Etiyopya Adis Ababa’da üçüncü basamak hastanenin pediyatri servisinde ilaç reçeteleme şeklinin değerlendirilmesi

Öz

Drugs have to be safe, effective and be used nationally and may require a special concern due to their unwanted side effects. Safely and effective use of drugs depend on prescribing pattern. The aim of the study was to assess the drug prescribing practice in pediatrics ward of St. Paul Specialized Hospital in Addis Ababa, Ethiopia. A retrospective study had been conducted from January 20 to February 15, 2009. Structured data collection formats were used to obtain data from patient records using stratified and random sampling techniques. Data were analyzed using SPSS for Windows version 16.0. Sums of 384 patient cards were included to the study in which 468 drugs were prescribed. Cotrimoxazole (18.87%), amoxicillin (14.50%), and paracetamol (10.4%) were the most commonly prescribed medications. Average number of drugs per encounter was 1.22. About 71.35%, 59.4%, 45.73% and 15.17% of drugs were prescribed with correct indication, frequency, dosage and duration respectively. There has been an inappropriate use of drugs in the hospital. Many drugs were prescribed without information regarding dosage, frequency and duration of treatment. Pharmacy professionals and physicians should check the completeness of patient cards and prescriptions to promote rational use of medications.

Anahtar Kelimeler

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Assessment of the pattern of drug prescribing in pediatrics ward in tertiary setting hospital in Addis Ababa, Ethiopia

Öz

İlaçlar emniyetli, etkili olmalı, ulusal olarak kullanılmalı ve istenmeyen yan etkilerinden dolayı özel özen gerektirebilmektedir. İlaçların güvenli ve etkin kullanımı reçeteleme şekline bağlıdır. Bu çalışmanın amacı,Etiyopya Adis Ababa’da St. Paul Specialized Hospital’in pediyatri servisinde ilaç reçeteleme uygulamasının değerlendirilmesi idi. Yirmi Ocak’dan 15 Şubat 2009’a kadar bir retrospektif çalışma gerçekleştirildi. Tabakalı ve random örneklem teknikleri kullanılarak hasta kayıtlarından data elde etmek için yapılandırılmış data toplama formatları kullanıldı. Data, Windows için SPSS (sürüm 16.0) kullanılarak analiz edildi. Dört yüz altmış sekiz ilacın reçetelendirildiği toplam 384 hasta kartları çalışmaya dahil edildi. Kotrimoksazol (%18.87), amoksisilin (%14.50) ve parasetamol (%10.4) en yaygın reçetelenen ilaçlardı. Karşılaşılan ilaçların ortalama sayısı 1.22 idi. İlaçların sırasıyla yaklaşık %71.35, %59.4, %45.73 ve %15.17’si doğru endikasyonda, sıklıkta, dozajda ve sürede reçelendirilmişti. Hastanede ilaçların uygun olmayan kullanımı vardı. Bir çok ilaç dozaj, sıklık ve tedavi süresi ile ilgili bilgi verilmeden reçetelenmişti. Eczane uzmanları ve doktorlar, ilaçların rasyonel kullanımını artırmak için reçetelerin ve hasta kartlarının tamamlılığını kontrol etmelidir.

Anahtar Kelimeler

• Addis Ababa, advers ilaç reaksiyonu, pediyatri, reçete

Kaynakça

1. 1. Dukes MNG (ed.). Drug utilization studies: methods and uses
2. WHO Regional Publications. Eur Ser No 45. WHO regional Office for Europe, WHO, Copenhagen, 1993
3. 2. Sanz EJ. Drug use in non-hospitalized children. Pharm Weekbl Sci 1992;14(1):1-8
4. 3. Impicciatore P, Choonara I. Status of new medicines approved by the European Medicines Evaluation Agency regarding paediatric use. Br J Clin Pharmacol 1999;48(1):15-8
5. 4. Wilton LV, Pearce G, Mann RD. The use of newly marketed drugs in children and adolescents prescribed in general practice
6. Pharmacoepidemiol Drug Saf 1999;8(Suppl 1):S37-45
7. 5. Conroy S, Choonara I, Impicciatore P, Mohn A, Arnell H, Rane A, et al. Survey of unlicensed and off label drug use in paediatric wards in European countries. European Network for Drug Investigation in Children. Br Med J 2000;320(7227):79- 82
8. 6. Drug Administration and Control Authority of Ethiopia

