Last update:
29-Sep-2000

Arch Hellen Med, 17(1), January-February 2000, 44-51

ORIGINAL PAPER

Drug prescribing in Primary Health Care I. The antimicrobials

N. ANTONAKIS,^1,2 N. TSAKOUNTAKIS,¹ S. TSOULOU,¹ M. PHILIPPAKI,¹ C. LIONIS^2
1Health Center of Anogia, Crete,
²Clinic of Social and Family Medicine, Department of Social Medicine,
University of Crete, Greece

OBJECTIVE To investigate aspects of the issue of medication prescribing and specifically the prescription of antimicrobial agents at the Anogia Health Center (AHC).
METHOD From a total of 25,350 prescriptions in the medical facilities of AHC during 1998, 12,500 were randomly selected and stored as computerized data. Analysis was made according to the distribution among the various health insurance organizations, the month of prescribing and the major drug categories as included in the last edition of the National Formulary. Anti-infective agent use was examined and the findings were correlated with those of previous Greek and foreign medical reports.
RESULTS The Agricultural Insurance Organization (AIO) covered 78% of the selected prescriptions. There was a statisticaly significant reduction in the number of drugs prescribed during the winter (P<0.001), and 61% of the prescriptions were for drugs given for CNS, musculoskeletal and cardiovascular disorders and anti-infective agents. Of the selected prescription 14.5% contained drugs against infection, 69.1% of which were antimicrobials. In contrast with previous studies macrolides were prescribed more commonly than β-lactames. Antistaphylococcal penicillins, quinolones and 3rd or 4th generation cephalosporins had been favoured less as the physicians’ therapeutic choices. Most of the antimicrobials were prescribed during the winter (P<0.001).
CONCLUSIONS The AIO plays major role in the State’s efforts to deal with the problem of excessive drug prescribing in primary health care, which is more marked during the summer and leads to drug overuse and waste of State money and resources. The State strategy must focus first on the drugs most often prescribed and intervene later with more complicated issues such as nurses’ involvement in prescribing, repeated prescriptions etc. Antimicrobial overuse still persists, although it is not as frequent as in the past.

Key words: Drugs, Formula, Medication, Prescription, Primary Health Care.