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巴西初级卫生保健中的处方书写质量。

Quality of prescription writing in Brazilian primary health care.

机构信息

Multicampi School of Medical Sciences, Federal University of Rio Grande do Norte, Caicó, Brazil.

Instituto Nacional de Salud Pública, Cuernavaca, México.

出版信息

Prim Health Care Res Dev. 2023 Jul 31;24:e49. doi: 10.1017/S1463423623000415.

Abstract

OBJECTIVE

To evaluate the quality of prescription writing in the context of public primary health care.

BACKGROUND

Prescription errors are one of the leading patient safety problems in primary care and can be caused by errors in therapeutic decisions or in the quality of prescription writing.

METHODS

Cross-sectional observational study conducted in a municipality in Northeastern Brazil. The assessment instrument (including 13 indicators and one composite indicator) was applied to a representative sample of drug prescriptions from the 24 Family Health Teams providing Primary Health Care in the municipality, dispensed in January 2021. Estimates of compliance and their 95% confidence intervals and graphical analysis of frequencies are assessed globally and stratified by dispensing units and prescribers.

FINDINGS

The average composite prescription writing quality on a 0-100 scale was 60.2 (95% CI 57.8-62.6). No quality criteria had 100% compliance. The highest compliance rates were found for 'frequency of administration' (98.9%) and 'identification of the prescriber' (98.9%). On the other hand, 'recorded information on allergy' (0.0%), 'patient's date of birth' (1.7%), 'nonpharmacological recommendations' (1.7%), and 'guidance on the use of the drug' (25%) were the indicators with lower compliance, contributing to 69% of the noncompliances found. The type and frequency of the errors in the quality of prescription writing uncovered in this study confirm the continuing need to tackle this problem to improve patient safety. The results identify priority aspects for interventions and further studies on the quality of prescription writing in the context of Primary Health Care in Brazil.

摘要

目的

评估公共初级卫生保健中处方书写的质量。

背景

处方错误是初级保健中导致患者安全问题的主要原因之一,可能是由于治疗决策或处方书写质量错误引起的。

方法

在巴西东北部的一个市进行了一项横断面观察性研究。评估工具(包括 13 个指标和一个综合指标)应用于该市 24 个提供初级卫生保健的家庭健康团队所开的药物处方的代表性样本,这些处方于 2021 年 1 月配药。评估了总体和按配药单位和开方者分层的合规性估计及其 95%置信区间和频率图形分析。

结果

0-100 分制的平均综合处方书写质量为 60.2(95%CI 57.8-62.6)。没有任何质量标准的合规率达到 100%。“给药频率”(98.9%)和“识别开方者”(98.9%)的合规率最高。另一方面,“记录过敏信息”(0.0%)、“患者出生日期”(1.7%)、“非药物建议”(1.7%)和“药物使用指导”(25%)是合规率较低的指标,占发现的不合规的 69%。本研究中发现的处方书写质量的错误类型和频率证实了继续解决这一问题以提高患者安全性的必要性。研究结果确定了在巴西初级卫生保健中干预和进一步研究处方书写质量的优先方面。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7a0/10466202/4daee0911d92/S1463423623000415_fig1.jpg

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