Üçüncü basamak bir hastanenin obezite polikliniğinde Dünya Sağlık Örgütü temel reçete göstergeleri kullanılarak akılcı ilaç kullanımının değerlendirilmesi
Öz
Amaç: Bu çalışmanın amacı, üçüncü basamak bir hastanenin obezite polikliniğinde reçete edilen ilaçların akılcı kullanımını DSÖ reçetelenme göstergeleri kullanarak değerlendirmektir.
Gereç ve Yöntem: 01 Nisan 2016-01 Ağustos 2017 tarihleri arasında obezite polikliniğine başvuran hastalar retrospektif olarak incelendi. Hastaların demografik özellikleri (yaş, cinsiyet), vücut kitle indeksi, yandaş hastalıklar, reçete edilen ilaç sayısı, ilaç isimleri, dozaj formları ve ilaç uygulama yolları gibi parametreler değerlendirildi.
Reçeteler, kişi başına düşen ortalama ilaç sayısı, jenerik isimle reçete edilen ilaçların yüzdesi, bir antibiyotik reçete edilen kişilerin yüzdesi, bir parenteral ilaç reçete edilen kişilerin yüzdesi ve temel ilaç listesinden reçetelenen ilaç yüzdesi gibi DSÖ temel reçetelenme göstergelerine göre analiz edildi.
Bulgular: Hastaların ortalama yaşı 47,5±12,4 idi ve çoğu kadındı (%88,1). Esansiyel hipertansiyon en sık görülen yandaş hastalıktı (%33). En sık reçete edilen ilaç Vitamin D3 (kolekalsiferol) (%23,7) idi. Kişi başına düşen ortalama ilaç sayısı 1,7 idi. Jenerik isimle reçete edilen ilaçların yüzdesi %0 idi. On dört (%2,8) hastaya antibiyotik, 26 hastaya (%5,2) parenteral ilaç reçete edildi. Temel ilaç listesinden reçetelenen ilaç yüzdesi %61,4 idi.
Sonuç: Kişi başına düşen ortalama ilaç sayısı ve bir antibiyotik ve enjeksiyon reçetelenen hasta yüzdesi gibi reçetelenme göstergelerinin DSÖ standart değerlerine uygun olduğunu, jenerik isimle reçetelenen ilaçların yüzdesi ve temel ilaç listesinden reçete edilen ilaçların yüzdesi gibi parametrelerin ise DSÖ ideal değerlerinden oldukça uzak olduğunu saptadık. Bu çalışmanın bulgularının, sağlık yetkililerinin rasyonel ilaç kullanımını teşvik etmek amacıyla uygun müdahaleleri uygulamasına katkıda bulunacağı düşünülmektedir.
Anahtar Kelimeler
Akılcı ilaç kullanımı ilaç kullanımı reçetelenme göstergeleri
Kaynakça
- World Health Organization. Promoting rational use of medicine: core components. WHO Policy and Perspectives on Medicines, 2002 Available from: http://apps.who.int/medicinedocs/pdf/h3011e/h3011e.pdf
- World Health Organization. The World Medicines Situation, Rational Use of medicines, 2011 WHO/EMP/MIE/2011.2.2. Available from: http://apps.who.int/medicinedocs/en/m/abstract/Js1806en/
- Ofori-Asenso R, Agyeman AA. Irrational use of medicines—a summary of key concepts. Pharmacy 2016; 4 (4): 35. doi: 10.3390/pharmacy4040035.
- Irunde H, Minzi O, Moshiro C. Assessment of Rational Medicines Prescribing in Healthcare Facilities in Four Regions of Tanzania. JPPCM 2017; 3 (4): 225-31. doi:10.5530/jppcm.2017.4.64.
- Demeke B, Molla F, Assen A, et al. Evaluation of drugs utilization pattern using who prescribing indicators in Ayder Referral Hospital, Northern Ethiopia. IJPSR 2015; 6 (2): 343-7. Available from:https://pdfs.semanticscholar.org/70d9/d3a13b0658c249c77c32257abe2144d28671.pdf.
- Akici A, Aydin V, Kiroglu A. Assessment of the association between drug disposal practices and drug use and storage behaviors. Saudi Pharmaceutical Journal 2018; 26: 7–13. doi: 10.1016/j.jsps.2017.11.006.
