巴林初级保健医生处方模式的日变化。

Damanhori Awatif H H, Al Khaja Khalid A J, Sequeira Reginald P, Al-Ansari Thuraya M

Ministry of Health, Manama, Kingdom of Bahrain.

J Eval Clin Pract. 2007 Feb;13(1):25-30. doi: 10.1111/j.1365-2753.2006.00642.x.

RATIONALE, AIMS AND OBJECTIVES: To evaluate the variation in prescribing by primary care doctors during the morning and the evening clinics and to determine whether these prescribing patterns are influenced by doctors' training background.

METHODS

A retrospective prescription-based study was carried out in 17 out of 20 primary care health centres in Bahrain distributed across the Kingdom.

RESULTS

A total of 4472 prescriptions containing 10 588 drug-items covering the prescribing practice of approximately 90% primary care doctors were analysed. Paracetamol was the most commonly prescribed drug in both clinics. Drugs such as diclofenac sodium, amoxycillin, ibuprofen, chlorpheniramine, hyoscine butylbromide, Actifed, Benylin and xylometazoline were the most commonly prescribed drugs to patients attending morning and evening clinics with a considerable variation in ordinal ranking of proportions. As regards morning clinic, chlorpheniramine and Fefol were prescribed by the family doctors (FDs) more often than by the general practitioners (GPs) (P<0.05), whereas, multivitamins were prescribed by the GPs more often than by the FDs (P=0.001). During the evening clinic, however, ibuprofen, chlorpheniramine, bromhexine and xylometazoline were prescribed by the FDs in a rate significantly higher than that prescribed by the GPs (P<0.05). The prevalence of acute and/or chronic morbidities in patient attending clinics was estimated based on the therapeutic indication for drugs used. The mean number of drugs per prescription was 2.41+/-1.3. Prescriptions containing three or more drugs comprised 41.7% of all prescriptions. The GPs had a greater tendency to practice polypharmacy than the FDs.

CONCLUSION

A significant diurnal variation in prescribing, and polypharmacy practice were related to the training background of the doctors. This quantitative study provides the baseline data for monitoring primary care prescribing practices in Bahrain. To further evaluate the underlying factors that influence drug use indicators, a qualitative study is needed.

原理、目的与目标：评估初级保健医生在上午和晚间门诊的开药差异，并确定这些开药模式是否受医生培训背景的影响。

方法

在巴林王国各地分布的20个初级保健健康中心中的17个开展了一项基于处方的回顾性研究。

结果

共分析了4472张处方，包含10588种药品，涵盖了约90%初级保健医生的开药情况。对乙酰氨基酚是两个门诊中最常开具的药物。双氯芬酸钠、阿莫西林、布洛芬、氯苯那敏、丁溴东莨菪碱、阿赛特、贝林和赛洛唑啉等药物是上午和晚间门诊患者最常开具的药物，各药物比例的序数排名有相当大的差异。在上午门诊中，家庭医生（FDs）开具氯苯那敏和福施福的频率高于全科医生（GPs）（P<0.05），而全科医生开具多种维生素的频率高于家庭医生（P=0.001）。然而，在晚间门诊中，家庭医生开具布洛芬、氯苯那敏、溴己新和赛洛唑啉的比例显著高于全科医生（P<0.05）。根据所用药物的治疗指征估计了门诊患者急性和/或慢性疾病的患病率。每张处方的平均药物数量为2.41±1.3。包含三种或更多药物的处方占所有处方的41.7%。全科医生比家庭医生更倾向于联合用药。