Birinci basamakta reçeteleme trendi ve sık karşılaşılan tanılara ait reçetelerin incelenmesi: Türkiye verisi

Yıl 2020, Cilt: 45 Sayı: 2, 695 - 708, 30.06.2020

Dilara Bayram Caner Vızdıklar Volkan Aydın Fatma İşli Ahmet Akıcı

https://doi.org/10.17826/cumj.681368

Cited By: 2

Öz

Amaç: Bu çalışmada Türkiye’de birinci basamakta düzenlenen reçetelerin ayrıntılarının incelenmesi ve bunların yıllara göre değişiminin değerlendirilmesi amaçlandı.
Gereç ve Yöntem: Türkiye’de 2013-2016 tarihleri arasında birinci basamak hekimleri tarafından yazılan ve Reçete Bilgi Sistemi’nde kayıtlı tüm elektronik reçetelerdeki ilaçların ayrıntıları incelendi. Hastaların cinsiyetleri ve yaş grupları özelinde reçete başına düşen ortalama ilaç sayıları (RBDİS) belirlendi. İncelenen yıllarda en sık karşılaşılan ilk yirmi ilacın yer aldığı reçetelerin yüzdeleri belirlendi. Dört yıllık süreçte tek tanılı reçeteler içerisinde en sık karşılaşılan on tanının yer aldığı reçetelerin yüzdesi ve RBDİS incelendi.
Bulgular: Dört yılın toplamında 518.335.821 adet reçetede 1.457.034.275 kalem ilaç reçetelendiği ve RBDİS’nin 2,81 olduğu tespit edildi. Tüm yıllarda reçetelerde en fazla yer alan ilaçlar “diğer soğuk algınlığı preparatları” (%19,2-%19,7) ve “amoksisilin+beta-laktamaz inhibitörü” (%9,9-%10,5) idi. Dört yılın toplamında tek tanılı reçetelerde hipertansiyon (%6,9, RBDİS: 2,00) ve “akut üst solunum yolu enfeksiyonu, tanımlanmamış” (ÜSYE), (%6,5, RBDİS: 2,61) tanıları ilk sıralardaydı.
Sonuç: Birinci basamaktaki reçetelerin daha çok kadınlara ve yaşlılara yazıldığı ve ÜSYE ile hipertansiyon endikasyon alanlarında yoğunlaştığı anlaşılmaktadır. Soğuk algınlığı preparatları, NSAİİ’ler, PPİ’ler, analjezikler ve geniş spektrumlu antibiyotiklerin fazla reçeteleniyor olması birinci basamakta rasyonel reçeteleme davranışı ile ilgili önemli sorunların varlığına işaret etmektedir. 

Anahtar Kelimeler

İlaç kullanımı, birinci basamak, ulusal veri, elektronik reçete, trend analizi

Destekleyen Kurum

Çalışmamızda sponsor desteği yoktur.

Teşekkür

Verilerin sağlanmasına ve çalışmaya olan katkılarından dolayı Dr.Hakkı Gürsöz’e, Uzm. Ecz. Mesil Aksoy’a, End. Müh. Esma Kadı’ya ve diğer Türkiye İlaç ve Tıbbi Cihaz Kurumu ilgili çalışanlarına ve Prof. Dr. Ayşe Gelal’a teşekkür ederiz

Investigation of prescribing trends and prescriptions for common diagnoses in primary care: Nationwide data of Turkey

Öz

IPurpose: This study aimed to examine the details of prescriptions issued in primary care and the changes over the years in Turkey.
Materials and Methods: We analyzed all electronic prescriptions registered to Prescription Information System by primary care physicians in Turkey between 2013 and 2016. The mean number of drugs per prescription (nDPP) was determined by patients’ sex and age groups. The percentages of the prescriptions containing the top twenty most frequently encountered drugs were determined for each year of the study. In the four-year period, the percentage of prescriptions with the ten most common diagnoses among prescriptions with single diagnosis and nDPP were examined.
Results: A total of 1.457.034.275 drugs were prescribed in 518.335.821 prescriptions and nDPP was 2.81 for the four-year period. The most commonly used drugs in all prescriptions were “other cold preparations” (19.2-19.7%) and “amoxicillin+beta-lactamase inhibitor” (9.9-10.5%). The diagnosis of hypertension (6.9%, nDPP: 2.00) and “acute upper respiratory tract infection, unspecified” (URTI), (6.5%, nDPP: 2.61) were in the top ranks in single-diagnosis prescriptions during four-year period.
Conclusion: Primary care prescriptions appear to be mostly generated for women and elderly populations, with a tendency for URTI and hypertension indications. Overprescriptions of cold preparations, NSAIDs, PPIs, analgesics, and broad-spectrum antibiotics imply existence of important problems in the primary care regarding rational prescribing behavior. 

Anahtar Kelimeler

Drug utilization, primary care, national data, electronic prescription, trend analysis

Kaynakça

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