9. Introduction Standard Treatment Guide lines for Zonal hospitals. First edition. Addis Ababa, Ethiopia: Chamber printing House, 2004
10. 7. Bonati M. Epidemiologic evaluation of drug use in children. J Clin Pharmacol 1994;34(4):300-5
11. 8. Schirm E, van den Berg P, Gebben H, Sauer P, De Jong-van den Berg L. Drug use of children in the community assessed through pharmacy dispensing data. Br J Clin Pharmacol 2000; 50(5):473-8
12. 9. Sanz EJ. Drug prescribing for children in general practice. Acta Paediatr 1998;87(5):489-90
13. 10. Thrane N, Sorensen HT. A one-year population-based study of drug prescriptions for Danish children. Acta Paediatr 1999;88(10):1131-6
14. 11. Maison P, Guillemot D, Vauzelle-Kervroëdan F, Balkau B, Sermet C, Thibult N, et al. Trends in aspirin, paracetamol and non-steroidal anti-inflammatory drug use in children between 1981 and 1992 in France. Eur J Clin Pharmcol 1998;54(8):659- 64
15. 12. Thrane N, Steffensen FH, Mortensen JT, Schonheyder HC, Sorensen HT. A population-based study of antibiotic prescriptions for Danish children. Pediatr Infect Dis 1999;18(4):333-7
16. 13. Sanz EJ, Boada JN. Drug utilization by children in Tenerife Island. Eur J Clin Pharmacol 1988;34(5):495-9
17. 14. Sanz EJ, Bergman U, Dahlström M. Pediatric drug prescribing
18. A comparison of Tenerife (Canary Islands, Spain) and Sweden
19. Eur J Clin Pharmacol 1989;37(1):65-8
20. 15. Rasmussen F, Smedby B. Life table methods applied to the use of medical care and of prescription drugs in early childhood. J Epidemiol Community Health 1989; 43(2):140-6
21. 16. Collet JP, Bossard N, Floret D, Gillet J, Honegger D, Boissel JP. Drug prescription in young children: results of a survey in France. Epicrèche Research Group. Eur J Clin Pharmacol 1991;41(5):489-91
22. 17. Straand J, Rokstad K, Heggedal U. Drug prescribing for children in general practice. A report from the Møre & Romsdal Prescription Study. Acta Paediatr 1998;87(2):218-24
23. 18. Rylance GW, Woods CG, Cullen RE, Rylance ME. Use of drugs by children. Br Med J 1988;297(6646):445-7
24. 19. Wessling A, Söderman P, Boethius G. Monitoring of drug prescriptions for children in the county of Jamtland and in Sweden as a whole in 1977-1987. Acta Paediatr Scand 1991;80(10):944-52
25. 20. Koeller JM, van den Berg CL. The clinical use of drugs applied therapeutics. In: Yee Young L, Koda-Kimble MA, eds. Applied Therapeutics. 6th ed. Vancouver: Applied Therapeutics; 1995:459-502
26. 21. Behrman RE. Nelson Textbook of Pediatrics, Fourth edition, Philadelphia, W.B. Saunders Company, 1992;386-417
27. 22. The world drug situation: WHO Geneva 1998
28. 23. Desta Z, Abdulwhab M. Prescription writing in Gondar outpatient teaching hospital, Ethiopia. East Afr Med J 1996;73(2):115-9
29. 24. Raina RK, Pillai GK. Outpatient medication prescribing patterns in a tropical teaching hospital. J Indian Med Assoc 1980;74(3):62-4
30. 25. Sekhar C, Raina RK, Pillai GK. Some aspects of drug use in Ethiopia. Trop Doct 1981;11(3):116-8
31. 26. Aseffa A, Desta Z, Tadesse I. Prescribing pattern of antibacterial drugs in a teaching hospital in Gondar, Ethiopia
32. East Afr Med J 1995;72(1):56-9
33. 27. Leka T, Abadir M. Prescribing pattern of analgesic drugs in 13 rural and regional hospitals of Ethiopia. Ethiop J Health Dev 1990;4:15-30
34. 28. Abula T, Desta Z. Prescribing pattern of drugs in pediatric wards of three Ethiopian Hospitals. Ethiop J Health Dev 1999;13(2):135-40
35. 29. Riaz H, Malik F, Raza A, Hameed A, Ahmed S, Shah PA, et al
36. Assessment of antibiotic prescribing behavior of consultants of different localities of Pakistan. Afr J Pharm Pharmacol 2011;5(5);596-601
37. 30. Yenet W. Baseline survey on prescribing indicators. Ethiop J Health Sci 2005;15(2):147-56
38. 31. Dikisso D, Kuma G, Teklemariam S. Baseline survey on prescribing indicatiors and the underlying factors influencing prescribing in South West Ethiopia. Ethiop J Health Dev 1998;12(2):87-93
39. 32. Kutty KVG, Sambasivam N, Nagarajan M. A study on drug prescribing pattern in Madurat city. Indian J Pharmacol 2002;34:361-2
40. 33. Bosu WK, Ofori-Adjei D. A 1-day survey of drug prescribing patterns in the District General Hospital of the Wassa West District of Ghana. Trop Doct 1997;27(4):222-6
41. 34. Hazra A, Tripathi SK, Alam MS. Prescribing and dispensing activities at the health facilities of a non-governmental organization. Natl Med J India 2000;13(4):177-82
42. 35. Flaherty JH, Perry HM, Lynchard GS, Morley JE
43. Polypharmacy and hospitalization among older home care patients. J Gerontol A Biol Sci Med Sci 2000;55(10):M554-9
44. 36. Das N, Khan AN, Badini ZA, Baloch H, Parkash J. Prescribing practices of consultants at Karachi, Pakistan. J Pak Med Assoc 2001;51(2):74-7
45. 37. Najmi MH, Hafiz RA, Khan I, Fazli FR. Prescribing practices: an overview of three teaching hospitals in Pakistan. J Pak Med Assoc 1998;48(3):73-7
46. 38. Mengistu A. Patterns of drug utilization in patients department, JUSH south west Ethiopia. Ethiop J Health Sci 2005;15(2):139- 45.