Evaluation of rational prescribing in paediatrics

Rational prescribing is challenging in neonatology. Drug utilization studies help identify and define the problem. We performed a review of the literature on drug use in neonatal units and describe global variations. We searched databases (EMBASE, CINAHL and Medline) from inception to July 2020, screened studies and extracted relevant data (two reviewers). The search revealed 573 studies of which 84 were included. India (n = 14) and the USA (n = 13) reported the most. Data collection was prospective (n = 56) and retrospective (n = 26), mostly (n = 52) from one center only. Sixty studies described general drug use in 34 to 450,386 infants (median (IQR) 190 (91–767)) over a median (IQR) of 6 (3–18) months. Of the participants, 20–87% were preterm. The mean number of drugs per infant (range 11.1 to 1.7, pooled mean (SD) 4 (2.4)) was high with some reporting very high burden (≥30 drugs per infant in 8 studies). This was not associated with the proportion of preterm infants included. Antibiotics were the most frequently used drug. Drug use patterns were generally uniform with some variation in antibiotic use and more use of phenobarbitone in Asia. This study provides a global perspective on drug utilization in neonates and highlights the need for better quality information to assess rational prescribing.

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PP226—Available and clinically applicable information for rational prescribing to older patients in European and American handbooks

Clinical Therapeutics ◽

10.1016/j.clinthera.2013.07.266 ◽

2013 ◽

Vol 35 (8) ◽

pp. e89-e90

Author(s):

J.L. Boer ◽

E. Beers ◽

T.C. Egberts ◽

H.G. Leufkens ◽

P.A. Jansen

Keyword(s):

Older Patients ◽

Rational Prescribing

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Polypharmacy and Rational Prescribing

Geriatric Rehabilitation ◽

10.1201/9781315373904-13 ◽

2017 ◽

pp. 231-244

Author(s):

Mikhail Zhukalin ◽

Christopher J. Williams ◽

Michael Reed ◽

Dale C. Strasser

Keyword(s):

Rational Prescribing

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Drug utilization audit of antipsychotics using WHO methodology: recommendations for rational prescribing

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20183941 ◽

2018 ◽

Vol 7 (10) ◽

pp. 2021

Author(s):

Iram Shaifali ◽

Rajib Karmakar ◽

Shalini Chandra ◽

Santosh Kumar

Keyword(s):

Drug Utilization ◽

Atypical Antipsychotics ◽

Essential Medicine ◽

Uttar Pradesh ◽

Cross Sectional ◽

Prescribing Indicators ◽

Male Predominance ◽

Rational Prescribing ◽

Prescribing Trends ◽

Prescribing Trend

Background: Utilization pattern of antipsychotics has undergone a major shift as the newly introduced atypical antipsychotics have heralded the market. Hence continuous studies on current prescribing trends are needed to provide most updated, effective and rational treatment of psychoses.Methods: This cross-sectional prospective study was conducted at Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India. OPD tickets of the department of psychiatry for the year 2016-2017 were evaluated for a total of 310 cases. These prescriptions were used to determine the drug utilization of antipsychotics and for their appropriateness against the WHO recommended core prescribing indicators.Results: A total of 310 patients satisfied the inclusion criteria and a male predominance was seen (male:female= 1.3:1). The most common psychotic disorder diagnosed was schizophrenia (44%). Majority of the patients (76%) received monotherapy and the prescribing trend showed a higher use of atypical antipsychotics (89%) over typical ones (11%). The most commonly prescribed anti-psychotic drugs were olanzapine (31%), followed by risperidone (26%). On analysing prescriptions according to the WHO core prescribing indicators it was observed that average number of antipsychotics prescribed per prescription was 1.32. 24% of drugs were prescribed by generic name and 5.2% were administered via injectable route. Drugs prescribed from National list of Essential Medicine, 2015 constituted 46%.Conclusions: The high inclination towards the use of atypical antipsychotics observed in our study correlates with the global changing trends in the treatment of schizophrenia. WHO prescribing indicators should be adhered to, to impart rational prescribing.

