Assessment of Prescription Pattern of Systemic Steroidal Drugs in the Outpatient Department of Menelik II Referral Hospital, Addis Ababa, Ethiopia, 2019

Wondmkun, Yohannes Tsegyie; Ayele, Akeberegn Gorems

doi:10.2147/ppa.s285064

Cited by 6 publications

(11 citation statements)

References 13 publications

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“…A cross-sectional study conducted at outpatient departments in referral hospitals in Ethiopia reported that 63.50% of glucocorticoids were utilized for the treatment of respiratory diseases. 49 However, it is important to note that evidence-based clinical practice guidelines and recommendations from the Centers for Disease Control and Prevention suggest that glucocorticoids are not effective for acute respiratory infections. 50 According to the 19th Week 2022 Influenza Weekly report released by the Chinese National Influenza Center, 51 the positivity rate of influenza virus detection in the southern provinces exhibited a slight increase during the 30th to 40th day when our intervention was implemented.…”

Section: Discussionmentioning

confidence: 99%

Feedback Intervention for the Control of Glucocorticoid Prescription in Primary Care Institutions: A Cluster Randomized Cross-Over Controlled Trial in Southwest China

Liu,

Wang,

Zhou

et al. 2024

RMHP

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Purpose The purpose of this study is to assess the effect of glucocorticoid prescription feedback intervention in complex primary care institutions for regulating its inappropriate use. Design, Setting and Interventions A six-month cluster randomized cross-over controlled trial was conducted in primary care institutions. A total of 347 physicians from 69 participating institutions were randomly allocated to either group A or group B. Both groups were given feedback interventions or serve as control. The feedback intervention comprised two components: a real-time pop-up warning of inappropriate glucocorticoid prescriptions based on the Hospital Information System and a high-proportion prescription feedback intervention warning system. Outcome Measures The primary outcome measure was the 10-day inappropriate glucocorticoid prescription rate, while the 10-day glucocorticoid prescription rate served as secondary outcome measure. Results At baseline, the 10-day inappropriate glucocorticoid prescription rates were 66.63% and 66.57% in group A and group B, respectively, showing no significant difference ( p = 0.140). Following the intervention, group A exhibited a significant reduction in 10-day inappropriate glucocorticoid prescription rate at the crossing point by 13.69% ( p < 0.001). In contrast, group B, which served as the control group, experienced an increase of 5.93% ( p = 0.037) at the same crossover point. After the crossover point, there was a decrease in 10-day inappropriate glucocorticoid prescription rate for both groups. Group B as the intervention group demonstrated a reduction of 28.22% compared to the crossing point ( p < 0.001), whereas group A showed a decrease of 12.20% ( p = 0.339). The characteristics of physicians did not significantly influence the inappropriate glucocorticoid prescription rate. Conclusion The real-time pop-up warning of inappropriate glucocorticoid prescriptions based on the Hospital Information System and high-proportion prescription feedback intervention warning system can effectively regulate the inappropriate glucocorticoid prescribing behavior of physicians. Trial Registration ISRCTN11747547.

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Section: Discussionmentioning

confidence: 99%

Feedback Intervention for the Control of Glucocorticoid Prescription in Primary Care Institutions: A Cluster Randomized Cross-Over Controlled Trial in Southwest China

Liu,

Wang,

Zhou

et al. 2024

RMHP

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“…Among all patients prescribed systemic glucocorticoids in this study, prescriptions for diseases of the respiratory system (60.8%) were the most common, of which 97.2% of the prescriptions were inappropriate. A study from Ethiopia ( 27 ) showed glucocorticoids were used in 63.5% of respiratory diseases. Another study from China also reported that 60.48% of glucocorticoids were used for respiratory diseases ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

“…Injectable of glucocorticoids (89.8%) was more common than oral glucocorticoids in this study. In China ( 67 ), the proportion of glucocorticoids used for injection reached 71.42% while in Serbian ( 27 ) 52.6% of systemic glucocorticoid prescriptions were injections. A study reported that 22.5% of acute respiratory infections were treated with intramuscular glucocorticoids in the United States ( 68 ).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have focused on oral glucocorticoid prescribing patterns in adults, including trends in the prevalence of oral glucocorticoids ( 14 , 16 , 24 , 25 ), common indications for glucocorticoids therapy ( 14 , 25 , 26 ), and common types of glucocorticoids use ( 14 , 27 ). A recent study reported characteristics of patients and their association with inappropriate use of systemic glucocorticoids in upper respiratory tract infections ( 28 ).…”

Section: Introductionmentioning

confidence: 99%

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Systemic glucocorticoid prescriptions pattern and factors of inappropriate use in primary care institutions of Southwest China

