评估印度各三级医疗中心按照世界卫生组织处方指标的药物处方模式和处方完整性：印度医学研究理事会合理用药中心网络在国家虚拟中心临床药理学活动下进行的一项多中心研究。
Assessment of prescribing pattern of drugs and completeness of prescriptions as per the World Health Organization prescribing indicators in various Indian tertiary care centers: A multicentric study by Rational Use of Medicines Centers-Indian Council of Medical Research network under National Virtual Centre Clinical Pharmacology activity.
机构信息
Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore, Tamil Nadu, India.
出版信息
Indian J Pharmacol. 2022 Sep-Oct;54(5):321-328. doi: 10.4103/ijp.ijp_976_21.
OBJECTIVE
The rational use of medicines as per the World Health Organization (WHO) should be practiced globally. However, data regarding the completeness of the prescriptions and their rational use is lacking from developing countries like India. Thus, the aim of this study was to assess the prescribing patterns of drugs and completeness of prescriptions as per WHO core drug use and complementary indicators to provide real-life examples for the Indian Council of Medical Research (ICMR) online prescribing skill course for medical graduates.
METHODS
Prescriptions of the patients, fulfilling inclusion criteria, attending Outpatient Departments of various specialties of tertiary care hospitals, were collected by thirteen ICMR Rational use of medicines centers located in tertiary care hospitals, throughout India. Prescriptions were evaluated for rational use of medicines according to the WHO guidelines and for appropriateness as per standard treatment guidelines using a common protocol approved by local Ethics committees.
RESULTS
Among 4838 prescriptions, an average of about three drugs (3.34) was prescribed to the patients per prescription. Polypharmacy was noted in 83.05% of prescriptions. Generic drugs were prescribed in 47.58% of the prescriptions. Further, antimicrobials were prescribed in 17.63% of the prescriptions and only 4.98% of prescriptions were with injectables. During the prescription evaluation, 38.65% of the prescriptions were incomplete due to multiple omissions such as dose, duration, and formulation.
CONCLUSION
Most of the parameters in the present study were out of the range of WHO-recommended prescribing indicators. Therefore, effective intervention program, like training, for the promotion of rational drug use practice was recommended to improve the prescribing pattern of drugs and the quality of prescriptions all over the country.
目的
全球应按照世界卫生组织（WHO）的规定合理使用药物。然而，发展中国家（如印度）缺乏关于处方完整性和合理使用的相关数据。因此，本研究旨在评估按照 WHO 核心药物使用和补充指标开处方的药物处方模式和处方完整性，为医学研究生印度医学研究理事会（ICMR）在线处方技能课程提供真实示例。
方法
通过位于三级保健医院的 13 个 ICMR 合理用药中心，收集符合纳入标准的各专科门诊患者的处方。根据 WHO 指南评估处方药物的合理性，并根据标准治疗指南使用当地伦理委员会批准的通用方案评估处方的适宜性。
结果
在 4838 张处方中，每张处方平均开给患者约 3 种（3.34 种）药物。83.05%的处方存在多种药物联合应用。47.58%的处方开的是仿制药。此外，17.63%的处方开了抗生素，只有 4.98%的处方开的是注射剂。在处方评估过程中，由于剂量、持续时间和剂型等多项遗漏，38.65%的处方不完整。
结论
本研究的大多数参数均超出了 WHO 推荐的处方指标范围。因此，建议实施有效的干预计划，如培训，以促进合理用药实践，从而改善全国的药物处方模式和处方质量。
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