- Castioni J, Marques-Vidal P, Abolhassani N, Vollenweider P, Waeber G. Prevalence and determinants of polypharmacy in Switzerland: data from the CoLaus study. BMC Health Services Research 2017; 17: 840. doi: 10.1186/s12913-017-2793-z.
- Pantalone KM, Hobbs TM, Chagin KM, et al. Prevalence and recognition of obesity and its associated comorbidities: crosssectional analysis of electronic health record data from a large US integrated health system. BMJ Open 2017; 7: e017583. doi:10.1136/bmjopen-2017-017583.
- Pappa E, Kontodimopoulos N, Papadopoulos AA, Tountas Y, Niakas D. Prescribed drug utilization and polypharmacy in a general population in Greece: association with socio-demographic, health needs, health services utilization and lifestyle factors. European Journal of Clinical Pharmacology 2011; 67(2):185-92. doi: 10.1007/s00228-010-0940-0.
- WHO. How to investigate drug use in health facilities: selected drug use indicators. Geneva: World Health Organization; 1993. Available from: http://apps.who.int/medicinedocs/en/d/Js2289e/. 11. Hogerzeil HV, Bimo MD, Ross-Degnan D, et al. Field tests for rational drug use in twelve developing countries. Lancet. 1993; 342 (8884): 1408-10. doi: 10.1016/0140-6736(93)92760-q.
- Teni FS, Belachew SA, Gebresillassie BM, et al. Pattern and appropriateness of medicines prescribed to outpatients at a university hospital in Northwestern Ethiopia. BioMed Research International 2017, Article ID 3729401, doi:https://doi.org/10.1155/2017/3729401.
- Hallama J, Boswell RG, DeVitob EE, Kober H. Gender-related differences in food craving and obesity. Yale Journal Of Biology And Medicine 2016; 89: 161-73. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918881/.
- Kyrou I, Randeva HS, Tsigos C, Kaltsas G, Weickert MO. Clinical problems caused by obesity. [Updated 2018 Jan 11] In: Feingold KR, Anawalt B, Boyce A, et al., (Editors) Endotext [Internet] 2018. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278973/.
- Mahajan HM, Honrao R, Borkar AS, Badwaik RT, Chopade SS, Surwase P. Drug utilization study in glaucoma patients in a tertiary care hospital of Central India. J Cont Med A Dent May-August 2015;3(2): 44-47. doi: 10.18049/jcmad/329.
- Shrestha B, Dixit SM. Assessment of drug use pattern using WHO prescribing indicators. J Nepal Health Res Counc 2018; 16 (40): 279-84.doi: https://doi.org/10.3126/jnhrc.v16i3.21424.
- Bilal AI, Osman ED, Mulugeta A. Assessment of medicines use pattern using World Health Organization’s Prescribing, patient care and health facility indicators in selected health facilities in eastern Ethiopia. BMC Health Services Research 2016; 16 (144). doi: 10.1186/s12913-016-1414-6.
- Lukali V, Michelo C. Factors associated with irrational drug use at a district hospital in Zambia: patient record-based observations. Medical Journal of Zambia 2015; 42 (1): 25-30. Available from: https://www.ajol.info/index.php/mjz/article/view/125814.
- Al-Azayzih A, Al-Azzam1 SI, Alzoubi KH, Shawaqfeh M, Masadeh MM. Evaluation of drug-prescribing patterns based on the WHO prescribing indicators at outpatient clinics of five hospitals in Jordan: a cross-Volume 60 Issue 1, March 2021 / Cilt 60 Sayı 1, Mart 2021 19 sectional study. International Journal of Clinical Pharmacology and Therapeutics 2017; 55 (5): 1-8. doi: 10.5414/CP202733.
- Atif M, Sarwar MR, Azeem M, Naz M, Amir S, Nazir K. Assessment of core drug use indicators using WHO/INRUD methodology at primary healthcare centers in Bahawalpur, Pakistan. BMC Health Services Research 2016; 16: 684. doi: 10.1186/s12913-016-1932-2.
