Drug therapy in an isolated rural community - abstract

ABSTRACT

This study was conducted in Carriacou, one of the Grenadine islands affiliated to Grenada, between October 1985 and Janaury 1986, to determine the extent and pattern of drug-prescribing in the island. Three doctors on the island provided general practitioner services at five clinics. From the case-notes, the name, age, sex, diagnosis, treatment and duration of treatment were collected. The diagnosis and treatment were coded and the information processed by computer. A total of 1,349 patients was seen 2,034 times 17.1 percent of attending patients received no medication, 54.6 percent received one drug per prescription and only 3.4 percent per cent three or more drugs per prescription; 49.2 percent of prescriptions were for less than 14 days whilst 37.3 percent were for 28 days or more. Penicillins were most commonly prescribed, accounting for 10.1 percent of all prescribed drugs. This was followed by aspirin (8.1 percent) and antacids (7.3 percent). Pencillins were the most frequently prescribed drugs for patients under 45 years of age. Antihypertensives were the most frequently prescribed drugs for patients over 45 years of age. There was not excessive prescribing of psychotropic drugs, antibiotics and analgesics when compared with more developed countries. The most frequently recorded health problems were hypertension (14.2 percent), upper respiratory tract infection (8.7 percent) and dyspepsia (6.5 percent). The high incidence of dyspepsia was related to the high alchohol intake and the use of aspirin to treat osteoarthritis. An examination of prescribing practices, increased community education and patient participation can result in more effective and economical use of drugs (AU)