Calikoglu E O, Koycegiz E, Kosan Z, Aras A
Department of Public Health, Ataturk University, Medical Faculty, Erzurum, Turkey.
Niger J Clin Pract. 2019 May;22(5):626-632. doi: 10.4103/njcp.njcp_258_18.
Widespread irrational medical prescription adversely affects the outcomes of patient health and medical services.
This study aims to investigate the determinants of medical prescription behavior of family physicians in Erzurum Province.
This cross-sectional descriptive study was conducted during August-December 2016 on a voluntary sample of 191 out of 234 physicians (81.6%) working at family health centers in the districts of Erzurum. Physicians were visited at their workplaces, and data were collected using a self-administered and structured, 45-item questionnaire.
The mean age of the physicians was 34.7 ± 7.9 years, and 70.7% (n = 135) of the participants were males. About 83.8% (n = 160) of physicians responded "yes" or "sometimes" to the question "Do you prescribe medicine on demand of the patients?" The two most important factors that affected the prescribing behavior of the participants were the pharmacology lectures attended during medical education (50.8%) and the prescribing experience acquired during clinical internship (46.0%). Presentations given by the representatives of drug companies, in-service training programs after graduation, and Internet/mobile phone applications had the lowest rate of contribution as behavioral determinants. The participants perceived having sufficient information in the areas of indication for use (77.5%) and daily dose (72.8%). Only 4.2% of participants deemed their knowledge of medication costs sufficient. Pharmacology lessons were found to be more effective in the prescribing behaviors of the physicians who had less than 10 years of professional experience (Chi-square = 12.131; P = 0.002).
Rational medical prescription continues to be a trouble among family physicians. The study findings suggest a substantial knowledge gap in participating physicians occurring after graduation and clinical internship training, in the areas of costs of medicine and rational medical prescribing.
广泛存在的不合理医疗处方对患者健康和医疗服务结果产生不利影响。
本研究旨在调查埃尔祖鲁姆省家庭医生医疗处方行为的决定因素。
本横断面描述性研究于2016年8月至12月进行，对埃尔祖鲁姆各地区家庭健康中心工作的234名医生中的191名（81.6%）进行自愿抽样。在医生工作场所对其进行访问，并使用一份45项的自填式结构化问卷收集数据。
医生的平均年龄为34.7±7.9岁，70.7%（n = 135）的参与者为男性。约83.8%（n = 160）的医生对“你会根据患者要求开药吗？”这个问题回答“是”或“有时会”。影响参与者处方行为最重要的两个因素是医学教育期间参加的药理学讲座（50.8%）和临床实习期间获得的处方经验（46.0%）。制药公司代表的演讲、毕业后的在职培训项目以及互联网/手机应用作为行为决定因素的贡献率最低。参与者认为在使用指征（77.5%）和每日剂量（72.8%）方面有足够的信息。只有4.2%的参与者认为自己对药物成本的了解足够。药理学课程在专业经验少于10年的医生的处方行为中被发现更有效（卡方 = 12.131；P = 0.002）。
合理医疗处方在家庭医生中仍然是个问题。研究结果表明，参与研究的医生在毕业后和临床实习培训后，在药物成本和合理医疗处方方面存在很大的知识差距。