- Maggiore RJ, Gross CP, Hurria A. Polypharmacy in Older Adults with Cancer. The Oncologist 2010; 15: 507–22. doi: 10.1634/theoncologist.2009-0290.
- Masnoon N, Shakib S, Kalish-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatrics 2017; 17:230. doi: 10.1186/s12877-017-0621-2.
- Santos MP, Costa PRF, Assis AMO, Santos CAST, Santos DB. Obesity and vitamin D deficiency: a systematic review and meta‐analysis. Etiology and Pathophysiology 2015; 16 (4): 341-9. doi: https://doi.org/10.1111/obr.12239.
- Adibe MO, Aguwa CN, Ukwe CV, Okonta JM, Udeogaranya PO. Outpatient utilization of anti-diabetic drugs in The South Eastern Nigeria. Int. J. Drug Dev & Res. 2009; 1 (1): 27-36. Available from: http://www.ijddr.in/drug-development/outpatient-utilization-of-antidiabetic-drugs-in-the-southeastern-nigeria.pdf
- Upadhyay DK, Palaian S, Ravi Shankar P, Mishra P, Sah AK. Prescribing pattern in diabetic outpatients in a tertiary care teaching hospital in Nepal. Journal of Clinical and Diagnostic Research 2007; 3: 248-55. Available from: https://www.jcdr.net/articles/PDF/94/0083_OA_Aug_07_E(L)_F(G)_pf.pdf.
- Vaniya HV, Darji NH, Patel VR, Gohel DJ. Drug Utilization Study in Ophthalmology Outpatients in a Tertiary Care Hospital. Advances in Pharmacology and Pharmacy 2016;4(2): 11-5. doi: 10.13189/app.2016.040201.
- Bashrahil KA. Indicators of rational drug use and health services in Hadramout, Yemen. Eastern Mediterranean Health Journal 2010; 16 (2): 151-5. Available from: http://applications.emro.who.int/emhj/V16/02/16_2_2010_0151_0155.pdf.
- Lenjisa JL, Fereja TH. A Retrospective Analysis of Prescribing Practices through WHO Prescribing Indicators at Four Selected Hospitals of West Ethiopia. J Bioanal Biomed 2014; 6 (4): 029-032. doi: 10.4172/1948-593X.1000105.
- Wubetu M, Derebe D, Mulaw T, Yimer T, Hailu G. Assessment of Drug Prescription Pattern in Two District Hospitals, Northwest Ethiopia. J Health Educ Res Dev 2018, 6: 1. doi: 10.4172/2380-5439.1000246
Evaluation of the rational drug use by using the World Health Organization core prescribing indicators at the obesity outpatient clinic of a tertiary care hospital
Öz
Aim: The aim of this study was to evaluate the rational use of drugs prescribed in the obesity outpatient clinic of a tertiary care hospital by using WHO prescribing indicators. Materials and Methods: The patients that admitted to obesity outpatient clinic between April 1, 2016-August 1, 2017 were reviewed retrospectively. Parameters such as patients’ demographic characteristics (age, sex), body mass index, comorbid diseases, number of prescribed drugs, drug names, dosage forms and routes of drug administration were evaluated. Prescriptions were analyzed according to the WHO core prescribing indicators such as average number of drugs per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed and percentage of drugs prescribed from essential drugs.
Results: The mean age of the patients was 47.5±12.4 years and most of them were female (88.1%). Essential hypertension was the most common co-morbid disease (33%). Vitamin D3 (cholecalciferol), (23.7%) was the most frequently prescribed drug. The average number of drugs per encounter was 1.7. The percentage of drugs prescribed by generic name was 0%. Antibiotics were prescribed in 14 (2.8%) patients and injections were prescribed in 26 (5.2%) patients. The percentage of drugs from essential drug list was 61.4%.
Conclusion: We demonstrated that the prescribing indicators such as the average number of drugs per encounter and the percentage of encounters with an antibiotic and injection prescribed were appropriate as compared to WHO standard values, parameters such as the percentage of drugs prescribed by generic name and the percentage of drugs prescribed from essential drug list was quite far from the WHO ideal values. The findings of this study will provide contributions to implement appropriate interventions by health authorities to promote rational drug use.
