EVALUATION OF THE ATTITUDES AND EXPERIENCES OF THE FAMILY PHYSICIANS AND SPECIALISTS RELATING TO PROVIDED TREATMENTS IN TERMS OF RATIONAL USE OF MEDICINE
Abstract
Introduction: Physicians’ perspectives are essential for rational use of medicine (RUM) activities. This study aimed at evaluation of physicians’ attitudes and experiences about therapeutical management process in terms of RUM in primary and secondary care.
Methods: A survey was applied to 1062 family physicians (FP) and 562 specialist physicians (SP) in Turkey. The questionnaire consisted of items assessing physicians’ RUM approaches, stratified by their demographic and occupational characteristics.
Results: A total of 55.4% of FPs and 32.1% of SPs declared that they prescribed to “>80% of their patientsâ€. The attitude of “no prescribing without physical examination†was more in females, in seniors, and in those with longer professional experiences in SP group (p<0.05), where no difference was found among FPs. More markedly in FPs, women provided more information than men about their patients’ diseases and pharmacological/non-pharmacological treatments. Most commonly demanded drugs by patients were “analgesics/antirheumaticsâ€, “cold-medicationsâ€, and “antibioticsâ€.
Conclusion: Physicians’ statements showed that patients had an underestimated tendency to demand specific drug prescriptions and physicians met such demands more than expected. Moreover, female physicians are more likely to inform their patients about pharmacotherapy details in both groups. These findings may be considered as beneficial for RUM dissemination activities.
Key words: physicians, rational drug use, primary health care, hospitals, prescribing
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Keywords:
physicians, rational drug use, primary health care, hospitals, prescribing
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References
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29. Akici A, Kalaca S, Ugurlu MU et al. Impact of a short postgraduate course in rational pharmacotherapy for general practitioners. Br J Clin Pharmacol 2004; 57(3):310-321.
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32. Pavin M, Nurgozhin T, Hafner G, Yusufy F, Laing R. Prescribing practices of rural primary health care physicians in Uzbekistan. Trop Med Int Health 2003; 8(2):182-190.
33. Alam K, Mishra P, Prabhu M et al. A study on rational drug prescribing and dispensing in outpatients in a tertiary care teaching hospital of Western Nepal. Kathmandu Univ Med J 2006; 4(4):436-443.
34. Akıcı A, Uğurlu MÜ, Gönül N. The evaluation of general practitioners’ knowledge and attitudes regarding rational use of drug. Sürekli Tıp Eğitimi Dergisi (STED) 2002; 11:253-256.
35. Bensing JM, Brink-Muinen A, Bakker DH. Gender differences in practice style: a Dutch study of general practitioners. Med Care 1993; 31:219–229.
36. Akici A, Kalaca S, Ugurlu MU et al. Patient knowledge about drugs prescribed at primary healthcare facilities. Pharmacoepidemiol Drug Saf 2004; 13(12):871-876.
37. Vashi A, Rhodes KV. "Sign right here and you're good to go": a content analysis of audiotaped emergency department discharge instructions. Ann Emerg Med 2011; 57(4):315-22.
38. Hogerzeil HV. Promoting rational prescribing: an international perspective. Br J Clin Pharmacol 1995; 39(1):1-6.
39. Akici A, Mollahaliloglu S, Ozgulcu S, Donertas B, Alkan A. Assessment of health care service in terms of rational use of medicines delivered to patients in primary health care centres and public hospitals. Turkish Family Physician 2015; 6(1):1-10.
40. Du Y, Knopf H. Self-medication among children and adolescents in Germany: results of the National Health Survey for Children and Adolescents (KiGGS). Br J Clin Pharmacol 2009; 68(4):599-608.
41. Trajanovska M, Manias E, Cranswick N, Johnston L. Use of over-the-counter medicines for young children in Australia. J Paediatr Child Health 2010; 46(1-2):5-9.
42. Aksoy M, Alkan A, Isli F. Rational drug use promotional activities of Ministry of Health. Turkiye Klinikleri J Pharmacol Special Topics 2015; 3(1):19-26.
43. Kemp EC, Floyd MR, McCord-Duncan E, Lang F. Patients prefer the method of "tell back-collaborative inquiry" to assess understanding of medical information. J Am Board Fam Med 2008; 21(1):24-30.
2. De Vries TP, Henning RH, Hogerzeil HV, Fresle DA. Guide to good prescribing. A practical manual. Geneva: WHO/DAP/94.11. World Health Organization. Action Programme on Essential Drugs, 1994, 6-75.
