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Prescription patterns of general practitioners in Peshawar, Pakistan.

Abstract / Summary: 
Comment (NPW): The authors conclude that there is a 'need to study factors associated with these practices and promote evidence-based prescription'. The current study was limited to examination of prescriptions, and did not address possible contributing factors. Availability of relevant, reliable, up-to-date information on medicines is a prerequisite factor for rtional prescribing, as stated by WHO: "Appropriate use of antibiotics [and other medicines] is only possible if healthcare workers and the public have access to reliable, unbiased information on medicines. Universal access to reliable information on medicines is readily achievable and should be a cornerstone of efforts to promote rational prescribing. There is an urgent need for concerted action."   It would be interesting to learn more. What information sources do prescribers use in Pakistan, and in other countries? For example, what is the extent of dependence on pharmaceutical promotional literature?
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Objectives: To find out prescription patterns of general practitioners in Peshawar.
Methods: Cross-sectional survey of drug prescriptions was done at six major hospitals and pharmacies of Peshawar between April and May 2011. A total of 1097 prescriptions that included 3640 drugs, were analyzed to assess completeness, average number of drugs, prescription frequency of various drug classes, and number of brands prescribed.
Results: No prescription contained all essential components of a prescription. Legibility was poor in 58.5% prescriptions. Physician's name and registration number were not mentioned in 89% and 98.2% prescriptions respectively. Over 78% prescriptions did not have diagnosis or indication mentioned. Dosage, duration of use, signature of physician and directions for taking drugs were not written in 63.8%, 55.4%, 18.5% and 10.9% of prescriptions respectively. On average each prescription included 3.32 drugs. Most frequently prescribed drug classes included analgesics (61.7%), anti-infective agents (57.2%), multi-vitamins (37.8%) and gastrointestinal drugs (34.4%). We found 206, 130, 105 and 101 different brands of anti-infective agents, gastrointestinal drugs, analgesics and multivitamins being prescribed.
Conclusion: We observed a high number of average drugs per prescription mostly using brand names, and over-prescription of analgesics, antimicrobials, multivitamins and anti-ulcer drugs. Quality of written prescriptions was poor in terms of completeness.
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Raza UA, Khursheed T, Irfan M, Abbas M, Irfan UM.

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