Investigation of prescribing trends and prescriptions for common diagnoses in primary care: Nationwide data of Turkey

Bayram, Dilara; Vızdıklar, Caner; Aydın, Volkan; İşli, Fatma; Akıcı, Ahmet

doi:10.17826/cumj.681368

Cited by 3 publications

(5 citation statements)

References 51 publications

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“…According to the 2014 data of the Turkey Pharmaceuticals and Medical Devices Agency (TITCK), Prescription Information System, Family Physicians’ most often prescribed diagnosis to patients over 65 is “essential hypertension” ( 58 ). The most common diseases after hypertension (30.7%) in the elderly are osteoarthritis (20.4%), heart failure (13.7%), diabetes mellitus (10.2%), coronary artery disease (9.8%), and osteoporosis (8.2%) ( 59 ).…”

Section: Discussionmentioning

confidence: 99%

“…The most common diseases after hypertension (30.7%) in the elderly are osteoarthritis (20.4%), heart failure (13.7%), diabetes mellitus (10.2%), coronary artery disease (9.8%), and osteoporosis (8.2%) ( 59 ). The most commonly prescribed medicines by family doctors are non-steroidal anti-inflammatory drugs (NSAIDs), acetylsalicylic acid (ASA), lansoprazole, pantoprazole, and metoprolol, respectively ( 58 ). In a study conducted with 493 elderly patients in Turkey in 2020, the most common diagnoses of patients were hypertension, generalized anxiety disorder, diabetes mellitus, Alzheimer’s, and atherosclerotic heart disease.…”

Section: Discussionmentioning

confidence: 99%

“…The top 5 medicines most frequently used by the patients in the sample were ASA (52.4%), proton pump inhibitors (46.6%), hydrochlorothiazide (40.7%), metoprolol (30.7%), and quetiapine (27%), respectively. In a study conducted in Turkey, it was determined that the most frequently prescribed medicine by family physicians for elderly patients was systemic diclofenac, and 5 of the first 21 drugs were NSAIDs ( 58 ). When compared to the literature, the frequently used medicines were similar, and the rate of patients using NSAIDs in this sample group (9%) was found to be much less than in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…ASA usage was found to be high in this sample, similar to the literature. In the case of using ASA for primary prophylaxis, the potential benefit and harm should be decided by weighing it, and reviewing the indications of patients using ASA may provide rational drug use ( 58 , 60 ). Likewise, the rate of patients using PPI was found to be high, similar to the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Similar to the literature, it is observed that metoprolol usage is higher in elderly patients. In the absence of comorbidities such as heart failure or ischemic heart disease, it is not recommended to use beta-blockers as the first-line treatment for hypertension in the elderly ( 58 , 60 ). It is observed that the quetiapine usage rate of the patients in this sample is high.…”

Section: Discussionmentioning

confidence: 99%

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Artificial intelligence-supported web application design and development for reducing polypharmacy side effects and supporting rational drug use in geriatric patients

Akyon

Akyon²,

Yılmaz³

2023

Front. Med.

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IntroductionThe main complications of polypharmacy, which is known as the simultaneous use of more than five drugs, are potentially inappropriate medicines(PIMs), drug–drug, and drug-disease interaction. It is aimed to prepare an auxiliary tool to reduce the complications of polypharmacy and to support rational drug use(RDU), by evaluating the patient with age, drugs, and chronic diseases in this study.Materials and methodsIn the first phase of this study, as methodological research, an up-to-date and comprehensive auxiliary tool as a reference method was generated with a database containing interaction information of 430 most commonly used drug agents and chronic diseases in geriatrics in the light of current and valid 6 PIM criteria for geriatric patients, and medication prospectuses, relevant current articles, and guidelines. Then, an artificial intelligence(AI) supported web application was designed and developed to facilitate the practical use of the tool. Afterward, the data of a cross-sectional observational single-center study were used for the rate and time of PIM and drug interaction detection with the web application. The proposed web application is publicly available at https://fastrational.com/.ResultsWhile the PIM coverage rate with the proposed tool was 75.3%, the PIM coverage rate of EU(7)-PIM, US-FORTA, TIME-to-STOPP, Beers 2019, STOPP, Priscus criteria in the web application database respectively(63.5%–19.5%) from the highest to the lowest. The proposed tool includes all PIMs, drug–drug, and drug-disease interaction information detected with other criteria. A general practitioner detects interactions for a patient without the web application in 2278 s on average, while the time with the web application is decreased to 33.8 s on average, and this situation is statistically significant.DiscussionIn the literature and this study, the PIM criteria alone are insufficient to include actively used medicines and it shows heterogeneity. In addition, many studies showed that the biggest obstacle to drug regulation in practice is “time constraints.” The proposed comprehensive auxiliary tool analyzes age, drugs, and diseases specifically for the patient 60 times faster than the manual method, and it provides quick access to the relevant references, and ultimately supports RDU for the clinician, with the first and only AI-supported web application.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Artificial intelligence-supported web application design and development for reducing polypharmacy side effects and supporting rational drug use in geriatric patients

Akyon

Akyon²,

Yılmaz³

2023

Front. Med.

