Suppr超能文献

尼泊尔中部三级医疗区医院门诊部处方模式及处方错误评估

Assessment of prescription pattern and prescription error in outpatient Department at Tertiary Care District Hospital, Central Nepal.

作者信息

Shrestha Rajeev, Prajapati Srijana

机构信息

Department of Pharmacy, Bharatpur District Hospital, kuber marga, Bhagawaoti Tol, Bharatpur-04, Chitwan, Nepal.

出版信息

J Pharm Policy Pract. 2019 Jul 10;12:16. doi: 10.1186/s40545-019-0177-y. eCollection 2019.

Abstract

BACKGROUND

The rational use of medicine improves patient's quality of life. Excessive and inappropriate prescriptions result in severe consequences. The study of drug use patterns and prescription errors is necessary to promote rational drug use in developing countries. The aim of the study was to evaluate prescription practice and help to the quality use of medicine.

METHODS

A retrospective, cross-sectional and quantitative study was conducted at Bharatpur District Hospital in central Nepal. The outpatient prescriptions retained at the pharmacy from November to December 2017 were used to evaluate prescription patterns and errors. The total of 770 prescriptions were reviewed. The stratified random sampling method was used.

RESULT

The total of 2448 drugs were prescribed in 770 prescriptions or patients. The average number of drugs per encounter was 3.2. The percentage of encounter with antibiotic and injection was 37.9% ( = 292) and 0.7% ( = 5), respectively. The percentage of drugs prescribed by generic and from an essential medicine list of Nepal was 2.9% ( = 72) and 21.3% ( = 521), respectively. The most common 32.5% of prescriptions contain three drugs and 24.7% of prescriptions contain four drugs. The average prescription errors per prescription were 3.4. Among total errors, omission errors related to prescriber were 1.5 ( = 1135), omission errors related to the drug were 1.5 ( = 1189) and commission errors were 0.3 ( = 269). The total of 249 drug interactions were found in 19.1% ( = 147) prescriptions. The common prescription errors were due to failure to mention prescriber name 87.5% ( = 674), failure to mention prescriber signature 19.2% ( = 148) and failure to mention diagnosis 39.2% ( = 302).

CONCLUSION

The study shows low compliance with WHO prescribing indicators and high prescription errors. The prescribing practices were not confirmed to the standard recommended by WHO. Prescribing from the Essential Drug List (EDL), low rates of generic prescribing, high antibiotic prescribing and polypharmacy were a major problem. The study found major errors in prescriber and prescribed medicine details. Remarkable drug interactions were seen in prescribed medicines. The study recommended necessary practices and policy formulation and implementation by DTC and regulatory bodies to promote the rational use of medicine.

摘要

背景

合理用药可提高患者生活质量。过度和不恰当的处方会导致严重后果。研究用药模式和处方错误对于促进发展中国家的合理用药很有必要。本研究的目的是评估处方实践并助力药品的合理使用。

方法

在尼泊尔中部的巴拉特普尔地区医院开展了一项回顾性、横断面定量研究。利用2017年11月至12月药房留存的门诊处方来评估处方模式和错误。共审查了770张处方。采用分层随机抽样方法。

结果

770张处方或患者共开具了2448种药物。每次就诊的平均用药数量为3.2种。使用抗生素和注射剂的就诊比例分别为37.9%(n = 292)和0.7%(n = 5)。使用通用名开具的药物以及来自尼泊尔基本药物清单的药物比例分别为2.9%(n = 72)和21.3%(n = 521)。最常见的情况是,32.5%的处方包含三种药物,24.7%的处方包含四种药物。每张处方的平均处方错误数为3.4个。在所有错误中,与开处方者相关的遗漏错误为1.5个(n = 1135),与药物相关的遗漏错误为1.5个(n = 1189),而开错错误为0.3个(n = 269)。在19.1%(n = 147)的处方中发现了总共249种药物相互作用。常见的处方错误包括未提及开处方者姓名的占87.5%(n = 674)、未提及开处方者签名的占19.2%(n = 148)以及未提及诊断的占39.2%(n = 302)。

结论

该研究表明对世界卫生组织的处方指标依从性较低且处方错误率较高。处方实践未符合世界卫生组织推荐的标准。从基本药物清单开处方、通用名处方率低、抗生素处方率高以及多药联用是主要问题。该研究发现开处方者和所开药物详情存在重大错误。在所开药物中发现了显著的药物相互作用。该研究建议药品技术委员会和监管机构采取必要措施并制定和实施相关政策以促进合理用药。

