Adebayo E T, Hussain N A
Army Dental Centre, Military Hospital, Ikoyi, Nigeria.
Ann Afr Med. 2010 Jul-Sep;9(3):152-8. doi: 10.4103/1596-3519.68366.
Most health expenditure of developing countries is on drugs and medical sundries but inappropriate use of such resources is common. To our knowledge, only few studies have been done in Africa on this issue , with inadequate consideration of the sociological context of the knowledge, attitude and practice of the prescribers especially doctors. This study presents the pooled data of the pattern of prescription drug use from three Nigerian Army hospitals using some WHO criteria, and the knowledge and attitude underlying doctors' prescribing practices in these hospitals.
Retrospective cross-sectional survey of one year (March 2006-February 2007). Systematic random sample of general out patient case notes from three hospitals were collected using WHO criteria. The knowledge, attitude and practice survey of doctors at each study site towards the concept of rational drug use (RDU) were assessed using a self-administered questionnaire.
Data collected from 660 case notes showed that average number of drugs per encounter was 2.8 while 49.3% of drugs were prescribed in the generic form. An average of 28.1% of patients encountered antibiotics. From the knowledge, attitude and practice survey, it is evident that 90.5% of 74 prescribers were aware of the existence of national essential drugs list but 58.1% of them did not use it as basis of prescriptions. In describing types of medicines preferred, 56.7% of prescribers claimed they prescribed a mixture of generic and branded drugs. Only 12.1% of prescribers could accurately detail the 5 steps of rational prescribing.
The pattern of prescription drug use in Nigerian Army hospitals is unsatisfactory. It is characterised by high number of drugs per prescription, high rate of antibiotic usage and unscientific prescription by doctors. There is a need for further education and research on rational drug use among prescribers in Nigerian military health facilities.
发展中国家的大部分卫生支出用于药品和医疗用品，但此类资源的不当使用很常见。据我们所知，非洲针对这一问题开展的研究很少，且对开处方者尤其是医生的知识、态度和行为的社会学背景考虑不足。本研究呈现了来自三家尼日利亚军队医院的处方用药模式的汇总数据，这些数据采用了世界卫生组织的一些标准，同时还展示了这些医院医生开处方行为背后的知识和态度。
进行为期一年（2006年3月至2007年2月）的回顾性横断面调查。使用世界卫生组织的标准，从三家医院系统随机抽取普通门诊病历。通过一份自填式问卷评估每个研究地点的医生对合理用药概念的知识、态度和行为。
从660份病历中收集的数据显示，每次就诊的平均用药数量为2.8种，而49.3%的药物是以通用名形式开具的。平均有28.1%的患者使用了抗生素。从知识、态度和行为调查中可以明显看出，74名开处方者中有90.5%知道国家基本药物清单的存在，但其中58.1%的人并未将其作为开处方的依据。在描述偏好的药品类型时，56.7%的开处方者称他们开具的是通用名药和品牌药的混合处方。只有12.1%的开处方者能够准确详述合理开处方的5个步骤。
尼日利亚军队医院的处方用药模式不尽人意。其特点是每张处方用药数量多、抗生素使用率高以及医生开处方不科学。尼日利亚军队医疗机构的开处方者需要接受关于合理用药的进一步教育和研究。
