Document Type : Original Article
Authors
1 Rational Use of Drugs Committee, Vice-Chancellery for Food and Drug, Urmia University of Medical Sciences, Urmia, Iran
2 Department of Gynecology and Obstetrics, Urmia University of Medical Sciences, Urmia, Iran
3 Department of Psychology, Islamic Azad University, Urmia, Iran
4 Department of Forensic Medicine and Clinical Toxicology, Urmia University of Medical Sciences, Urmia, Iran
Abstract
Objective: As chief prescribers, physicians could have a key role in rational drug use. Core
prescribing indicators of all physicians have been evaluated in the Islamic Republic of Iran
for several years, but no study has assessed the effects of academic status of doctors on
their prescribing behaviors. We aimed to compare prescribing indicators of two groups of
academic and non-academic specialist physicians working in Urmia, Iran.
Methods: In this cross-sectional study, prescribing indicators of the total number of 37
academic and 104 non-academic specialist physicians in six medical specialties (infectious
diseases, psychiatry, otorhinolaryngology, gynecology, pediatrics and general surgery) were
studied during 2012 using Rx‑analyzer, a dedicated computer application. A set of five quality
indicators was used based on the World Health Organization and International Network
for Rational Use of Drugs recommendations.
Findings: Totally, 709,771 medications in 269,660 prescriptions were studied. For academic
and non-academic specialist physicians, the average number of medications per prescription
was 2.26 and 2.65, respectively. Similarly, patients’ encounters with injectable pharmaceuticals
were 17.37% and 26.76%, respectively. The corresponding figures for antimicrobial agents
were 33.12% and 45.46%, respectively. The average costs of every prescription were 6.53 and
3.30 United States Dollar for academic and non-academic specialist physicians, respectively.
All the above‑mentioned differences were statistically significant.
Conclusion: Better prescribing patterns were observed in academic specialist physicians.
However, they prescribed medications that were more expensive, while the reason was not
investigated in this study. Further studies may reveal the exact causes of these differences.
Keywords
De Vries TP. Do medical students copy the drug treatment
choices of their teachers or do they think for themselves? Eur
J Clin Pharmacol 2010;66:407‑12.
2. Figueras A. The use of drugs is not as rational as we believe
but it can’t be! The emotional roots of prescribing. Eur J Clin
Pharmacol 2011;67:433‑5.
3. WHO. The Rational Use of Drugs – Report of the Conference
of Experts Nairobi, 25‑29, November 1985. Geneva; 1987.
4. Desalegn AA. Assessment of drug use pattern using WHO
prescribing indicators at Hawassa University Teaching and
Referral Hospital, South Ethiopia: A cross‑sectional study.
BMC Health Serv Res 2013;13:170.
5. About INRUD. International Network for Rational Use of
Drugs (INRUD) Available from: http://www.inrud.org/About‑INRUD/index.cfm. [Last cited on 2014 May 25].
6. Ross‑Degnan D, Laing R, Quick J, Ali HM, Ofori‑Adjei D,
Salako L, et al. A strategy for promoting improved
pharmaceutical use: The International Network for Rational
Use of Drugs. Soc Sci Med 1992;35:1329‑41.
7. Sadeghian GH, Safaeian L, Mahdanian AR, Salami S,
Kebriaee‑Zadeh J. Prescribing quality in medical specialists
in Isfahan, Iran. Iran J Pharm Res 2013;12:235‑41.
8. Soleymani F, Abdollahi M. Management information system
in promoting rational drug use. Int J Pharmacol 2012;8:586‑9.
9. NCRUD. Prescription Indicators in Iran for Years 1390. Tehran:
National Committee for Rational Use of Drugs, Food and Drug
Organization, Ministry of Health and Medical Education,
Islamic Republic of Iran; 2011.
10. Iranian Center for Statistics. Results of National Consensus
of 1390. Tehran; 2011.
11. AHFS. Drug Information Essentials, a Resource for Health
Care Professionals, USA: American Society of Health System
Pharmacists, Bethesda; 2009.
12. Vallano A, Montané E, Arnau JM, Vidal X, Pallarés C, Coll M,
et al. Medical speciality and pattern of medicines prescription.
Eur J Clin Pharmacol 2004;60:725‑30.
13. Wang H, Li N, Zhu H, Xu S, Lu H, Feng Z. Prescription pattern
and its influencing factors in Chinese county hospitals: A
retrospective cross‑sectional study. PLoS One 2013;8:e63225.
14. Isah AO, Laing R, Quick J, Mabadeje AF, Santoso B,
Hogerzeil H, et al. The development of reference values for
the WHO health facility core prescribing indicators. West Afr
J Pharmacol Drug Res 2001;18:6‑11.
15. Isah AO, Ross‑Degnan D, Quick J, Laing R, Mabadeje AF.
The Development of Standard Values for the WHO Drug
Use Prescribing Indicators. Available from: http://www.
Archives.Who.Int/Prduc2004/Rducd/ICIUM_Posters/1a2_Txt.
Htm. [Last updated on 2008 Jul 08; Last cited on 2014 Mar 16].
16. NguyenHT, WirtzVJ, Haaijer‑RuskampFM, TaxisK. Indicators
of quality use of medicines in South‑East Asian countries: A
systematic review. Trop Med Int Health 2012;17:1552‑66.