Guyon A B, Barman A, Ahmed J U, Ahmed A U, Alam M S
Improvement of Drug Management Project, UNICEF, Dhaka, Bangladesh.
Bull World Health Organ. 1994;72(2):265-71.
The drug use pattern and the quality of care were assessed in 80 public sector facilities throughout rural Bangladesh. A total of 40 thana health complexes and 40 union subcentres, the lowest level in primary health care facilities, were selected at random. A total of 2880 prescriptions, consultations, and drug-dispensing practices were studied, and the availability and use of essential drugs and of the essential drugs list were recorded. The average consulting time (54 seconds), the proportion of adequate examinations (37%), and prescription of drugs according to standard treatment guidelines (41%) were unsatisfactory. The mean number of drugs prescribed per patient was 1.44; 25% were treated with antibiotics, and 17% with metronidazole, irrespective of the diagnoses. The availability of drugs (54%) and the presence of an essential drugs list (16%) in the health facilities were low. However, 78% of the drugs were prescribed by their generic names, 85% complied with the essential drugs list, and 81% were dispensed according to prescription. The average dispensing time (23 seconds) and the proportion of patients who correctly understood the dosage (55%) were poor.
在孟加拉国农村地区的80家公共部门医疗机构中评估了用药模式和医疗服务质量。随机选取了40个乡卫生综合机构和40个联合分中心,它们是初级卫生保健机构中的最低层级。共研究了2880份处方、会诊及药品配发情况,并记录了基本药物的可获得性及使用情况以及基本药物清单。平均会诊时间(54秒)、充分检查的比例(37%)以及按照标准治疗指南开药的比例(41%)都不尽人意。每位患者平均开药数量为1.44种;无论诊断结果如何,25%的患者接受了抗生素治疗,17%的患者接受了甲硝唑治疗。医疗机构中药物的可获得性(54%)以及基本药物清单的存在情况(16%)较低。然而,78%的药物以通用名开具处方,85%符合基本药物清单,81%按照处方配发。平均配发时间(23秒)以及正确理解用药剂量的患者比例(55%)都很低。