Akici Ahmet, Kalaça Sibel, Uğurlu M Umit, Oktay Sule
Department of Pharmacology, Marmara University School of Medicine, Haydarpasa 81326, Istanbul, Turkey.
Eur J Clin Pharmacol. 2004 May;60(3):211-6. doi: 10.1007/s00228-004-0749-9. Epub 2004 Mar 31.
In the present study, prescribing behavior of general practitioners (GPs) was investigated in the example of childhood upper and lower respiratory-tract infections (URTIs and LRTIs).
A face-to-face interview was performed with 352 parents admitted to seven primary health care centers for their children diagnosed with URTI or LRTI. Prescriptions ( n=331) written by 25 GPs working at these centers were analyzed regarding legibility, format and suitability of drug choice.
Almost 60% of parents had self-medicated their children prior to admitting to the doctor. Of the patients, 29 (8.2%) were not examined by the physicians, but were directly prescribed medicine. The physicians did not tell the diagnosis to 25.3% of the patients, did not inform 41.2% of them about the drugs and did not caution 95.7% about the side effects. Further, the physicians did not inform 42.6% of the patients about drug use instructions, did not inform 83.5% about the warnings and did not inform 81.2% about non-drug treatment. Approximately 5% of the individuals remembered the name of the drugs. Only 26.3% of the prescriptions were easily readable, and only five scripts (1.5%) contained all necessary information. The majority of the patients were given antibiotics, penicillin+beta lactamase inhibitors being the first. Paracetamol was the most frequently prescribed analgesic/antipyretic for both indications, followed by nimesulide and ibuprofen.
The present study revealed inappropriate drug use in the treatment of respiratory-tract infections in children at the primary health care level in a district of Istanbul, Turkey. Furthermore, it has been shown that GPs practicing at primary health care centers should be trained to give adequate information about the disease and the treatment to the patients/parents to achieve good compliance and optimal drug therapy for children.
在本研究中，以上下呼吸道感染（URTIs和LRTIs）为例，对全科医生（GPs）的处方行为进行调查。
对因孩子被诊断患有URTI或LRTI而入住7家初级卫生保健中心的352名家长进行了面对面访谈。分析了在这些中心工作的25名全科医生所开的331份处方，内容涉及字迹清晰度、格式以及药物选择的适宜性。
近60%的家长在带孩子看医生之前已自行给孩子用药。在这些患者中，29名（8.2%）未接受医生检查，而是直接被开了药。医生未向25.3%的患者说明诊断结果，未向41.2%的患者告知所开药物，也未向95.7%的患者提及副作用。此外，医生未向42.6%的患者说明用药说明，未向83.5%的患者告知注意事项，也未向81.2%的患者介绍非药物治疗方法。约5%的人记得所开药物的名称。只有26.3%的处方易于辨认，只有5份处方（1.5%）包含所有必要信息。大多数患者使用了抗生素，其中青霉素+β-内酰胺酶抑制剂位居首位。对这两种病症而言，扑热息痛是最常开具的止痛/退烧药，其次是尼美舒利和布洛芬。
本研究揭示了土耳其伊斯坦布尔一个地区初级卫生保健层面在儿童呼吸道感染治疗中存在用药不当的问题。此外，研究表明，在初级卫生保健中心执业的全科医生应接受培训，以便向患者/家长提供有关疾病和治疗的充分信息，从而实现儿童良好的依从性和最佳药物治疗效果。