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Comparison of paracetamol and diclofenac prescribing preferences for adults in primary care

Bayram

Aydın

Sanli

et al. 2021

Prim Health Care Res Dev

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Introduction: The most frequently prescribed analgesic drugs in primary care centers in Turkey are diclofenac and paracetamol, respectively. In this study, we aimed to compare paracetamol-included prescriptions (PIP) and diclofenac-included prescriptions (DIP) generated for adult patients in primary care. Methods: In this cross-sectional study, PIPs (n = 280 488) and DIPs (n = 337 935) created for adults by systematic sampling among primary care physicians working in Istanbul in 2016 (n = 1431) were examined. The demographic characteristics, diagnoses, and additional drugs in PIPs and DIPs were compared. Results: Women constituted the majority in both groups (69.8% and 67.9%, respectively; P < 0.05), and mean age at PIP (52.6 ± 18.8 years) was lower compared to DIP (56.3 ± 16.1 years), (P < 0.05). In single-diagnosis prescriptions, 11 of the 15 most common diagnoses in PIP were respiratory tract infections (47.9%); three pain-related diagnoses formed 4.6% of all these prescriptions. In DIP, the number of pain-related diagnoses, mostly of musculoskeletal origin, was eight (28.5%); four diagnoses (7.8%) were upper respiratory tract infections. While hypertension was the third most common diagnosis in PIP (6.1%), it was ranked first in DIP (8.0%). The percentage of prescriptions with additional analgesic (14.0% versus 18.3%, P < 0.001), proton-pump inhibitor (13.8% versus 18.4%; P < 0.001), and antihypertensive (22.0% versus 24.8%, P < 0.001) was lower in PIP compared to DIP. However, the percentage of prescriptions with antibiotics (31.3% versus 14.7%, P < 0.001) was higher in PIP. Conclusion: Paracetamol appears to be preferred mostly in upper respiratory tract infections compared to the preference of diclofenac rather in painful/inflammatory musculoskeletal conditions. The presence of hypertension among the most commonly encountered diagnoses for these analgesic drugs points to challenges in establishing the diagnosing-treatment match and indicates potential irrational prescribing practice, especially for interactions.

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İlaç Tedavi̇si̇nde Heki̇mi̇n Sorumluluğu

Yalçınkaya,

Atalık

2024

Karatekin Hukuk Dergisi

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İlaç tedavisi günümüzde en sık kullanılan hastalık tedavi yöntemidir. İlaç sektörü ise devasa bütçelerin ayrıldığı bir sektör haline gelmiştir. İlaçların hastalıkların tedavisinde sıklıkla kullanılması ve aynı zamanda insan sağlığı için tehlikeliliği de göz önünde bulundurulduğunda ilaç tedavisinin çok dikkatli bir şekilde yapılması gerekmektedir. İlaç tedavisinin önemli süjelerinde birisi de hekimlerdir. Hekimler hastalığı teşhis etmekte, tedavi yöntemini belirlemekte ve belirlenen tedavi yöntemine uygun ilacı, bu ilacın dozajını ve uygulama yöntemini tespit etmekte ve bu hususları içeren reçete düzenlemektedir. Bu nedenle ilaçların hastaya vermiş olduğu zarar gündeme geldiğinde gerekli koşullarda oluşmuşsa hekimlerin de sorumluluğu söz konusu olmaktadır. İlaç tedavisinin tıbbi müdahalenin bir çeşidi olması nedeniyle tıbbi müdahalede aranan hukuka uygunluk şartlarının ilaç tedavisinde de aranması gerekmektedir. Tıbbi müdahalede yapılan hatalı uygulamalar hekimlerin sorumluluğuna neden olmaktadır. Hekimler hatalı ilaç tedavisi uygulamaları nedeniyle cezai olarak şahsen, hukuki olarak ise malvarlıkları ile sebep oldukları zararı tazminle yükümlüdürler. İlaçların insan sağlığı üzerindeki doğrudan etkisi düşünüldüğünde hekimlerin ilaç tedavisinde dikkat ve özen yükümlülüklerinden taviz vermemeleri gerekmektedir.

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Investigation of prescribing trends and prescriptions for common diagnoses in primary care: Nationwide data of Turkey

Cited by 3 publications

References 51 publications

Artificial intelligence-supported web application design and development for reducing polypharmacy side effects and supporting rational drug use in geriatric patients

Artificial intelligence-supported web application design and development for reducing polypharmacy side effects and supporting rational drug use in geriatric patients

Comparison of paracetamol and diclofenac prescribing preferences for adults in primary care

İlaç Tedavi̇si̇nde Heki̇mi̇n Sorumluluğu

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