Zeng

Xingqin

et al. 2022

Front. Public Health

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BackgroundInappropriate use of glucocorticoids in primary care institutions is serious. It not only causes economic burden, but leads to many adverse reactions. The purpose of this study is to explore systemic glucocorticoid prescription pattern and factors of inappropriate use in primary care institutions.MethodsThis is a retrospective study. Systemic glucocorticoids prescribed in 58 primary care institutions in Guizhou province of Southwest China in 2020 were selected from the Health Information System. All prescriptions were classified as appropriate or inappropriate use. Inappropriate use was classified into the following two categories: (a) Inappropriate indications; (b) Inappropriate selection of glucocorticoids. Multivariate analysis was used to explore the factors associated with inappropriate use of systemic glucocorticoids.ResultsA total of 63,315 glucocorticoid prescriptions were included in the analysis. Diseases of the respiratory system (60.8%) and diseases of the skin and subcutaneous tissue (23.1%) were the most common indications for use. Injections (89.8%) predominated and dexamethasone (86.5%) was the most prescribed glucocorticoid. 68.2% of all prescriptions were inappropriate. Compared to physicians with a college degree, physicians with a junior college (OR: 1.12, 95% CI: 1.08–1.17) and technical secondary education (OR: 1.12, 95% CI:1.05–1.19) were more likely to prescribe glucocorticoids inappropriately as were attending physicians (OR: 1.12, 95% CI: 1.01–1.25) and resident physicians (OR: 1.31, 95% CI: 1.15–1.48) compared to associate chief physicians. The risk of inappropriate glucocorticoid use was highest in patients 65 years of age and older (OR: 6.00, 95% CI: 5.62–6.40). In contrast, prescriptions given by injection were more likely to be used inappropriately than those given orally (OR: 0.44, 95% CI: 0.41–0.46).ConclusionInappropriate use of systemic glucocorticoids without appropriate indications was extremely prominent in primary care institutions of Guizhou Province, especially in diseases of the respiratory system and among the elderly. The risk of inappropriate glucocorticoid use was highest in patients 65 years of age and older. It is important to note that physicians younger than 33, with more than 40 years of service, and attending or residents were more likely to inappropriately prescribe glucocorticoids.

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“…Therefore, imputing missing data leads to reasonable, valuable, and unbiased results. Among numerous studies that investigated medical prescriptions in various ways [9][10][11], a considerable proportion reported a significant rate of up to one-third for the physician's specialty missingness [12][13][14][15][16][17]. Despite the provision of a remarkable increase in the accuracy of disease labeling of patients, one of the overlooked applications of studying prescriptions is predicting the physician's specialty.…”

Section: Introductionmentioning

confidence: 99%

Predicting the Physician’s Specialty Using a Medical Prescription Database

Akhlaghi

Tabesh

Mahaki

et al. 2022

Computational and Mathematical Methods in Medicine

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Purpose. The present study is aimed at predicting the physician's specialty based on the most frequent two medications prescribed simultaneously. The results of this study could be utilized in the imputation of the missing data in similar databases. Patients and Methods. The research is done through the KAy-means for MIxed LArge datasets (KAMILA) clustering and random forest (RF) model. The data used in the study were retrieved from outpatients' prescriptions in the second populous province of Iran (Khorasan Razavi) from April 2015 to March 2017. Results. The main findings of the study represent the importance of each combination in predicting the specialty. The final results showed that the combination of amoxicillin-metronidazole has the highest importance in making an accurate prediction. The findings are provided in a user-friendly R-shiny web application, which can be applied to any medical prescription database. Conclusion. Nowadays, a huge amount of data is produced in the field of medical prescriptions, which a significant section of that is missing in the specialty. Thus, imputing the missing variables can lead to valuable results for planning a medication with higher quality, improving healthcare quality, and decreasing expenses.

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Assessment of Prescription Pattern of Systemic Steroidal Drugs in the Outpatient Department of Menelik II Referral Hospital, Addis Ababa, Ethiopia, 2019

Cited by 6 publications

References 13 publications

Feedback Intervention for the Control of Glucocorticoid Prescription in Primary Care Institutions: A Cluster Randomized Cross-Over Controlled Trial in Southwest China

Feedback Intervention for the Control of Glucocorticoid Prescription in Primary Care Institutions: A Cluster Randomized Cross-Over Controlled Trial in Southwest China

Systemic glucocorticoid prescriptions pattern and factors of inappropriate use in primary care institutions of Southwest China

Predicting the Physician’s Specialty Using a Medical Prescription Database

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