世卫组织/INRUD 核心药物使用指标和常用处方药物：来自斯里兰卡的国家调查。
WHO/INRUD Core drug use indicators and commonly prescribed medicines: a National Survey from Sri Lanka.
机构信息
Department of Pharmacology, Faculty of Medicine, University of Colombo, No 25, Kynsey Road, Colombo, 08, Sri Lanka.
出版信息
BMC Pharmacol Toxicol. 2021 Oct 28;22(1):67. doi: 10.1186/s40360-021-00535-5.
BACKGROUND
Identification of internationally comparable indicators of medicines use are important for a country to implement strategies and regulations to improve usage of medicines. Sri Lanka established a new National Medicines Regulatory Authority in 2015 and this survey evaluated the medication use indicators in Sri Lanka, according to the International Network on Rational Use of Drugs (INRUD), prior to its implementation.
METHODS
This descriptive-cross-sectional study was conducted in 80 pharmacies, representing all 25 districts of the country. Three pharmacy categories were included; privately owned pharmacies, 'Rajya Osusala' pharmacies operated by the State Pharmaceuticals Corporation (SPC) of Sri Lanka and SPC Franchisee pharmacy outlets. Selection of pharmacies from respective districts were done proportionate to estimated population. Data were collected to identify WHO/INRUD core drug use indicators and the commonly prescribed medicines.
RESULTS
Total of 2328 prescriptions were included ('Rajya Osusala 559; SPC Franchise 711; private pharmacies 1058). Altogether 7,255 medicines were prescribed, and the 3 most commonly prescribed medicines were atorvastatin, losartan and metformin. Average number of medicines per encounter was 3.1±1.9 (Median: 3; range 1-12) Highest average number of medicines per encounter was reported in prescriptions received at 'Rajya Osusala' pharmacies (3.6±2.2), significantly higher than in other categories of pharmacies (p<0.001). Percentage of medicines prescribed by generic name was only 35.5%, highest at the 'Rajya Osusala' pharmacies (40.6%), significantly higher than other categories of pharmacies. The overall percentage of medicines prescribed from essential medicine list (EML) was 68.8%, without any significant variation between different categories of pharmacies. The percentage of medicines actually dispensed and accurately labelled were 92.4 and 98.5% respectively.
CONCLUSIONS
The average number of medicines per encounter was higher than the WHO recommended value but the usage of antibiotic and injectable drugs were within recommended standards. Generic prescribing, was very much lower. The EML prescribing, labelling and percentage dispensed medicines fared much better although lower than the WHO recommended 100% compliance. This island wide study has provided national wide data before the implementation of key changes in regulation of medicines in Sri Lanka and a repeat survey will be useful to identify impact of the new legislations.
背景
确定具有国际可比性的药品使用指标对一个国家实施改善药品使用的战略和法规非常重要。2015 年，斯里兰卡成立了新的国家药品监管局，在实施该机构之前，本调查根据国际合理用药网络（INRUD）评估了斯里兰卡的用药指标。
方法
本描述性横断面研究在该国 25 个区的 80 家药店进行。包括三种药店类型；私营药店、由斯里兰卡国家制药公司（SPC）运营的“Rajya Osusala”药店和 SPC 特许经营药店。各区药店的选择是按照估计的人口比例进行的。收集数据以确定世卫组织/INRUD 核心药物使用指标和常用处方药物。
结果
共纳入 2328 份处方（“Rajya Osusala 559；SPC 特许经营 711；私人药房 1058）。总共开出了 7255 种药物，最常用的三种药物是阿托伐他汀、氯沙坦和二甲双胍。每次就诊的平均用药数为 3.1±1.9（中位数：3；范围 1-12）。在“Rajya Osusala”药房收到的处方中报告的每次就诊平均用药数最高（3.6±2.2），显著高于其他类别的药房（p<0.001）。按通用名开处方的药物比例仅为 35.5%，“Rajya Osusala”药房最高（40.6%），显著高于其他类别的药房。从基本药物清单（EML）开处方的药物比例总体为 68.8%，不同类别的药房之间没有明显差异。实际配药和准确标签的药物比例分别为 92.4%和 98.5%。
结论
每次就诊的平均用药数高于世卫组织推荐值，但抗生素和注射药物的使用符合推荐标准。通用名处方的使用率非常低。虽然低于世卫组织推荐的 100%合规率，但 EML 处方、标签和配药比例要好得多。这项全岛范围的研究在斯里兰卡药品监管法规发生重大变化之前提供了全国范围的数据，重复调查将有助于确定新法规的影响。
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