Skip to main content

Free Content Cotrimoxazole prescribing by dispensing and non-dispensing doctors: do they differ in rationality?

Download Article:

You have access to the full text article on a website external to Ingenta Connect.

Please click here to view this article on Wiley Online Library.

You may be required to register and activate access on Wiley Online Library before you can obtain the full text. If you have any queries please visit Wiley Online Library

Abstract:

Summary background 

Dispensing doctors (DDs) have been found to prescribe significantly more drugs, more injections and more antibiotics per patient than non-dispensing doctors (NDDs). However, the rationality of prescription in relation to diagnoses and symptoms has not been studied. objectives 

To identify and assess differences in the rationality of cotrimoxazole prescription by DDs and NDDs evaluated by drug choice and dosage in relation to diagnoses and symptoms. methods 

Cohort study of 28 private sector DDs and 25 NDDs in Zimbabwe, using retrospective data from 688 patient records. Drug choice and dose in relation to the recorded diagnoses and symptom(s) were assessed. A new method was developed and tested to measure rationality in a specific and realistic way. A ‘correctness-score list’ was developed based on a panel of four evaluators assessing the rationality of cotrimoxazole prescription in relation to diagnoses and symptoms. This list was then used as a reference for the assessment. results 

The two groups of prescribers did not differ significantly with respect to rationality of drug choice. Both DDs and NDDs prescribed cotrimoxazole to patients for diagnoses and symptoms for which cotrimoxazole could not be justified (41.4%vs. 43.5%). DDs compared with NDDs used subcurative doses more often (26.4% of the encounters compared with 11.7%; P = 0.035) and correct doses less frequent (58.0% compared with 72.6%; P = 0.047). conclusion 

The prescription of cotrimoxazole by both DDs and NDDs was widely irrational. They prescribed cotrimoxazole too frequently, and DDs used subcurative doses to a wider extent. By this prescribing practice, both groups, but especially the DDs, contribute to increasing health hazards, cost and risk of developing bacterial resistance. The method for assessing rationality of drug prescribing was found feasible, and it is recommended that it be further tested and developed.

Keywords: Zimbabwe; cotrimoxazole; dispensing doctors; dosage; prescription practice; rational prescribing

Document Type: Research Article

DOI: https://doi.org/10.1046/j.1365-3156.2002.00923.x

Affiliations: Royal Danish School of Pharmacy, Department of Social Pharmacy, Copenhagen, Denmark

Publication date: 2002-10-01

  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more