Context: One of the serious global problems is the irrational prescribing of medicines that can be regarded as harmful or wasteful. Inappropriate use and overuse of medicines, waste resources and therefore lead to health and economic consequences in patients. The goal of this systematic review was to identify factors associated with irrational prescriptions of medicine.Evidence Acquisition: We searched the Cochrane database of systematic reviews (via Cochrane library), PubMed, Medline, Scopus, Science Direct, BMC, Scholar Google, and SID from 1980 up to October of 2016. Results:Of the 594 papers, 26 papers were finally included. The combined results of the 26 papers indicated 24 factors for unnecessary prescriptions of medicine. Factors related to the patient were expectations, demand to prescribe, and poor medical knowledge. Factors related to the physician were inaccurate diagnosis, inadequate awareness and knowledge, low experience, information asymmetry, poor medical education, and the physician's attitude. Factors related to the institutional and political issues were fee-for-service, out-of-pocket payment, financial incentives, insurance reimbursements, insurance coverage, medicine subside, medicine advertisement, ineffective monitoring programs, regulation on prescription, prescription supervision, clinical guidance, and medicines near-expiry dates or expired. Conclusions:It can be concluded that the irrational/unnecessary prescription of medicine was influenced by many different factors, such as patient, physician, and institution. Thus to prevent irrational/unnecessary prescription, one needs to consider all the involved factors.Keywords: Drug Prescriptions, Prescriptions, Physician-Patient Relations ContextDifferent forms of irrational prescription include misuse, abuse, overuse, and polypharmacy. One of the serious global problems is irrational prescribing of medicines that can be considered as harmful and/or wasteful (1). While patients have the choice to select their doctors, doctors have the choice to decide on the kind of diagnosis and the quantity of health services patients consume. In other words, the doctor is the first gate to medicine use (2, 3). However, because of the patient's inadequate information about medicine, the physician has the possibility to influence both the kind of diagnosis and the number of health services provided, as well as possibly the number of visits (4-8). Physician-induced demand clearly implies an effort to persuade patients to overuse services (4, 9-12). According to WHO reports, more than 50% of all medicines are inappropriately prescribed or sold, and nearly half of the patients do not take them appropriately (13). The report shows that patients are treated better in public sectors than private ones based on standard clinical guidelines (1). Ramezankhani et al. in a study on assessing the medicine prescriptions of health care centers, found out that prescription of medicine in the private sector was more than that of the public sector due to better monit...
PurposeThe study aimed to measure scientific and social impacts of Iranian researchers' “Top Papers” in clinical medicine using citation and altmetric indicators.Design/methodology/approachIn this applied descriptive-analytical study, it used scientometric analysis. A total of 166 “Top Papers” of Iranian researchers in clinical medicine category of Web of Science (WoS) database including “Highly Cited Papers” and “Hot Papers” published between 2009 and 2019 were used. Overall, 29 indicators and their data were extracted from WoS, Scopus, ResearchGate (RG) and PlumX in March 2020.FindingsThe results showed that there exists a positive correlation between the number of citations in WoS, Scopus, RG, PubMed and Crossref. In addition, it was found that there existed a positive correlation between the received citations by articles and altmetric indicators. According to the results, there is a strong correlation between RG Research Interest and citation impact. The correlation analysis on the Plum Analytics categories including “Usage”, “Capture”, “Mention”, “Social Media” and “Citation” showed the correlations between five dimensions of impact were positive and significant. The results have led the authors to think more about new metrics that can response to new developments in the new information areas.Research limitations/implicationsThere are limitations to access altmetric.com in Iran and cannot be used easily. On the other hand, because of considering 24 indicators, authors had to investigate only a sample of 166 top papers from Iranian researchers to present the detailed results. About nature of altmetric indicators, although they reflect the nonacademic impact of articles alongside bibliographic indicators, they still cannot be a complete representative of the influence of their owners.Practical implicationsThis study can indicate a practical application appropriate for the future study. It would be valuable to further examine how social academic platforms construct images of impact of research and how this impacts the social impact of the university as a mission. This study suggests that social media attention to academic research can be much greater than what is shown in traditional indicators such as citation.Originality/valueThis study examines 29 indicators from four platforms including RG, WoS, Scopus and PlumX, simultaneously and measures the relationship among them.
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