The examination of family physicians' prescriptions in terms of rational use of medicine

The aim of this study is to examine prescriptions that is written by family physicians in Istanbul through WHO indicators in terms of rational use of medicine. As a cross-sectional study, 5.936.852 prescriptions which are written in 2016 by 1431 family physicians in Istanbul, who are selected through systematic sampling, were analyzed in this research. Furthermore, physicians are were listed according to the number of medicine, cost of medicine, and the number of antibiotics per prescription. The prescribing performances of physician groups who ranked in the 1st and 4th quarter in two of those three criteria, were compared. The findings of this research demonstrates that the number of diagnosis per prescription is 1,94±1,70 and the numbers of medicine and box per prescription are 2,79±1,94 and 6,04±4,48 respectively. The cost per prescription is 107,62±327,50 (IQR: 18,54-105,33). Women between 18-64 age appears as the group for which prescriptions are written at most. Single-diagnosis prescriptions comprise 49.6% of all prescriptions. Hypertension is ranked first in both all and single-diagnosis prescriptions (9.8% and 9.5% respectively). ''Common cold medications'' are most commonly written medicines in both groups of prescriptions (7.1% and 11.3% respectively). The percentage of antibiotic which was written in the prescriptions of infectious disease is 83.1% in acute sinusitis, 70.4% in tonsillopharyngitis and 90.3% in dental cavities. ACEi and ARB medicines, in which contraindication occurs if they are written together, are found to be written together in 0.3% of all prescriptions. The total cost for ''General Examination'' prescriptions without any diagnosed disease, which consist 1.7% of all prescriptions, is 6.675.796,43 TL. When diagnoses are compared in terms of their prescribing performance, good prescribers are more succesful in all diagnoses than the other group in accordance with their treatment guidance and except cystitis all differences are significant (p<0,001). When the comparison was conducted in terms of the ROM criteria, good prescribers had better performance as well (p<0,001). Family physicians who have less content in their prescriptions tend to be better based on ROM indicators and the consistent with their treatment guidance. However, the rate for the irrational use of antibiotics is higher for physicians in general.