Kartal Training and Research Hospital, Kartal, Istanbul, Turkey.
Eur J Clin Pharmacol. 2013 Aug;69(8):1581-7. doi: 10.1007/s00228-013-1505-9. Epub 2013 Apr 16.
The rational use of drugs (RUD) is primarily the responsibility of physicians. The aim of this study was to investigate whether physicians are aware of RUD principles and how they apply them in daily medical practice.
A total 136 physicians working at the Kartal Training and Research Hospital in Istanbul were enrolled in the study between February and March 2012. A face-to-face interview was conducted with physicians to assess their knowledge and attitude regarding RUD.
A large majority of the physicians declared that consultation time was insufficient (84 %). The data obtained from the survey indicate that 54 % of the enrolled physicians monitored the therapeutic outcome and that 27 % found the information given to the patient to be sufficient. Participating physicians stated that the less known characteristics of the drugs they prescribed were drug interactions, traceability in market, and price. The most preferred reference source was Vademecum (a drug guideline prepared by the private sector). Two major factors contributing to prescribing patterns were "self study" and "observation of teachers" at clinical training. There was a significant difference between internists-surgeons and residents-specialists in the number of prescribed drugs per prescription (p < 0.001) and in the information provided to the patient on the prescribed drugs (name, effect, dose, instructions, possible side effect) (p < 0.05), respectively.
Our findings overall show that the principles of RUD were not fully applied in daily medical practice by the participating physicians. One important reason for this is a heavy patient load, which requires a change in managerial practices within the healthcare system. The other, more essential explanation is education; consequently, serious consideration should be given to including effective clinical pharmacotherapy training and RUD courses in the medical education curriculum.
合理用药（RUD）主要是医生的责任。本研究旨在调查医生是否了解 RUD 原则以及他们如何将这些原则应用于日常医疗实践。
2012 年 2 月至 3 月，在伊斯坦布尔 Kartal 培训和研究医院招募了 136 名医生参与这项研究。通过与医生进行面对面访谈，评估他们对 RUD 的知识和态度。
绝大多数医生表示咨询时间不足（84%）。调查数据表明，54%的医生监测治疗效果，27%的医生认为向患者提供的信息足够。参与调查的医生表示，他们不太了解所开药物的特性包括药物相互作用、市场可追溯性和价格。最常使用的参考资料是 Vademecum（由私营部门编写的药物指南）。影响处方模式的两个主要因素是“自学”和临床培训中“观察老师”。内科医生-外科医生和住院医师-专科医生之间的处方药数量（p<0.001）和向患者提供的处方药信息（名称、效果、剂量、说明、可能的副作用）（p<0.05）存在显著差异。
我们的研究结果总体表明，参与研究的医生在日常医疗实践中并未完全应用 RUD 原则。造成这种情况的一个重要原因是患者负担过重，这需要医疗系统管理实践的改变。另一个更重要的原因是教育，因此，应该认真考虑在医学教育课程中纳入有效的临床药物治疗培训和 RUD 课程。
