A prescription analysis study of drug utilisation in polyclinics in Barbados - abstract

ABSTRACT

A drug utilisation review was carried out in three polyclinics in Barbados by analysing prescriptions. The prescribing patterns of seven doctors were assessed with respect to (1) the total number of different drugs prescribed, (2) the therapeutic category of each drug, (3) whether they were prescribed by generic or trade name, (4) the number of drugs per patient visit, (4) the cost of one in five prescriptions and (5) the choices within the three most prescribed categories, i.e. analgesics and anti-inflammatory drugs, antibiotics and diruetics. The number of different drugs used by individual doctors was extremely modest. It ranged from 29 to 60 (mean 47). The number of drugs used correlated positively with the number of items per patient visit. The mean items per patient ranged from 1.82 to 3.12. Eighty-eight per cent of prescriptions were written by trade name. Only one doctor, the most highly trained, showed a noticeable preference for generic prescribing, and in spite of a relatively high score of items per patient visit his prescription costs were below the average. Paracetamol (cost 1.5 cents) and then bendrofluazide (cost 1.1 cents) were the two most frequently prescribed drugs. This illustrates prescriber compliance with formulary recommendations. Some other prescribing practices were much less rational and economical. Prescription analysis is an essential tool for monitoring drug use. It reveals bad prescribing practices and can assess responses to education. It provides a logical and cost-effective means of physician audit with potential for improving prescribing practices and hence health care (AU)