Aina B A, Tayo F, Taylor O, Eniojukan J F
Department of of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, University of Lagos, College of Medicine Campus, Idi Araba, Lagos, Nigeria.
Nig Q J Hosp Med. 2009 Jan-Mar;19(1):20-6. doi: 10.4314/nqjhm.v19i1.50203.
Malaria is a curable and preventable disease and it is a major public health problem in Nigeria. Chloroquine was the first line drug in its treatment in Nigeria until recently where the Artemisinin based Combination Therapies (ACTs) are being promoted. Inappropriate prescribing, i.e., the failure to prescribe drugs in accordance with guidelines based on scientific evidence to ensure safe, effective, and economic use, is an irrational drug use behavior. Increased benefits from chloroquine or a slowdown of progression to resistance could be achieved by improving prescribing practice, drug quality, and patient compliance.
To determine the antimalarial prescribing pattern and to assess rational prescribing of chloroquine by prescribers in government hospitals and parastatals in Lagos State.
The study was carried out in all the ten government General Hospitals under Lagos State Hospitals Management Board (now Lagos State Health Service Commission), one parastatal hospital and one oil company clinic, using patient prescriptions. One hundred prescriptions each for adults and children for each month for a period of one year (January to December 2000) were systematically sampled. Where there were fewer than 100 prescriptions in a month, all the prescriptions available were sampled for analysis.
Average number of drugs per encounter in all the hospitals was 4.259 +/- 0.009. Average number of injections per encounter was 1.215 +/- 0.009. About 48.5% of all the presriptions had at least one injection while 40.9% of the prescriptions had dipyrone injection. Average drug cost per encounter was N 147.40 +/- 0.765. Percentage of encounters with chloroquine was 82.5% followed by sulphadoxine-pyrimethamine 14.2%. Percentage of prescriptions with correct dose of chloroquine was 47.5%
Polypharmacy exists in all the hospitals. The average number of drugs per encounter for the majority of the hospitals was above 4. Less than half of the prescriptions had the correct dose of chloroquine. This study can serve as a baseline for intervention on irrational prescribing.
疟疾是一种可治愈且可预防的疾病，在尼日利亚是一个重大的公共卫生问题。直到最近青蒿素联合疗法（ACTs）得到推广之前，氯喹一直是尼日利亚治疗疟疾的一线药物。不恰当的处方开具，即未能按照基于科学证据的指南开具药物以确保安全、有效和经济地用药，是一种不合理的用药行为。通过改善处方开具实践、药品质量和患者依从性，可以增加氯喹的益处或减缓耐药性的发展。
确定拉各斯州政府医院和准政府机构中开处方者的抗疟药处方模式，并评估氯喹的合理处方情况。
该研究在拉各斯州医院管理委员会（现为拉各斯州卫生服务委员会）下属的所有十家政府综合医院、一家准政府医院和一家石油公司诊所进行，采用患者处方。在一年时间（2000年1月至12月）内，每月系统抽取100张成人和儿童的处方。如果一个月内处方少于100张，则抽取所有可用处方进行分析。
所有医院每次诊疗的平均用药数量为4.259±0.009。每次诊疗的平均注射次数为1.215±0.009。所有处方中约48.5%至少有一次注射，40.9%的处方有安乃近注射。每次诊疗的平均药费为147.40奈拉±0.765。使用氯喹的诊疗比例为82.5%，其次是磺胺多辛 - 乙胺嘧啶，为14.2%。氯喹剂量正确的处方比例为47.5%。
所有医院都存在联合用药情况。大多数医院每次诊疗的平均用药数量超过4种。不到一半的处方氯喹剂量正确。本研究可为不合理处方干预提供基线数据。