相似文献

1
Assessment of prescription pattern and prescription error in outpatient Department at Tertiary Care District Hospital, Central Nepal.
J Pharm Policy Pract. 2019 Jul 10;12:16. doi: 10.1186/s40545-019-0177-y. eCollection 2019.
2
Prescription writing pattern among the dental practitioners of a tertiary care hospital in Karachi.
BMC Prim Care. 2024 Jul 27;25(1):273. doi: 10.1186/s12875-024-02532-z.
4
A cross-sectional study on current prescription trends and errors in outpatient department of a Bangladeshi secondary care district hospital.
Perspect Clin Res. 2022 Jul-Sep;13(3):161-167. doi: 10.4103/picr.PICR_245_20. Epub 2021 Mar 26.
6
Analysis of the prescription pattern of psychotropics in an outpatient department of a general hospital psychiatry unit.
Med J Armed Forces India. 2022 Jan;78(1):74-79. doi: 10.1016/j.mjafi.2020.03.006. Epub 2020 May 20.
7
Assessment of Antibiotic Prescribing Patterns at Outpatient Pharmacy Using World Health Organization Prescribing Indicators.
J Prim Care Community Health. 2019 Jan-Dec;10:2150132719886942. doi: 10.1177/2150132719886942.
9
Prescription analysis of pediatric outpatient practice in nagpur city.
Indian J Community Med. 2010 Jan;35(1):70-3. doi: 10.4103/0970-0218.62564.

引用本文的文献

2
Exploring Potentially Inappropriate Medication Use on Elderly Patients in a General Medicine Ward Using 2023 AGS Beers Criteria.
Aging Med (Milton). 2025 Jun 15;8(3):238-248. doi: 10.1002/agm2.70025. eCollection 2025 Jun.
3
Morbidity and Drug Prescribing Pattern in Pediatric Outpatient Department of Kankai Nagar Hospital of Eastern Nepal.
Sage Open Pediatr. 2025 Mar 16;12:30502225251319878. doi: 10.1177/30502225251319878. eCollection 2025 Jan-Dec.
5
Medication errors in community pharmacies: a systematic review of the international literature.
PLoS One. 2025 May 20;20(5):e0322392. doi: 10.1371/journal.pone.0322392. eCollection 2025.
6
Digital platform for prescription analytics and antibiotic surveillance in an outpatient department setup.
Indian J Pharmacol. 2025 Jan 1;57(1):27-32. doi: 10.4103/ijp.ijp_201_25. Epub 2025 May 6.
7
Exploring potential drug-drug interactions in discharge prescriptions: ChatGPT's effectiveness in assessing those interactions.
Explor Res Clin Soc Pharm. 2025 Jan 15;17:100564. doi: 10.1016/j.rcsop.2025.100564. eCollection 2025 Mar.
8
Exploring the medicine cost of managing Diabetes Mellitus in Nepal: A cross-sectional analysis of oral hypoglycaemic medications.
PLoS One. 2024 Dec 5;19(12):e0310706. doi: 10.1371/journal.pone.0310706. eCollection 2024.
9
Exploration of drug therapy related problems in a general medicine ward of a tertiary care hospital of Eastern Nepal.
Explor Res Clin Soc Pharm. 2024 Oct 16;16:100528. doi: 10.1016/j.rcsop.2024.100528. eCollection 2024 Dec.
10

本文引用的文献

2
Evaluation of prescription errors and prescribing indicators in the private practices in Bahawalpur, Pakistan.
J Chin Med Assoc. 2018 May;81(5):444-449. doi: 10.1016/j.jcma.2017.12.002. Epub 2018 Mar 13.
3
Essential Medicine Utilization and Situation in Selected Ten Developing Countries: A Compendious Audit.
J Int Soc Prev Community Dent. 2017 Jul-Aug;7(4):147-160. doi: 10.4103/jispcd.JISPCD_224_17. Epub 2017 Jul 31.
4
Analysis of medication errors at a large tertiary care hospital in Saudi Arabia: a retrospective analysis.
Int J Clin Pharm. 2017 Oct;39(5):1004-1007. doi: 10.1007/s11096-017-0514-7. Epub 2017 Jul 26.
6
Overuse and Misperceptions of Nonsteroidal Anti-inflammatory Drugs in the United States.
Am J Med Sci. 2016 Nov;352(5):472-480. doi: 10.1016/j.amjms.2016.08.028. Epub 2016 Sep 21.
7
A study of medication errors in a tertiary care hospital.
Perspect Clin Res. 2016 Oct-Dec;7(4):168-173. doi: 10.4103/2229-3485.192039.
8
A survey exploring the knowledge and perceptions of senior medical students in Nepal toward generic medicines.
SAGE Open Med. 2016 Aug 4;4:2050312116662570. doi: 10.1177/2050312116662570. eCollection 2016.
9
Drug utilization, prescription errors and potential drug-drug interactions: an experience in rural Sri Lanka.
BMC Pharmacol Toxicol. 2016 Jun 25;17(1):27. doi: 10.1186/s40360-016-0071-z.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验