Mollahaliloglu Salih, Alkan Ali, Donertas Basak, Ozgulcu Senay, Akici Ahmet
Health Policies Board, Ministry of Health, Ankara, Turkey.
Turkish Medicines and Medical Devices Agency, Department of Rational Drug Use, Drug Supply Management and Promotion, Ministry of Health, Ankara, Turkey.
Eurasian J Med. 2013 Jun;45(2):92-8. doi: 10.5152/eajm.2013.20.
Irrational pharmacotherapy is a widespread health care problem, and knowing the prescription practices of physicians at an institutional level can present solutions. This study aimed to investigate whether physicians' prescribing patterns showed differences at the level of the health care institution.
Photocopies of 3201 prescriptions written at primary health care centers (PHCs), public hospitals, private hospitals, and university hospitals (UHs) were collected from 10 provinces in Turkey. The prescriptions were evaluated according to prescribing indicators, and the details of drug utilization were compared for different health care institutions.
The average number of medicines per prescription was 2.83, and the highest average was noted in PHCs (2.96). The average cost per prescription was US $51.57, and the highest average cost was found in UHs (US $166.10). The most frequently prescribed drug group was different among health care institutions. With the exception of UHs, the "cold-cough medicines" were the most frequently prescribed medicines at all of the institutions. Thirty-nine percent of the prescriptions included antibiotics.
Despite the similarities between the distributions of diagnoses on prescriptions by health care institutions, the contents of the prescriptions showed differences. The high levels of prescriptions for "cold-cough medicines," whose use is widely debated, and the widespread tendency of physicians to prescribe antibiotics suggest that there is a growing need for disseminating the principles of rational pharmacotherapy. Furthermore, institutional differences must be considered when conducting rational pharmacotherapy programs.
不合理药物治疗是一个普遍存在的医疗保健问题，了解医疗机构层面医生的处方行为有助于找到解决办法。本研究旨在调查医生的处方模式在医疗机构层面是否存在差异。
从土耳其10个省份收集了基层医疗中心（PHC）、公立医院、私立医院和大学医院（UH）开具的3201张处方的复印件。根据处方指标对这些处方进行评估，并比较不同医疗机构的药物使用细节。
每张处方的平均用药数量为2.83种，其中基层医疗中心的平均用药数量最高（2.96种）。每张处方的平均费用为51.57美元，大学医院的平均费用最高（166.10美元）。不同医疗机构中最常开具的药物类别不同。除大学医院外，所有机构中“感冒咳嗽药”都是最常开具的药物。39%的处方包含抗生素。
尽管不同医疗机构处方上的诊断分布存在相似性，但处方内容存在差异。对于使用存在广泛争议的“感冒咳嗽药”的高处方率，以及医生普遍开具抗生素的倾向表明，传播合理药物治疗原则的需求日益增加。此外，在开展合理药物治疗项目时必须考虑机构差异。
