Abdullah Muhammad Ahmed, Ahmed Ameer Sikander, Shaikh Babar Tasneem, Kaleem Mohammad Bilal, Sumbal Abdullah, Naeem Zahid
Department of Public Health, School of Public Health, Al-Shifa Trust, Rawalpindi, Pakistan.
Department of Internal Medicine, Akbar Niazi Teaching Hospital, Islamabad, Pakistan.
Int J Health Sci (Qassim). 2024 Jan-Feb;18(1):29-34.
Amidst inconsistent prescribing patterns and potentially harmful medication errors in the field of medical practice, this study endeavored to explore the prescription practices of physicians in Rawalpindi metropolitan city in Pakistan.
A mixed method study was conducted based on the analysis of 1232 prescriptions gathered from 16 pharmacies, along with in-depth interviews with 13 practicing physicians. The prescriptions were assessed for legibility, polypharmacy, patient details, history, diagnosis, and other relevant information. Data were analyzed using descriptive statistics, and the prevalence of various aspects of prescription accuracy was calculated. Thematic analysis was conducted on the qualitative data.
Almost half of the prescriptions were from the private general practitioners, and the rest were from hospital-based doctors and consultants. Only a small percentage of prescriptions were fully legible, and many had incomplete or missing patient information, medical history, and diagnosis. Polypharmacy was also found to be prevalent, with significant differences in prescription accuracy across different medical specialties. The absence of continuing medical education, influence of pharmaceutical industry, and overcrowded practice settings drive the doctors to prescription practices. On the user side, perception of polypharmacy, patient-physician communication, and availability and cost of medicines emerged as major themes.
There is an obvious need to improve prescription accuracy regarding patient safety on the whole. Increased investment in health-care infrastructure, greater access to continuing medical education, and a commitment to promote evidence-based medicine could make a difference. Prescription practices must be safe, effective, and aligned with the latest advances in medical science.
鉴于医疗实践领域中处方模式不一致以及存在潜在有害的用药错误,本研究致力于探索巴基斯坦拉瓦尔品第市医生的处方习惯。
开展了一项混合方法研究,分析了从16家药店收集的1232份处方,并对13名执业医生进行了深入访谈。对处方的易读性、联合用药、患者详细信息、病史、诊断及其他相关信息进行评估。使用描述性统计分析数据,计算处方准确性各方面的患病率。对定性数据进行主题分析。
几乎一半的处方来自私人全科医生,其余来自医院医生和顾问。只有一小部分处方完全清晰可读,许多处方的患者信息、病史和诊断不完整或缺失。联合用药也很普遍,不同医学专科的处方准确性存在显著差异。缺乏继续医学教育、制药行业的影响以及拥挤的执业环境促使医生形成处方习惯。在患者方面,对联合用药的认知、医患沟通以及药品的可及性和成本成为主要主题。
总体而言,显然有必要提高与患者安全相关的处方准确性。增加对医疗基础设施的投资、增加继续医学教育的机会以及致力于推广循证医学可能会有所作为。处方习惯必须安全、有效,并与医学科学的最新进展保持一致。