Age* No. No. TRM AB Inj Vit No. No. items Drug names (preferably generic names but brand names Cost per # Diagnosis (yrs) items generics (Y/N) (Y/N) (Y/N) (Y/N) on dispensed if generic names unknown) prescription 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Totals Average % of % of % of % of % of % of total % of total % total total total items items items items cases cases cases *If <1 year indicate as follows: 3 months = 3/12, 5 months = 5/12, etc.; TRM=Traditional Medicine; AB=Antibiotic; INJ=Injection; VIT=Vitamin; Px=Prescription
# Diagnosis Age* (yrs) No. items No. generics TRM (Y/N) AB (Y/N) Inj (Y/N) Vit (Y/N) No. on No. items dispensed Drug names (preferably generic names but brand names if generic names unknown) Cost per prescription 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Totals Average % % of total items % of items % of total cases % of total cases % of cases % of total items % of total items *If <1 year indicate as follows: 3 months = 3/12, 5 months = 5/12, etc.; TRM=Traditional Medicine; AB=Antibiotic; INJ=Injection; VIT=Vitamin; Px=Prescription
tool_7_medicines_in_health_care_delivery_10mar2016.docx