الفهرس | Only 14 pages are availabe for public view |
Abstract Medications play very important role in the health care. Also, medications contribute to significant improvements in health outcomes especially, when used correctly and appropriately. Although, medications are very commonly used but they are also one of the most common sources of error and adverse events in health care. A lot of international studies indicate that a high prevalence of medication related problems including medication errors and adverse drug reactions can be associated with hospitalization cases. Many studies have described medication error rates in hospital settings, but data for primary care is relatively scarce. Primary Healthcare is very important health facility because it is the first gate that is receiving the patients before referral them to the hospitals. Primary Healthcare includes many services like; family planning, maternity care, child care, dental care, health educational services, communicable diseases control, emergency care and environmental health services. This study is a cross sectional study that was conducted in the accredited family healthcare centers affiliated to Ministry of Health at different medical districts of Alexandria. The aim of our study is to assess the adherence to Egyptian standards of prescription order writing and to compare adherence between family health centers without DIC ”Drug information center” and family health centers with DIC and to determine factors associated with non-adherence to basic standards of prescription order writing. The study was conducted during the period from 1st of October 2016 till 31st of March 2017. The results of the current study were as following: Assessment of drug prescribers’ adherence to Egyptian standards of prescription order writing and WHO recommendations, the total numbers of prescriptions collected were 1500. The largest contribution was from ElSeyouf (13.7%), AlAmrawy and Bacous (13.1%) each, followed by AlMandara and Sanstefano (12.7%) each, then Smouha (12.1%). Summary and Conclusion 51 The total adherence for prescriber’s information items was almost 100 % .For patient’s information items adherence was 100%, for patient’s name, 98.4% for diagnosis, 76.3% for age, 32.3% for weight and 20.4% for gender. Total adherence for writing the medication frequency was 98.9%, route of administration was 98.4%, dose was 98.1%, duration was 93.9%, Concentration was 90.9%, and dosage form was 88.1% and generic prescription was 85.3%. Comparison of adherence between centers without DIC and centers with DIC. A significant higher proportion of prescriptions adherence to all patient’s information items was reported in centers with DIC compared to centers without DIC. There were statistically significant differences in adherence of centers with DIC to write generic, trade name, dosage form, Concentration and dose, all prescriber’s information items were fulfilled in centers with DIC. Factors associated with non-adherence to basic standards of prescription order writing. The presence of DIC was a significant factor guarding against non- adherence to basic standards of prescription order writing. Centers with DIC were the least non-adherent (18.7%). Age showed non –adherence in 61.1%of prescribers below 30 years were nonadherent, compared to 37% in the age (30-45) while 50.3% in the age (>45-60) such non – adherence was statistically significant. There was statistically significant difference with in experience category with the highest non-adherence among those with< 5 years’ experience. Males showed more non-adherence (56.4%). Dentists and gynecologists showed higher non- adherence (59.5%and 54.5%respectivrly), GP and diploma graduated physicians were more non-adherent (54.4% and 51.4%)respectively. Absence of physicians with knowledge about WHO recommendations were more non-adherent (51.4%).Physicians who see more than 25 patients per day were more non – adherent (57.3% of them) . Summary and Conclusion 52 from the results of the study we conclude that: There is a defect in adherence to the basic standards of prescription order writing in the accredited family healthcare centers in Alexandria in patient’s information and drug information with more non-adherence in centers without DIC. The presence of DIC and specialty of the physicians being pediatricians or internists were factors associated with less non – adherence. |