{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T18:00:23Z","timestamp":1785348023878,"version":"3.55.0"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Suboptimal medicine use practices remain a major global health challenge, particularly in low- and middle-income countries, where it contributes to increased healthcare costs, and the growing burden of antimicrobial resistance. This study aimed to evaluate drug use patterns at Thika Level 5 Hospital in Kenya using World Health Organization (WHO) core drug use indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A facility-based cross-sectional study was conducted in the outpatient department. Data were collected from 600 prescriptions, 100 patient encounters, and facility-level assessments using standardized WHO\/INRUD data collection tools. Descriptive and inferential analyses were performed using IBM SPSS Statistics (version 29), and findings were descriptively compared with WHO reference standards.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The mean number of drugs per prescription was 3.18, which was higher than the WHO recommended range of 1.6\u20131.8. Generic prescribing was 45.86% while antibiotic prescribing was observed in 58.7% of encounters. Injection use was 13.0% and 76.86% of prescribed medicines were from the Essential Medicines List (EML).<\/jats:p>\n                    <jats:p>Patient-care indicators showed a mean consultation time of 4.26 minutes and a mean dispensing time of 122.8 seconds, which was below the WHO- recommended reference value. Only 30.0% of medicines were adequately labelled, and 44.0% of patients demonstrated complete knowledge of their medications. Significant associations were observed between dispensing time and patient knowledge (p\u2009=\u20090.001), as well as between labelling adequacy and patient understanding (p\u2009&lt;\u20090.001).<\/jats:p>\n                    <jats:p>In contrast, all facility indicators met WHO standards, with full availability of essential medicines, treatment guidelines, and stock records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite strong facility readiness, important gaps were identified in prescribing and patient-care practices. These findings highlight opportunities for interventions aimed at strengthening antimicrobial stewardship initiatives, promoting generic prescribing, improving dispensing practices, and enhancing patient counselling to support improved medicine use practices..<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0354373","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T17:26:57Z","timestamp":1785346017000},"page":"e0354373","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Drug use patterns at a Kenyan referral hospital: A cross-sectional study using WHO core indicators"],"prefix":"10.1371","volume":"21","author":[{"given":"Robi Cynthia","family":"Chacha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0630-8228","authenticated-orcid":true,"given":"Ermias Mergia","family":"Terefe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"pone.0354373.ref001","volume-title":"Promoting rational use of medicines","author":"World Health Organization","year":"2025"},{"issue":"1","key":"pone.0354373.ref002","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1186\/s12877-025-06395-6","article-title":"Rational use of medicines in the older adult: the role of trust in the health care system","volume":"25","author":"M Nal","year":"2025","journal-title":"BMC Geriatr"},{"issue":"1","key":"pone.0354373.ref003","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/s12913-024-12172-9","article-title":"Evaluation of a national framework for rational use of medicines in Kazakhstan and its role in improving medicine use practices at the organizational and national levels","volume":"25","author":"G Zhussupova","year":"2025","journal-title":"BMC Health Serv Res"},{"issue":"8","key":"pone.0354373.ref004","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0272936","article-title":"Drug prescribing and dispensing practices in regional and national referral hospitals of Eritrea: Evaluation with WHO\/INRUD core drug use indicators","volume":"17","author":"SM Siele","year":"2022","journal-title":"PLoS One"},{"issue":"7","key":"pone.0354373.ref005","article-title":"Drug use evaluation of ceftriaxone: the case of Ayder Referral Hospital, Mekelle, Ethiopia","volume":"3","author":"FA Abebe","year":"2012","journal-title":"Int J Pharm Sci Res"},{"issue":"1","key":"pone.0354373.ref006","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.glohj.2023.02.002","article-title":"The role of drug utilization evaluation in medical sciences","volume":"7","author":"R Gangwar","year":"2023","journal-title":"Global Health 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Assoc"},{"key":"pone.0354373.ref010","doi-asserted-by":"crossref","first-page":"4173586","DOI":"10.1155\/2020\/4173586","article-title":"Evaluation of Drug Use Pattern in Emergency Department of Dilchora Referral Hospital, Dire Dawa, Ethiopia","volume":"2020","author":"KM Mishore","year":"2020","journal-title":"Emerg Med Int"},{"issue":"1","key":"pone.0354373.ref011","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/s12913-017-2097-3","article-title":"Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study","volume":"17","author":"M Sisay","year":"2017","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"pone.0354373.ref012","doi-asserted-by":"crossref","DOI":"10.1093\/jacamr\/dlz087","article-title":"Evaluation of the clinical practice of aminoglycoside use in paediatric patients in Kenya: findings and implications for lower-middle income countries","volume":"2","author":"EJ Onyango","year":"2020","journal-title":"JAC Antimicrob Resist"},{"issue":"1","key":"pone.0354373.ref013","doi-asserted-by":"crossref","first-page":"38","DOI":"10.4103\/picr.PICR_29_20","article-title":"Drug use evaluation of cephalosporins in a tertiary care hospital","volume":"13","author":"YC Shetty","year":"2022","journal-title":"Perspect Clin Res"},{"key":"pone.0354373.ref014","doi-asserted-by":"crossref","first-page":"20251211","DOI":"10.31584\/jhsmr.20251211","article-title":"Retrospective Evaluation of an Antimicrobial Stewardship Program in a Tertiary Care Hospital: A Pharmacist\u2019s Perspective","author":"M Niyas","year":"2025","journal-title":"J Health Sci Med Res"},{"key":"pone.0354373.ref015","volume-title":"How to investigate drug use in health facilities: selected drug use indicators","author":"World Health Organization","year":"1993"},{"issue":"1","key":"pone.0354373.ref016","first-page":"24","article-title":"Assessment of 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