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Trend analysis reveals that the average number of drugs usually contained per prescription decreases down the years, as is seen in this study (R² = 0.300), but the trend was not revealed to be significantly contributed by differences in practice patterns from each year (p=.082, F=2.071, df =4).

Number of Drugs Prescribed Using Generic Names From 2018 to 2022

The number of drugs in a prescription that are prescribed using their generic name by prescribers ranges from 70% to 80.64% in the study environment. This observed percentages of drug prescriptions or generic name scores below the recommended WHO 100% standard. Exactly 70.06%, 74.10%, 73.08%, 80.64%, and 75.11% of the drugs were prescribed in their generic names in the year 2018, 2019, 2020, 2021 and 2022 respectively. This is shown in table 2 below.

Table 2: Number of Drugs Prescribed Using Generic Names From 2018 to 2022

An average of about 3.1484+/-2.51027 drugs were reported to be prescribed in their generic names per prescription. There were no statistically significant differences in performance when individual means of the separate years were compared (p-2.51027, F=.868, df=4). Trend analysis reveals an increasing percentage in the number of generic drug prescriptions within the years of study (R² = 0.462), depicting the year 2036 for possible 100% generic drug prescriptions if this tempo is maintained.

Discussion

The study aimed to analyze antibiotic utilization patterns from 2018 to 2022 being a comprehensive study at Diette Koki Memorial Hospital, Bayelsa State, Nigeria. The study was carried out on 15,108 drugs in 3692 prescriptions containing antibiotics at the Diette-Koki Memorial Hospital, Opolo, Yenagoa Bayelsa state from the year 2018 to 2022. A total of 640, 383, 1245, 522, and 902 prescriptions were extracted from the records in the year 2018, 2019, 2020, 2021, and 2022 respectively. An average of 4.0921 +/_2.08104 drugs were reported to be contained per prescription of which an average of 3.1484 +/-2.51027 drugs were prescribed using their generic names. The study reported an insignificant decrease in the number of drugs usually contained per prescription though (R² = 0.300), and an insignificant increase in the percentage of drugs prescribed in their generic names (R² = 0.462). The study noted an average of 4.0921 drugs per prescription, with a slight decrease observed over the years (R² = 0.300). However, this decrease was reported as statistically insignificant. The coefficient of determination (R²) is reported as 0.300, suggesting that around 30% of the variation in the average number of drugs per prescription can be explained by the changes observed over the years. However, the statement mentions that this decrease is statistically insignificant. In statistical terms, this could mean that the observed decrease is not large enough to confidently conclude that it is a real and meaningful change rather than just a random variation. The insignificance could be due to the fact that the change is within the margin of error or variability expected in the data. In summary, while there is a slight decrease in the average number of drugs per prescription, the statistical analysis suggests that this decrease is not significant enough to draw strong conclusions about a real trend.

On average, 76.94% of total drugs were prescribed using their generic names, showing a slight but statistically insignificant increase over the years (R² = 0.462).

The R² value of 0.462 suggests that approximately 46.2% of the variation in the prescription rate of generic names can be explained by the changes observed over the years. However, the use of the term "statistically insignificant" implies that this increase is not significant enough to confidently conclude that it represents a meaningful change. In other words, the observed increase could be due to random variability in the data. While there is a slight increase in the use of generic names, the statistical insignificance suggests caution in interpreting this change as a real trend. It might be within the expected variability of prescription practices. There might be specific factors, policies, or changes in medical practice that might contribute to this increase.  The study indicates a predominant use of generic names in drug prescriptions, with a slight increase over the years. However, the statistical insignificance suggests the need for careful interpretation, and further investigation into potential contributing factors could enhance the understanding of this trend.

Summary

The study analyzed antibiotic utilization patterns from 2018 to 2022 at Diette Koki Memorial Hospital, Bayelsa State, Nigeria on 15,108 drugs in 3692 prescriptions containing antibiotics. With a total of 640, 383, 1245, 522, and 902 prescriptions extracted from the records in the years 2018, 2019, 2020, 2021, and 2022 respectively, an average of 4.09 +/_2.08 drugs per prescription of which 3.14 +/-2.51 drugs being prescribed using their generic names. The study reported an insignificant decrease in the number of drugs usually contained per prescription though (R² = 0.300), and an insignificant increase in the percentage of drugs prescribed in their generic names (R² = 0.462).

Conclusion

The analysis of antibiotic prescription patterns from 2018 to 2022 at Diette Koki Memorial Hospital underscores critical discrepancies between established guidelines and actual prescribing practices. The findings reveal prevalent deviations in generic prescription rates. The escalation in antibiotic resistance, as emphasized by global health experts [5,6], emphasizes the urgency of optimizing antibiotic prescribing practices. This study accentuates the imperative need for tailored interventions to improve antibiotic stewardship and align prescribing practices with global guidelines to combat the looming threat of antimicrobial resistance.

Recommendations

The following recommendations are hereby made due to the observation recorded in this study

1. Implementation of Antibiotic Stewardship Programs: Diette Koki Memorial Hospital should establish comprehensive antibiotic stewardship programs (ASPs) to enhance prescribing practices [2]. These programs would encompass education, guidelines, and feedback mechanisms to promote judicious antibiotic usage.
2. Utilization of Electronic Decision Support Systems: Integration of electronic decision support systems (DSS) within the hospital's healthcare infrastructure can aid healthcare practitioners in adhering to standardized antibiotic prescribing guidelines [4].
3. Regular Training and Education: Continuous training programs on updated antibiotic guidelines and resistance patterns should be conducted for healthcare providers [3]. This initiative would ensure that practitioners are well-informed and equipped to make prudent antibiotic choices.
4. Surveillance and Monitoring: The establishment of robust surveillance mechanisms to monitor antibiotic prescriptions and resistance patterns will facilitate ongoing assessment and refinement of prescribing practices [1].