A review of prescribing practices in a Nigerian military hospital

AIM: ilaçların uygun kullanımı sağlık kurumları ve sağlık çalışanları için temeldir. Reçeteleme uygulamaları ilaçların kullanımını etkilmektedir. Bu değerlendirmenin amacı, bir Nijerya askeri hastanesindeki reçeteleme uygulamalarını ulusal ve uluslararası raporlar ile karşılaştırmaktır. YÖNTEM: Bu retrospektif tanımlayıcı araştırma Ocak–Mart 2007 tarihleri arasında Nijerya askeri hastanenin genel poliklinik bölümünde yapılmıştır. Dünya Sağlık Örgütü kriterleri ve hekimlerin ilaçların akılcı kullanımı kavramı üzerine bilgi, tutum ve uygulamaları (KAP) kullanarak reçete yazmanın değerlendirmesi ve hasta bakım ve tesis göstergelerinden oluşmuştur. BULGULAR: Araştırmaya 240 vaka dâhil edilmiştir, hasta başına ortalama reçete sayısı 2,2’dir ve ulusal hasta başına düşen reçete sayısından düşüktür (3,8). Ancak jenerik ilaç reçete etme oranı yetersiz (%39,4) bulunmuştur. Reçete edilen ilaçların sadece %50,0’sinin dağıtıldığı, dağıtılan ilaçların ise %2,3’ünün kaydının tutulduğu saptanmıştır. KAP çalışması sonucunda hekimlerin %77,4’ünün temel ilaçlar listesine sahip olduğu ait ancak sadece %1’inin akılcı reçeteleme adımlarına uyduğu, %40,0’ının ise en az iki adımı doğru uyguladığı görülmüştür. SONUÇ: Bu çalışmanın sonucu Nijerya askeri hastanesinde; jenerik ürün reçeteleme, reçetelenen ürünün dağıtılması uygulamalarının düşük düzeyde ve dağıtılan ilaçların kaydedilmesi uygulamasının ise çok düşük düzeyde olduğunu göstermiştir. Nijerya ve diğer gelişmekte olan ülkelerde uygun sağlık bakımı sağlamak için temel ilaçlara erişimin iyileştirilmesine ve reçete uygulamalarının geliştirmesine ihtiyaç bulunmaktadır.

Bir Nijerya askeri hastanesinde reçete uygulamalarının değerlendirilmesi

AIM: Appropriate utilization of medicines is essential for the patient, health institutions and health care workers. The prescribing practices influences utilization of medicines. The aim of this review is to present the prescribing practices in a Nigerian military hospital for comparison with national and international reports. METHOD: This retrospective descriptive study was conducted at the general out patient department of a Nigerian military hospital between January and March 2007. It consisted of an evaluation of core prescribing, patient care and facility indicators using World Health Organisation criteria and knowledge, attitude and practice (KAP) study of prescribers on the concept of rational use of medicines. RESULTS: Out of a sample of 240 case notes studied, the mean number of medicines prescribed per patient was lower (2.2) than the national value (3.8); but the rate of generic prescribing was poor (39.4%). Only 50.0% of prescribed drugs were actually dispensed with 2.3% of the dispensed drugs being well labelled. From the KAP study, 77.4% of prescribers/dispensers owned a copy of the essential medicines list but only one correctly gave the steps to rational prescribing; few (40.0%) could give at least 2 correct steps. CONCLUSION: This study of a Nigerian military hospital shows that the prescribing practices are characterised by low rate of generic prescription, actual dispensing of medicines and a very low rate of labelling dispensed medicines. There is need to improve prescribing practice in Nigeria and other developing countries by improving access to essential medicines to ensure affordable health care.

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