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Prescription Writing Skills of Pre-Clinical Medical and Dental Undergraduate Students

Journal of Nepal Medical Association ◽

10.31729/jnma.157 ◽

2008 ◽

Vol 47 (172) ◽

Author(s):

GP Rauniyar ◽

RK Roy ◽

BP Das ◽

G Bhandari ◽

SK Bhattacharya

Keyword(s):

Prospective Study ◽

Undergraduate Students ◽

Writing Skills ◽

First Year ◽

Limited Extent ◽

Dental Examination ◽

Preclinical Phase ◽

Rational Prescribing ◽

Second Year ◽

Prescription Writing

Objective of this prospective study was to assess the acquisition of prescribing skill of preclinicalmedical and dental undergraduate students. Prescription writing skills of 258 students of both firstand second year of MBBS and BDS students were analyzed through an objective structured practicalexamination. MBBS student of second year scored 85.01% and 92.82% respectively in physician anddrug related component whereas first year MBBS students scored 89.9% and 83.4%. BDS studentof first year scored 91.96% and 86.33% in physician and drug related components which is betterthan second year that scored 83.33% and 77.94% respectively. This study revealed that the studentsof both courses acquire prescribing skills to a limited extent during preclinical phase. Prescribingerrors were found both in physician and drug related components. To minimize the different form ofprescribing errors vigorous training in the internship period will help to minimize prescribing errorsand improve rational prescribing too.Key words: dental, examination, medical, objective, prescription, student

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Temazepam for insomnia?

Drug and Therapeutics Bulletin ◽

10.1136/dtb.16.6.21 ◽

1978 ◽

Vol 16 (6) ◽

pp. 21-22

Keyword(s):

Careful Consideration ◽

Active Metabolites ◽

Commercial Practice ◽

Rational Prescribing ◽

Trade Names

Temazepam, 3-hydroxydiazepam, is one of the active metabolites of diazepam. It has recently been marketed under the names of Normison (Wyeth) and Euhypnos (Montedison). We regret the introduction of a drug under two trade names: this is a commercial practice which makes rational prescribing more difficult. Nevertheless, this drug merits careful consideration as an hypnotic.

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India's consumer groups call for more rational prescribing

BMJ ◽

10.1136/bmj.312.7023.76 ◽

1996 ◽

Vol 312 (7023) ◽

pp. 76-76 ◽

Cited By ~ 2

Author(s):

G. Mudur

Keyword(s):

Rational Prescribing

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Perceção e Atitudes Sobre Prescrição Racional Durante a Formação Médica: Resultados de Grupos Focais com Estudantes de Medicina e Médicos Internos

Acta Médica Portuguesa ◽

10.20344/amp.10945 ◽

2019 ◽

Vol 32 (9) ◽

pp. 593

Author(s):

Isabel Boaventura ◽

João Costa ◽

Ricardo Miguel Fernandes ◽

Joaquim Ferreira

Keyword(s):

Focus Groups ◽

Educational Strategies ◽

Therapeutic Approaches ◽

Self Evaluation ◽

Rational Prescribing ◽

And Behaviors ◽

De Medicina ◽

Young Physicians ◽

Structured Questionnaire ◽

Treatment Personalization

Introduction: Clinical pharmacology educational strategies for medicine students seek to foster skills that range from technical knowledge to the development of behaviors that ensure rational prescribing decisions. The authors present the results of a study to evaluate the perceptions, attitudes and behaviors linked with rational prescribing throughout training.Material and Methods: Four focus groups were held with first, third and fifth year medical students and residents from the first years of various specialties, with a total of 29 participants. A semi-structured questionnaire with open-ended questions was used to facilitate interaction between the participants, alongside case-studies to explore the behaviors associated with therapeutic decisions.Results: The analysis of the references showcased an evolution of concepts throughout academic training. References regarding guidelines and effectiveness emerge during the third year; safety and treatment personalization emerge during the fifth year and specialist training. Efficacy studies, systematic reviews, regulatory documents and online platforms were considered the most relevant sources of information.Discussion: The literature review showcases the need to implement strategies dedicated to the development of adequate skills for rational prescribing. The use of focus groups may be a useful methodology to engage students in self-evaluation of their skills and inform faculty of the perceptions and behaviors of students.Conclusion: This analysis illustrates the awareness of students and young physicians to the need to adapt therapeutic approaches to the characteristics of the patient. These concepts should be reinforced so that young doctors feel more prepared for rational prescription in complex clinical situations.

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