Kanagasabapathy Sivagami, Rajagopal Anandaraj, Murugan Vignesh, Balagurumoorthy Maharani, Vasudevan Kavita
Department of Community Medicine, KMCH IHSR, Coimbatore, Tamil Nadu, India.
Department of Community Medicine, Indira Gandhi Medical College and Research Institute, Puducherry, India.
J Family Med Prim Care. 2024 Nov;13(11):5193-5197. doi: 10.4103/jfmpc.jfmpc_922_24. Epub 2024 Nov 18.
Prescription auditing is a crucial tool for evaluating a range of concerns, including injectable usage, polypharmacy, the use of generic names, and the quality of treatment given to patients in primary care facilities. The objective of the study was to assess, using WHO core drug use indicators, the drug use patterns of general outpatients (OPD) at a rural healthcare facility.
A cross-sectional study was conducted in a rural peripheral health centre in Puducherry for a period of one year from September 2019 to August 2020. A total of 1200 prescriptions were analysed using the World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) monitoring tool to evaluate the prescription practices. Prescriptions of consenting patients attending OPD for general ailments were included in the study. Three to four prescriptions were chosen randomly on a daily basis. Patients who attended special clinics were excluded. The data was entered and analysed in MS Excel.
The average number of drugs per encounter was 3.10. The number of drugs prescribed by generic name was 65.7% and 39.8% of the encounters had antibiotics prescribed. Around 23.0% of the prescriptions contained injections. Of the prescribed drugs, 97.4% were available in the essential drug list. The average dispensing time observed was 20.80 sec. Out of the 3723 drugs prescribed 92.2% were actually dispensed and 77.5% were adequately labelled. Out of the 1200 patients interviewed regarding the dosage 72.0% had knowledge regarding the correct dosage. The health centre had a copy of the essential drug list and 83.0% of the drugs were available from the key drug list.
Many indicators had shown sub-optimal values when compared to the recommended ones by WHO/INRUD. Timely interventions like continuing medical education for budding physicians, improving the doctor-population ratio, adequate number of pharmacists in public health facilities will improve prescription practices which in turn may contribute to mitigating antimicrobial resistance.
处方审核是评估一系列问题的关键工具,包括注射剂使用情况、多药联用、通用名药物的使用以及基层医疗机构给予患者的治疗质量。本研究的目的是使用世界卫生组织核心药物使用指标,评估一家农村医疗机构普通门诊患者的用药模式。
于2019年9月至2020年8月在本地治里的一家农村外围健康中心进行了一项为期一年的横断面研究。使用世界卫生组织/合理用药国际网络(WHO/INRUD)监测工具对总共1200份处方进行分析,以评估处方开具情况。本研究纳入了因一般疾病到普通门诊就诊且同意参与的患者的处方。每天随机选择三到四份处方。排除到专科门诊就诊的患者。数据录入MS Excel并进行分析。
每次就诊的平均用药数量为3.10种。使用通用名开具的药物数量占65.7%,39.8%的就诊开具了抗生素。约23.0%的处方包含注射剂。在开具的药物中,97.4%在基本药物清单中。观察到的平均发药时间为20.80秒。在3723种开具的药物中,92.2%实际配发,77.5%有适当标签。在就剂量接受访谈的1200名患者中,72.0%了解正确剂量。该健康中心有一份基本药物清单,83.0%的药物可从重点药物清单中获取。
与WHO/INRUD推荐的指标相比,许多指标显示的值未达最佳。诸如为初出茅庐的医生提供继续医学教育、提高医生与人口比例、在公共卫生机构配备足够数量的药剂师等及时干预措施,将改善处方开具情况,进而有助于减轻抗菌药物耐药性。