Al-Azayzih Ahmad, Al-Azzam Sayer I, Alzoubi Karem H, Shawaqfeh Mohammad, Masadeh Majed M
Int J Clin Pharmacol Ther. 2017 May;55(5):425-432. doi: 10.5414/CP202733.
Irrational drug prescribing is considered one of the major challenges for the healthcare sectors worldwide, leading to negative outcomes in patients including various drug-related problems, such as polypharmacy, adverse drug events, more demands on drug monitoring, and unwanted increase in treatment cost.
The main objective of this study was to evaluate the trends and issues related to prescription at outpatient hospital pharmacies in Jordan and to contrast that to the WHO rational medication list and WHO drug use indicators.
This study was a cross-sectional study, conducted between January 2014 and May 2014. It involved a total number of 24,089 patient encounters from five teaching and referral hospitals in Jordan. The encounters included patients who were prescribed at least one medication during their visit to outpatient clinics in those hospitals.
The average number of drugs per prescription was 2.93. The percentage of encounters which had antibiotics or injections in the prescription was 17.7% and 8.1%, respectively. The top three most common prescribed antibiotics were amoxicillin (n = 2,129, 49.9%), ciprofloxacin (n = 609, 14.3%), and clarithromycin (n = 267, 6.3%), while the most common prescribed injections were insulin and insulin analogs (n = 766, 39.2%), cyanocobalamin (Vitamin B) (n = 612, 31.3%), and erythropoietin (n = 80, 4.1%). The percentage of prescriptions by generic was 57.6%, whereas the prescribing from the essentials drug list (formulary) was close to optimal (99.8%).
CONCLUSION: The average number of prescribed drugs per encounter was higher than what was considered ideal according to WHO standards; the other issue found was a lower percentage of generic prescribing compared to WHO ideal value. The rest of prescribing indicators including the injections prescribing, antibiotics prescribing, and prescribing from the essential drug list were within the optimal range of values recommended by the WHO. .
不合理用药被认为是全球医疗保健部门面临的主要挑战之一，会给患者带来负面后果，包括各种与药物相关的问题，如多种药物并用、药物不良事件、对药物监测的更多需求以及治疗费用不必要的增加。
本研究的主要目的是评估约旦门诊医院药房的处方趋势和问题，并将其与世界卫生组织合理用药清单及世界卫生组织药物使用指标进行对比。
本研究为横断面研究，于2014年1月至2014年5月进行。研究涉及约旦五家教学和转诊医院的总共24,089例患者就诊情况。这些就诊情况包括在这些医院门诊就诊期间至少开具了一种药物的患者。
每张处方的平均药物数量为2.93种。处方中含有抗生素或注射剂的就诊百分比分别为17.7%和8.1%。最常用的三种抗生素是阿莫西林（n = 2,129，49.9%）、环丙沙星（n = 609，14.3%）和克拉霉素（n = 267，6.3%），而最常用的注射剂是胰岛素和胰岛素类似物（n = 766，39.2%）、氰钴胺（维生素B）（n = 612，31.3%）和促红细胞生成素（n = 80，4.1%）。通用名处方的百分比为57.6%，而基本药物清单（处方集）的处方接近最佳水平（99.8%）。
每次就诊开具的平均药物数量高于世界卫生组织标准所认为的理想数量；发现的另一个问题是通用名处方的百分比低于世界卫生组织的理想值。包括注射剂处方、抗生素处方以及基本药物清单处方在内的其他处方指标均在世界卫生组织推荐的最佳值范围内。
