Background According to the recommendations of scientific societies and legislation, medicines prescription should be performed by the active ingredient (AI) to avoid drug-related problems. In clinical practice, for various reasons, physicians tend to use brand names (BN).
Purpose To evaluate the quality of prescriptions through the prescription by AI in inpatients compared with the prescription by BN and to compare with a previous study in our department.
Material and methods Observational and retrospective study in a tertiary teaching hospital conducted during October 2013. We included all inpatients admitted to non-critical units. Using the Unit Dose Drugs Dispensing System (UDDDS) pharmacists reviewed all the treatment lines of the medical orders. A database was designed and filled with data collected: number of lines of treatment prescribed as an AI or BN and medical service. Furthermore, we classified medicines by their treatment group according to the WHO classification: Anatomical, Therapeutic, Chemical classification system (ATC). As the last step, the results obtained were compared with those found in a similar study in October 2010.
Results During one month, UDDDS revised 1999 treatment lines in 2013 and 1973 treatment lines in the 2010 study. Physicians prescribed 1166 (58%) versus 1303 (66%) by the BN in 2013 and 2010 respectively. At clinical service distribution, lines of inpatient pharmacotherapy admitted to Pneumology (77%) and Psychiatry (72%) were the most prescribed by BN in the 2013 study; in the 2010 study, these were Psychiatry (86%) too, Gynaecology (83%) and Orthopaedic Surgery (83%). In the other clinical services, it appears that the requirements are approximately 50% AI. The reverse trend was observed in the Short Stay Unit, Paediatrics and Neurosurgery reaching around 60% of treatment lines with the AI in the 2013 study and also reaching 60% in the Haematology department in 2010. Sorted by ATC classification, the most prescriptions in 2013 by BN were in the N group with 31%, followed by A, B and J with 23%, 17% and 17% respectively.
Conclusion Most medical orders continue to be prescribed by the BN despite the prescribing quality recommendations. Maybe when computer-assisted prescription comes to our hospital, this situation will be reversed.
ReferencesNo conflict of interest.
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