• Main Authors: Holloway, K. A., Ivanovska, V., Wagner, A. K., Vialle‐Valentin, C., Ross‐Degnan, D.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Developing Countries; Drug therapy; drug use; General aspects; Humans; Inappropriate Prescribing - statistics & numerical data; interventions; LDCs; Medical sciences; Pharmaceutical Preparations - administration & dosage; Practice Patterns, Physicians' - statistics & numerical data; prescribing; Primary care; Primary Health Care
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/tmi.12123

Objective To assess progress in improving use of medicines in developing and transitional countries by reviewing empirical evidence, 1990–2009, concerning patterns of primary care medicine use and intervention effects. Methods We extracted data on medicines use, study setting, methodology and interventions from published and unpublished studies on primary care medicine use. We calculated the medians of six medicines use indicators by study year, country income level, geographic region, facility ownership and prescriber type. To estimate intervention impacts, we calculated greatest positive (GES) and median effect sizes (MES) from studies meeting accepted design criteria. Results Our review comprises 900 studies conducted in 104 countries, reporting data on 1033 study groups from public (62%), and private (mostly for profit) facilities (26%), and households. The proportion of treatment according to standard treatment guidelines was 40% in public and