3. Akici A, Oktay S. Rational pharmacotherapy and pharmacovigilance. Curr Drug Saf 2007; 2(1):65-69.
4. Tsiantou V, Moschandreas J, Bertsias A et al. General practitioners' intention to prescribe and prescribing patterns in selected European settings: The OTCSOCIOMED project. Health Policy 2015; 119(9):1265-1274.
5. Le Doare K, Barker CI, Irwin A, Sharland M. Improving antibiotic prescribing for children in the resource-poor setting. Br J Clin Pharmacol 2015; 79(3):446-455.
6. Laing R, Hogerzeil H, Ross-Degnan D. Ten recommendations to improve use of medicines in developing countries. Health Policy Plan 2001, 16(1), 13-20.
7. Akici A, Kalaca S, Ugurlu MU, Oktay S. Prescribing habits of general practitioners in the treatment of childhood respiratory-tract infections. Eur J Clin Pharmacol 2004; 60(3):211-216.
8. Akici A, Kalaca S, Goren MZ et al. Comparison of rational pharmacotherapy decision-making competence of general practitioners with intern doctors. Eur J Clin Pharmacol 2004; 60(2):75-82.
9. Basaran NF, Akici A. Aspects of physicians' attitudes towards the rational use of drugs at a training and research hospital: a survey study. Eur J Clin Pharmacol 2013; 69(8):1581-1587.
10. Leblebicioglu H, Canbaz S, Peksen Y, Gunaydin M. Physicians' antibiotic prescribing habits for upper respiratory tract infections in Turkey. J Chemother 2002; 14(2):181-184.
11. Jain S, Upadhyaya P, Goyal J et al. A systematic review of prescription pattern monitoring studies and their effectiveness in promoting rational use of medicines. Perspect Clin Res 2015; 6(2):86-90.
12. Neyaz Y, Qureshi NA, Khoja T et al. Physicians medication prescribing in primary care in Riyadh City, Saudi Arabia. Literature review, part 1: variations in drug prescribing. East Mediterr Health J 2011; 17(2):126-131.
13. AkdaÄŸ R. Turkey Health Transformation Program Evaluation Report (2003-2010). Ankara: Republic of Turkey Ministry of Health. MoH Publ. No:839. ISBN:978-975-590-377-4, 2011:3-439.
14. Atun R, Aydın S, Chakraborty S et al. Universal health coverage in Turkey: enhancement of equity. Lancet 2013; 382(9886):65-99.
15. Versporten A, Bolokhovets G, Ghazaryan L et al. Antibiotic use in eastern Europe: a cross-national database study in coordination with the WHO Regional Office for Europe. Lancet Infect Dis 2014; 14(5);381-387.
16. Le Grand A, Hogerzeil HV, Haaijer-Ruskamp FM. Intervention research in rational use of drugs: a review. Health Policy Plan 1999; 14(2):89-102.
17. World Health Organization. How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators. Geneva: World Health Organization. WHO/DAP/93.1, 1993, 12-24.
18. Mollahaliloğlu S, Başara Bora B, Eryılmaz Z. The Ministry of Health of Turkey Health Statistics Yearbook 2010. Ankara: Republic of Turkey, Ministry of Health, Refik Saydam Hygiene Center Presidency, School of Public Health. 2011. ISBN: 978-975-590-366-8, 77.
19. Vallano A, Montane E, Arnau JM et al. Medical specialty and pattern of medicines prescription. Eur J Clin Pharmacol 2004; 60(10):725-730.
20. Hajjaj FM, Salek MS, Basra MK, Finlay AY. Non-clinical influences on clinical decision-making: a major challenge to evidence-based practice. J R Soc Med 2010; 103(5):178-187.
21. Franks P, Bertakis KD. Physician gender, patient gender, and primary care. J Womens Health 2003; 12:73–80.
22. Basaran NF, Akici A. Patients' experience and perspectives on the rational use of drugs in Turkey: a survey study. Patient Prefer Adherence 2012; 6:719-724.
23. Deveugele M, Derese A, Van den Brink-Muinen A, Bensing J, De Maeseneer J. Consultation length in general practice: cross sectional study in six European countries. BMJ 2002; 325(7362):472.
24. Arslan LS, Semin S. Attitudes and practices of primary healthcare center patients about drug use in Turkey. Patient Educ Couns 2006; 62(2):250-259.
