[The evaluation of prescribing practice in a general internal medicine outpatient clinic with special reference to gastrointestinal medicines].

Prescribing patterns of 13 residents in a medical outpatient clinic were evaluated between March and June 1986. Prescribed drugs influencing the gastrointestinal tract were also analyzed in order to define quality of the therapeutic process. Advertising for these special drugs in 3 Swiss medical journals was analyzed and compared with the prescribing behavior of participating physicians. 6300 patients with 3346 prescriptions (0.5 prescription/patient) were enrolled in the study. 16.5% of all prescriptions involved cardiovascular, 13.5% gastrointestinal, 9.5% non steroidal antirheumatic, 9.1% analgesic, 7.7% psychotropic and 7.4% antibiotic drugs. The share of 14 other classes of drugs was less than 4%. 471 prescriptions of gastrointestinal acting drugs were distributed over 288 patients (0.6 prescription/patient). 160 patients had irritable bowel syndrome, 40 ulcer disease, 23 inflammatory/infectious bowel disease, 18 gastroesophageal reflux, 18 anal diseases, 11 other gastrointestinal disorders and 15 were treated without diagnosis. Distribution of drugs was as follows: 27.5% bulk laxatives, 26% antacids, 15.7% H2-receptor antagonists, 13.5% anticholinergic agents, 4.9% laxatives, 3.4% loperamide, 9% other drugs. There was an increase in prescriptions per visit from 0.8 in 1980 to 1.5 in 1986. No important influence of drug advertising in 3 different medical journals published between January and June 1986 could be found. Considering the documented diagnoses, the therapeutic decisions were correct in 95.5% of cases treated. In conclusion, drug prescribing habits are permissive, the therapeutic approach is acceptable and the influence of drug advertising is negligible.