Galappatthy Priyadarshani, Ranasinghe Priyanga, Liyanage Chiranthi K, Wijayabandara Maheshi, Warapitiya Dinuka S, Jayasekara Dilini, Jayakody Raveendra L
Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Colombo North Teaching Hospital, Ragama, Sri Lanka.
Adv Pharmacol Pharm Sci. 2021 Jan 29;2021:6625377. doi: 10.1155/2021/6625377. eCollection 2021.
Irrational prescribing is common, especially in developing countries. It is important to identify the magnitude of irrational use, to take necessary steps to promote rational prescribing. We identified core prescribing indicators and commonly prescribed medicines at ward settings (IW) and outpatients' clinics (OPC) in a tertiary care hospital in Sri Lanka. A descriptive cross-sectional study was carried out at IW and OPC settings. Prescriptions were obtained from 5 major specialties (Clinical Medicine (CM), Gynaecology and Obstetrics (GO), Paediatrics, Psychiatry, and Surgery). The WHO core prescribing indicators were used to describe the pattern of prescribing, and the most commonly prescribed medicines were identified. A total of 1,318 prescriptions were analyzed. The five most commonly prescribed medicines were paracetamol (31.0%), omeprazole (20.6%), folic acid (18.3%), atorvastatin (16.2%), and salbutamol (15.3%). The average number of medicines per encounter was 4.8 ± 3.6 (IW: 5.7 ± 4; OPC: 3.8 ± 2.8; < 0.001), with the highest IW (7.8 ± 4.2) and OPC (7.8 ± 2.7) values were from CM, being significantly higher than all other disciplines ( < 0.05). Percentage encounters with an antibiotic or an injection was 26.4% and 30.1%, respectively, with IW being significantly higher than OPC ( < 0.001). Percentage of medicines prescribed by generic name and from the essential medicine list (EML) was 90.1% and 91.1%, respectively, with no significant IW and OPC difference. In conclusion, a high degree of polypharmacy was noted. The use of injectable medicines, prescribing from the EML, and generic name prescribing was satisfactory; however, overall rational prescribing needs further improvement. Further investigation into the degree of rational prescribing associating it with clinical information will be important.
不合理用药现象普遍存在,尤其是在发展中国家。识别不合理用药的程度,并采取必要措施促进合理用药十分重要。我们在斯里兰卡一家三级医院的病房(IW)和门诊诊所(OPC)确定了核心处方指标和常用药物。在IW和OPC环境中开展了一项描述性横断面研究。处方来自5个主要专科(临床医学(CM)、妇产科(GO)、儿科、精神病科和外科)。采用世界卫生组织核心处方指标来描述处方模式,并确定最常用的药物。共分析了1318张处方。五种最常用的药物是对乙酰氨基酚(31.0%)、奥美拉唑(20.6%)、叶酸(18.3%)、阿托伐他汀(16.2%)和沙丁胺醇(15.3%)。每次就诊的平均用药数量为4.8±3.6(IW:5.7±4;OPC:3.8±2.8;<0.001),IW(7.8±4.2)和OPC(7.8±2.7)的最高值来自CM,显著高于所有其他学科(<0.05)。使用抗生素或注射剂的就诊百分比分别为26.4%和30.1%,IW显著高于OPC(<0.001)。使用通用名和基本药物清单(EML)中药物的处方百分比分别为90.1%和91.1%,IW和OPC之间无显著差异。总之,发现了高度的多药联用现象。注射用药物的使用、从EML中开出处方以及使用通用名开处方情况令人满意;然而,总体合理用药仍需进一步改善。进一步调查合理用药程度并将其与临床信息相关联将很重要。