25. Akıcı A. General principle of rational use of medicine and current situation in Turkey. Turkiye Klinikleri J Pharmacol-Special Topics 2015; 3(1):1-10.
26. Zhong W, Maradit-Kremers H, St Sauver JL et al. Age and sex patterns of drug prescribing in a defined American population. Mayo Clin Proc 2013; 88(7):697-707.
27. Mollahaliloglu S, Alkan A, Donertas B, Ozgulcu S, Akici A. Prescribing practices of physicians at different health care institutions. Eurasian J Med 2013; 45(2):92-98.
28. Akici A. Prescribing in elderly according to the principles of rational drug use and the dimentions of drug utilization in elderly in Turkey. Turkish J Geriatrics 2006; 9:19-27.
29. Akici A, Kalaca S, Ugurlu MU et al. Impact of a short postgraduate course in rational pharmacotherapy for general practitioners. Br J Clin Pharmacol 2004; 57(3):310-321.
30. Dong L, Yan H, Wang D. Drug prescribing indicators in village health clinics across 10 provinces of Western China. Fam Pract 2011; 28(1):63-67.
31. Mahmood A, Elnour AA, Ali AAA, Hassan NA, Shehab A, Srikanth A. Evaluation of rational use of medicines (RUM) in four government hospitals in UAE. Saudi Pharmaceutical Journal. 2016; 24(2):189-96.
32. Pavin M, Nurgozhin T, Hafner G, Yusufy F, Laing R. Prescribing practices of rural primary health care physicians in Uzbekistan. Trop Med Int Health 2003; 8(2):182-190.
33. Alam K, Mishra P, Prabhu M et al. A study on rational drug prescribing and dispensing in outpatients in a tertiary care teaching hospital of Western Nepal. Kathmandu Univ Med J 2006; 4(4):436-443.
34. Akıcı A, Uğurlu MÜ, Gönül N. The evaluation of general practitioners’ knowledge and attitudes regarding rational use of drug. Sürekli Tıp Eğitimi Dergisi (STED) 2002; 11:253-256.
35. Bensing JM, Brink-Muinen A, Bakker DH. Gender differences in practice style: a Dutch study of general practitioners. Med Care 1993; 31:219–229.
36. Akici A, Kalaca S, Ugurlu MU et al. Patient knowledge about drugs prescribed at primary healthcare facilities. Pharmacoepidemiol Drug Saf 2004; 13(12):871-876.
37. Vashi A, Rhodes KV. "Sign right here and you're good to go": a content analysis of audiotaped emergency department discharge instructions. Ann Emerg Med 2011; 57(4):315-22.
38. Hogerzeil HV. Promoting rational prescribing: an international perspective. Br J Clin Pharmacol 1995; 39(1):1-6.
39. Akici A, Mollahaliloglu S, Ozgulcu S, Donertas B, Alkan A. Assessment of health care service in terms of rational use of medicines delivered to patients in primary health care centres and public hospitals. Turkish Family Physician 2015; 6(1):1-10.
40. Du Y, Knopf H. Self-medication among children and adolescents in Germany: results of the National Health Survey for Children and Adolescents (KiGGS). Br J Clin Pharmacol 2009; 68(4):599-608.
41. Trajanovska M, Manias E, Cranswick N, Johnston L. Use of over-the-counter medicines for young children in Australia. J Paediatr Child Health 2010; 46(1-2):5-9.
42. Aksoy M, Alkan A, Isli F. Rational drug use promotional activities of Ministry of Health. Turkiye Klinikleri J Pharmacol Special Topics 2015; 3(1):19-26.
43. Kemp EC, Floyd MR, McCord-Duncan E, Lang F. Patients prefer the method of "tell back-collaborative inquiry" to assess understanding of medical information. J Am Board Fam Med 2008; 21(1):24-30.
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Akici A, Kilboz M, Tamirci M, Aydin V, Mollahaliloglu S, Ozgulcu S, Alkan A. EVALUATION OF THE ATTITUDES AND EXPERIENCES OF THE FAMILY PHYSICIANS AND SPECIALISTS RELATING TO PROVIDED TREATMENTS IN TERMS OF RATIONAL USE OF MEDICINE. JDDT [Internet]. 15Mar.2017 [cited 18Apr.2024];7(2):18-. Available from: https://www.jddtonline.info/index.php/jddt/article/view/1383
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