Anahtar Kelimeler
Kaynakça
- World Health Organization. Promoting rational use of medicine: core components. WHO Policy and Perspectives on Medicines, 2002 Available from: http://apps.who.int/medicinedocs/pdf/h3011e/h3011e.pdf
- World Health Organization. The World Medicines Situation, Rational Use of medicines, 2011 WHO/EMP/MIE/2011.2.2. Available from: http://apps.who.int/medicinedocs/en/m/abstract/Js1806en/
- Ofori-Asenso R, Agyeman AA. Irrational use of medicines—a summary of key concepts. Pharmacy 2016; 4 (4): 35. doi: 10.3390/pharmacy4040035.
- Irunde H, Minzi O, Moshiro C. Assessment of Rational Medicines Prescribing in Healthcare Facilities in Four Regions of Tanzania. JPPCM 2017; 3 (4): 225-31. doi:10.5530/jppcm.2017.4.64.
- Demeke B, Molla F, Assen A, et al. Evaluation of drugs utilization pattern using who prescribing indicators in Ayder Referral Hospital, Northern Ethiopia. IJPSR 2015; 6 (2): 343-7. Available from:https://pdfs.semanticscholar.org/70d9/d3a13b0658c249c77c32257abe2144d28671.pdf.
- Akici A, Aydin V, Kiroglu A. Assessment of the association between drug disposal practices and drug use and storage behaviors. Saudi Pharmaceutical Journal 2018; 26: 7–13. doi: 10.1016/j.jsps.2017.11.006.
- Castioni J, Marques-Vidal P, Abolhassani N, Vollenweider P, Waeber G. Prevalence and determinants of polypharmacy in Switzerland: data from the CoLaus study. BMC Health Services Research 2017; 17: 840. doi: 10.1186/s12913-017-2793-z.
- Pantalone KM, Hobbs TM, Chagin KM, et al. Prevalence and recognition of obesity and its associated comorbidities: crosssectional analysis of electronic health record data from a large US integrated health system. BMJ Open 2017; 7: e017583. doi:10.1136/bmjopen-2017-017583.
- Pappa E, Kontodimopoulos N, Papadopoulos AA, Tountas Y, Niakas D. Prescribed drug utilization and polypharmacy in a general population in Greece: association with socio-demographic, health needs, health services utilization and lifestyle factors. European Journal of Clinical Pharmacology 2011; 67(2):185-92. doi: 10.1007/s00228-010-0940-0.
- WHO. How to investigate drug use in health facilities: selected drug use indicators. Geneva: World Health Organization; 1993. Available from: http://apps.who.int/medicinedocs/en/d/Js2289e/. 11. Hogerzeil HV, Bimo MD, Ross-Degnan D, et al. Field tests for rational drug use in twelve developing countries. Lancet. 1993; 342 (8884): 1408-10. doi: 10.1016/0140-6736(93)92760-q.
- Teni FS, Belachew SA, Gebresillassie BM, et al. Pattern and appropriateness of medicines prescribed to outpatients at a university hospital in Northwestern Ethiopia. BioMed Research International 2017, Article ID 3729401, doi:https://doi.org/10.1155/2017/3729401.
- Hallama J, Boswell RG, DeVitob EE, Kober H. Gender-related differences in food craving and obesity. Yale Journal Of Biology And Medicine 2016; 89: 161-73. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918881/.
- Kyrou I, Randeva HS, Tsigos C, Kaltsas G, Weickert MO. Clinical problems caused by obesity. [Updated 2018 Jan 11] In: Feingold KR, Anawalt B, Boyce A, et al., (Editors) Endotext [Internet] 2018. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK278973/.
- Mahajan HM, Honrao R, Borkar AS, Badwaik RT, Chopade SS, Surwase P. Drug utilization study in glaucoma patients in a tertiary care hospital of Central India. J Cont Med A Dent May-August 2015;3(2): 44-47. doi: 10.18049/jcmad/329.
- Shrestha B, Dixit SM. Assessment of drug use pattern using WHO prescribing indicators. J Nepal Health Res Counc 2018; 16 (40): 279-84.doi: https://doi.org/10.3126/jnhrc.v16i3.21424.
