Use of Drugs Subject to Controlled Prescriptions: a Retrospective Analysis

Öz

Use of Drugs Subject to Controlled Prescriptions: a Retrospective Analysis

Abstract

Objective: Use of drugs that may lead to abuse or dependence are subject to controlled prescriptions (CPs) in many countries, and these are closely monitored by health authorities. According to national regulations in Turkey, CPs may be red coloured (RCPs) or green coloured (GCPs). The aim of this study was to evaluate the use of such drugs in Istanbul. Study Design: Retrospective case-control study. Material and Methods: During the study period (01/01-31/12 2009), 502874 CPs were reported. Among these, 4000 CPs each month were randomly selected and evaluated. Results: The majority of GCPs were issued to women (55.6%), while the majority of RCPs were issued to men (68.4%). GCPs were most frequently prescribed by physicians working in private hospitals (33.6%) while RCPs by physicians working in university hospitals (39.7%). GCPs were mostly prescribed by psychiatrists (37.6%) while for RCPs were child and adolescent psychiatrists (35.9%). Psycholeptics (ATC code N05) were the most prescribed controlled drugs (CDs) (43.8%). Methylphenidate (53.9%) was the mostly prescribed on RCPs and alprazolam (39.6%) was on GCPs. Conclusion: We demonstrate that utilization of CDs shows demographical and institutional differences. These data could be of help to improve surveillance of CDs as well as to train prescribers and patients. Turkish Başlık: Kontrole Tabi İlaçların Kullanımı: Retrospektif Bir Çalışma Anahtar Kelimeler: Kontrole tabi reçeteler, Kontrole tabi ilaçlar, Narkotikler, Psikotrop ilaçlar, Kırmızı ve Yeşil reçeteler Amaç: Kötüye kullanılma ya da bağımlılığa yol açma riski taşıyan ilaçlar pek çok ülkede kontrole tabidir ve kullanımları sağlık otoriteleri tarafından yakından izlenmektedir. Türkiye'deki ulusal düzenlemelere göre, çoğu kontrole tabi ilaç (KTİ) kırmızı reçete (KR) ya da yeşil reçete (YR) formatında işlem görmektedir. Çalışmada, İstanbul'da bu formatta işlem gören KTİ'lerin kullanımının araştırılması amaçlanmıştır. Gereç ve Yöntemler: Çalışma periyodu boyunca (01/01-31/12 2009), 502 874 kontrole tabi reçete (KTR) İstanbul Sağlık Müdürlüğü'ne ulaştırılmıştır. Bu reçeteler arasından, her ay için rastgele seçilen 4 000 KTR araştırmada incelenmiştir. Bulgular: YR'lerin daha çok kadınlara (%55.6), KR'lerin daha çok erkeklere (%68.4) yazıldığı saptandı. YR'lerin en sık özel hastanelerde (%33.6), KR'lerin en sık üniversite hastanelerinde (%39.7) yazıldığı saptandı. YR'lerin en fazla psikiyatri (%37.6), KR'lerin en fazla çocuk ve ergen psikiyatrisi (%35.9) uzmanları tarafından yazdığı saptandı. Psikoleptiklerin (ATC kodu: N05), (%43.8) en çok reçetelenen KTİ olduğu saptandı. En sık reçete edilmiş olan KTİ'lerin KR'lerde metilfenidat (%53.9), YR'lerde alprazolam (%39.6) olduğu saptandı. Sonuç: KTİ kullanımının demografik ve kurumsal farklılıklar gösterdiği bu araştırmayla ortaya konmuş oldu. Bu bilgilerin, KTİ takip sistemlerinin geliştirilmesinde ve bu ilaçları yazan ya da kullanan kişilere yönelik etkinliklerde yol gösterici olması beklenmektedir.

Keywords

• Controlled prescriptions, controlled medicines, narcotics, psychotropic medications, green and red coloured scripts

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