Factors affecting family physicians’ drug prescribing: a cross-sectional study in Khuzestan, Iran

Arab, Mohammad; Torabipour, Amin; Rahimifrooshani, Abbas; Rashidian, Arash; Fadai, Nayeb; Askari, Roohollah

doi:10.15171/ijhpm.2014.103

Cited by 13 publications

(13 citation statements)

References 27 publications

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“…We were still unable to fully explain the reasons for this prescriber variability even though we accounted for more higher levels characteristics compared to the other two studies [ 25 , 26 ]. Past studies had shown medical training and prescribers’ experience were associated with prescribing practices [ 39 , 40 ]. However, this does not appear to be so in our study, aside from the family medicine specialist which we postulate is due to the characteristics of the patients they see.…”

Section: Discussionmentioning

confidence: 99%

Variation of polypharmacy in older primary care attenders occurs at prescriber level

et al. 2018

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BackgroundPolypharmacy is particularly important in older persons as they are more likely to experience adverse events compared to the rest of the population. Despite the relevance, there is a lack of studies on the possible association of patient, prescriber and practice characteristics with polypharmacy. Thus, the aim of this study was to determine the rate of polypharmacy among older persons attending public and private primary care clinics, and its association with patient, prescriber and practice characteristics.MethodsWe used data from The National Medical Care Survey (NMCS), a national cross-sectional survey of patients’ visits to primary care clinics in Malaysia. A weighted total of 22,832 encounters of patients aged ≥65 years were analysed. Polypharmacy was defined as concomitant use of five medications and above. Multilevel logistic regression was performed to examine the association of polypharmacy with patient, prescriber and practice characteristics.ResultsA total of 20.3% of the older primary care attenders experienced polypharmacy (26.7%% in public and 11.0% in private practice). The adjusted odds ratio (OR) of polypharmacy were 6.37 times greater in public practices. Polypharmacy was associated with patients of female gender (OR 1.49), primary education level (OR 1.61) and multimorbidity (OR 14.21). The variation in rate of polypharmacy was mainly found at prescriber level.ConclusionPolypharmacy is common among older persons visiting primary care practices. Given the possible adverse outcomes, interventions to reduce the burden of polypharmacy are best to be directed at individual prescribers.

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Section: Discussionmentioning

confidence: 99%

Variation of polypharmacy in older primary care attenders occurs at prescriber level

et al. 2018

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“…The results showed that the average number of drugs prescribed per prescription was 3.14, which is higher than the recommended optimum level (≤ 3). Studies in Iran have reported this index to be 2.6 to 4.11 [ 10 , 15 – 17 , 22 , 23 ]. In a national study, the average number of drugs per prescription was reported to be 3.07 (for all specialties) and 3.3 for general practitioners.…”

Section: Discussionmentioning

confidence: 99%

Prescribing patterns of rural family physicians: a study in Kermanshah Province, Iran

Ahmadi

Zarei

2017

BMC Public Health

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BackgroundThe inappropriate use of drugs due to irrational prescriptions is a common problem in Iran, but there is little evidence of prescription patterns in rural family physicians. This study aimed to explore the prescribing pattern and rational drug use indicators for family physicians using Index of Rational Drug Prescribing (IRDP) in Kermanshah Province, Iran.MethodsIn this retrospective study, 352,399 prescriptions from 184 family physicians in 103 primary health care (PHC) centers were examined. As stated, an analysis was done for rational use indicators suggested by World Health Organization (WHO): e.g., the percentage of prescriptions containing antibiotics, injections, and those prescribed by a generic name and from a national essential medicine list, plus the average number of drugs per prescription; these factors were all taken into account. Rational drug use was studied with the IRDP.ResultsThe average number of drugs per prescription was 3.14 (± 1.2) and the average cost per prescription was 116,740 IRR (USD 3.6). Around 19% of prescriptions had more than four drugs, while the percentage of prescriptions involving antibiotics and injections was 52.1% and 24.4%, respectively. There was 95.1% drugs prescribed by their generic name and 95.9% were retrieved from the essential drugs list. The value of the IRDP was 3.70 out of 5.ConclusionThe findings of this study showed that some degree of irrational drug prescribing exists among family physicians, especially in terms of injections, antibiotics, and polypharmacy. It is recommended that there be continuing education programs for physicians regarding rational prescribing for different kinds of medical indications. Clinical practice guidelines should also assist with the rational use of medicine.

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“…Therefore, the payment may decrease if the physicians cannot preserve and maintain the assigned population, which may result in physicians' dissatisfaction (30). Delayed payments and low levels of bonuses are also regarded as reasons for physicians' dissatisfaction (31). One of the strengths of targeted payments is to encourage physicians to meet the desired standards of care and population health.…”

Section: Discussionmentioning

confidence: 99%

Payment system of urban family physician programme in the Islamic Republic of Iran: is it appropriate?

Doshmangir

Rashidian

Takian

et al. 2018

East Mediterr Health J

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Factors affecting family physicians’ drug prescribing: a cross-sectional study in Khuzestan, Iran

Abstract: In Khuzestan, the mean of medication per patient was fewer than national average. Approximately, pattern of prescribed drug by family physicians (including dosage form and type of drugs) was similar to other provinces of Iran.

Cited by 13 publications

References 27 publications

Variation of polypharmacy in older primary care attenders occurs at prescriber level

Variation of polypharmacy in older primary care attenders occurs at prescriber level

Prescribing patterns of rural family physicians: a study in Kermanshah Province, Iran

Payment system of urban family physician programme in the Islamic Republic of Iran: is it appropriate?

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