- Bilal AI, Osman ED, Mulugeta A. Assessment of medicines use pattern using World Health Organization’s Prescribing, patient care and health facility indicators in selected health facilities in eastern Ethiopia. BMC Health Services Research 2016; 16 (144). doi: 10.1186/s12913-016-1414-6.
- Lukali V, Michelo C. Factors associated with irrational drug use at a district hospital in Zambia: patient record-based observations. Medical Journal of Zambia 2015; 42 (1): 25-30. Available from: https://www.ajol.info/index.php/mjz/article/view/125814.
- Al-Azayzih A, Al-Azzam1 SI, Alzoubi KH, Shawaqfeh M, Masadeh MM. Evaluation of drug-prescribing patterns based on the WHO prescribing indicators at outpatient clinics of five hospitals in Jordan: a cross-Volume 60 Issue 1, March 2021 / Cilt 60 Sayı 1, Mart 2021 19 sectional study. International Journal of Clinical Pharmacology and Therapeutics 2017; 55 (5): 1-8. doi: 10.5414/CP202733.
- Atif M, Sarwar MR, Azeem M, Naz M, Amir S, Nazir K. Assessment of core drug use indicators using WHO/INRUD methodology at primary healthcare centers in Bahawalpur, Pakistan. BMC Health Services Research 2016; 16: 684. doi: 10.1186/s12913-016-1932-2.
- Maggiore RJ, Gross CP, Hurria A. Polypharmacy in Older Adults with Cancer. The Oncologist 2010; 15: 507–22. doi: 10.1634/theoncologist.2009-0290.
- Masnoon N, Shakib S, Kalish-Ellett L, Caughey GE. What is polypharmacy? A systematic review of definitions. BMC Geriatrics 2017; 17:230. doi: 10.1186/s12877-017-0621-2.
- Santos MP, Costa PRF, Assis AMO, Santos CAST, Santos DB. Obesity and vitamin D deficiency: a systematic review and meta‐analysis. Etiology and Pathophysiology 2015; 16 (4): 341-9. doi: https://doi.org/10.1111/obr.12239.
- Adibe MO, Aguwa CN, Ukwe CV, Okonta JM, Udeogaranya PO. Outpatient utilization of anti-diabetic drugs in The South Eastern Nigeria. Int. J. Drug Dev & Res. 2009; 1 (1): 27-36. Available from: http://www.ijddr.in/drug-development/outpatient-utilization-of-antidiabetic-drugs-in-the-southeastern-nigeria.pdf
- Upadhyay DK, Palaian S, Ravi Shankar P, Mishra P, Sah AK. Prescribing pattern in diabetic outpatients in a tertiary care teaching hospital in Nepal. Journal of Clinical and Diagnostic Research 2007; 3: 248-55. Available from: https://www.jcdr.net/articles/PDF/94/0083_OA_Aug_07_E(L)_F(G)_pf.pdf.
- Vaniya HV, Darji NH, Patel VR, Gohel DJ. Drug Utilization Study in Ophthalmology Outpatients in a Tertiary Care Hospital. Advances in Pharmacology and Pharmacy 2016;4(2): 11-5. doi: 10.13189/app.2016.040201.
- Bashrahil KA. Indicators of rational drug use and health services in Hadramout, Yemen. Eastern Mediterranean Health Journal 2010; 16 (2): 151-5. Available from: http://applications.emro.who.int/emhj/V16/02/16_2_2010_0151_0155.pdf.
- Lenjisa JL, Fereja TH. A Retrospective Analysis of Prescribing Practices through WHO Prescribing Indicators at Four Selected Hospitals of West Ethiopia. J Bioanal Biomed 2014; 6 (4): 029-032. doi: 10.4172/1948-593X.1000105.
- Wubetu M, Derebe D, Mulaw T, Yimer T, Hailu G. Assessment of Drug Prescription Pattern in Two District Hospitals, Northwest Ethiopia. J Health Educ Res Dev 2018, 6: 1. doi: 10.4172/2380-5439.1000246
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Mart 2021 |
| Gönderilme Tarihi | 13 Temmuz 2020 |
| Yayımlandığı Sayı | Yıl 2021Cilt: 60 Sayı: 1 |
