Vallano Antoni, Fortuny Joan, Arnau Josep Maria, Laporte Joan-Ramon
Servicio de Farmacología Clínica, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Fundació Institut Català de Farmacologia, Barcelona, España.
Med Clin (Barc). 2003 Nov 15;121(17):645-9. doi: 10.1016/s0025-7753(03)74048-2.
Drug prescription at hospital discharge often implies continuation of the treatment in primary health care. The aim of this study was to assess prescription of generics at discharge from a hospital emergency service.
Longitudinal and retrospective study, on a random sample of medical reports in a hospital emergency service during one year (August 2000 to July 2001). Information on the medical specialty, prescribed generic drugs and marked availability of the corresponding generic drugs pharmaceutical specialties was collected. Factors associated with generic prescription were analyzed by means of logistic regression analysis.
A sample of 1,245 medical reports was selected in which 2,315 drugs were prescribed. Although generic drugs were available for 33.3% (CI 95%, 31.4-35.2) of prescriptions, 9.5% (95% CI, 8.3-10.7) of prescribed drugs were generics. The average price of trademark prescribed medicines, for which there was a generic equivalent, was 7.09 Euros (95% CI, 6.54-7.63 Euros), and that of the corresponding generic versions was 5.08 Euros (95% CI, 4.68-5.48 Euros). Variables associated with generic drug prescription included the particular study period (OR=1.35; 95% CI, 0.99-1.84), the medical specialty of the prescriber (OR=1.40; 95% CI, 1.05-1.86), availability of generic drugs (OR=1.76; 95% CI, 1.30-2.39) and low price of prescribed drugs (OR=2.67; 95% CI, 1.80-3.98).
In spite of the availability of generic drugs, prescription of generic drugs at discharge of this hospital emergency service was low. Prescription and use of generic drugs should be promoted in hospitals.
医院出院时的药物处方通常意味着在初级卫生保健中继续进行治疗。本研究的目的是评估医院急诊服务出院时的仿制药处方情况。
纵向回顾性研究,对某医院急诊服务一年内(2000年8月至2001年7月)的医疗报告进行随机抽样。收集有关医学专科、所开仿制药以及相应仿制药制剂的显著可获得性的信息。通过逻辑回归分析来分析与仿制药处方相关的因素。
选取了1245份医疗报告样本,其中开出了2315种药物。尽管33.3%(95%置信区间,31.4 - 35.2)的处方有仿制药可用,但所开药物中只有9.5%(95%置信区间,8.3 - 10.7)是仿制药。有通用等效仿制药的品牌处方药的平均价格为7.09欧元(95%置信区间,6.54 - 7.63欧元),而相应仿制药版本的平均价格为5.08欧元(95%置信区间,4.68 - 5.48欧元)。与仿制药处方相关的变量包括特定的研究时间段(比值比 = 1.35;95%置信区间,0.99 - 1.84)、开处方者的医学专科(比值比 = 1.40;95%置信区间,1.05 - 1.86)、仿制药的可获得性(比值比 = 1.76;95%置信区间,1.30 - 2.39)以及所开药物的低价(比值比 = 2.67;95%置信区间,1.80 - 3.98)。
尽管有仿制药可用,但该医院急诊服务出院时的仿制药处方率较低。应在医院中推广仿制药的处方和使用。