Department of Pharmacy Quaid-i-Azam University Islamabad, Pakistan.
Department of Surgery, Pakistan institute of Medical sciences, Islamabad, Pakistan.
Ann Ig. 2020 Jul-Aug;32(4):368-375. doi: 10.7416/ai.2020.2360.
Appropriate utilization of therapeutic agents is a basic component of the quality of health outcomes for the patients and the community. A pilot study was conducted to evaluate the rational use of medicines and antibiotics, based on World Health Organization (who) prescribing indicators.
We performed a retrospective, descriptive, cross-sectional pilot study in the medical outpatient departments in four tertiary care hospitals of Islamabad, Pakistan, in order to verify the correct prescribing of medicines according to the validated indicators prepared by the World Health Organization (who).
The Registries of all the prescriptions formulated during the period April 02 2017 - April 01 2018 by the outpatient departments of four tertiary care hospitals (two government funded hospitals (GH-A and GH-B) and two private funded hospitals (PH-C and PH-D) were considered. According to the World Health Organization recommendations, during the following month (April 02 2018 to May 1 2018), 600 prescriptions (150 per hospital) were collected by a random sampling method, verified and analyzed through a statistical tool (SPSS version 22.0).
Mean number of medicines per prescription were 4.6 (Optimal value ≤ 2), with the highest value observed in GH-B hospital. Out of these, 350 (58.3%) (Optimal value < 30%) prescriptions consisted of antibiotics and 340 (56.6%) (Optimal value < 25%) prescriptions consisted of injectable medicines, with marked differences between hospitals. About 550 (19.6%) medicines were prescribed by generic name in all selected prescriptions with the lowest value observed in PH-D (9.9%) (Optimal value = 100%). Overall, 88% medicines were prescribed from National essential medicine list/formulary (Optimal value = 100%). All the prescribing core indicators showed significant difference between hospitals (P = 0.001). The most commonly prescribed antibiotic was ceftriaxone (37.4%), followed by ciprofloxacin (15.1%).
Poor adherence to WHO prescribing indicators were observed in all medical outpatient departments in selected hospitals. WHO recommended core interventions should be implemented on trial basis to develop strategies to achieve long-lasting benefits.
治疗药物的合理使用是患者和社区健康结果质量的基本组成部分。一项试点研究旨在根据世界卫生组织（WHO）处方指标评估药物和抗生素的合理使用情况。
我们在巴基斯坦伊斯兰堡的四家三级保健医院的门诊部门进行了回顾性、描述性、横断面试点研究，以根据世界卫生组织（WHO）制定的经过验证的指标验证药物的正确处方。
考虑了四家三级保健医院（两家政府资助医院（GH-A 和 GH-B）和两家私人资助医院（PH-C 和 PH-D）门诊部门在 2017 年 4 月 2 日至 2018 年 4 月 1 日期间制定的所有处方登记册。根据世界卫生组织的建议，在接下来的一个月（2018 年 4 月 2 日至 5 月 1 日）期间，通过随机抽样方法收集了 600 张处方（每家医院 150 张），并通过统计工具（SPSS 版本 22.0）进行了验证和分析。
每张处方的平均用药数为 4.6（最佳值≤2），GH-B 医院的最高值。其中，350 张（58.3%）（最佳值<30%）处方包含抗生素，340 张（56.6%）（最佳值<25%）处方包含注射剂，医院之间存在显著差异。在所有选定的处方中，有 550 种（19.6%）药物以通用名开处方，PH-D 的最低值为 9.9%（最佳值=100%）。总体而言，88%的药物是从国家基本药物清单/处方中开的（最佳值=100%）。所有处方核心指标在医院之间均有显著差异（P=0.001）。最常开的抗生素是头孢曲松（37.4%），其次是环丙沙星（15.1%）。
在所选择的医院的所有门诊部门都观察到对世卫组织处方指标的遵守情况不佳。应试行实施世卫组织建议的核心干预措施，以制定实现持久效益的战略。
