The impact of the National Essential Medicines Policy on prescribing behaviours in primary care facilities in Hubei province of China
The impact of the National Essential Medicines Policy on prescribing behaviours in primary care facilities in Hubei province of China
复制标题
国家基本药物政策对湖北省基层医疗机构处方行为的影响
DOI：
10.1093/heapol/czs116
复制
发表时间：
2013-10-01
影响因子：
3.2
通讯作者：
Zhang, Xinping
中科院分区：
文献类型：
--
作者：
Yang, Lianping;Liu, Chaojie;Zhang, Xinping
研究设计准实验设计和时间趋势分析。方法采用系统的随机抽样策略从2009年1月至2011年7月逐步实施NEMP的18个初级保健组织的55 800处方。我们检查了处方模式的变化。在后来阶段实施NEMP的设施是控制的。立即增加了对所有规定的药物的基本药物的摄取，最终接近95％。总共有38151个处方（68％）涉及抗生素，我们发现NEMP干预后没有减少抗生素。通过肠胃外途径施用了高百分比（59-66％）的处方药，并且在NEMP干预后未发现降低。尽管每次处方药的平均数量保持不变（近四个），但在NEMP干预措施后，每张处方的平均成本显着下降（Yen 44.67 vs Yen 26.67 CNY，P <0.03）。结论NEMP干预措施降低了平均每张处方成本；但是，抗生素和不必要的肠胃外施用的非理性使用仍然很普遍。 NEMP的目标是部分实现的；因此，我们建议一种涉及所有利益相关者的战略方法，以全面实现所有愿望。
Study design Quasi-experimental design and time-trend analysis.Methods A systematic random sampling strategy was employed to select 55 800 prescriptions from 18 primary care organizations who progressively implemented the NEMP from January 2009 to July 2011. We examined the change of patterns of prescriptions. The facilities that implemented the NEMP at a later stage served as control.Results An immediate increased uptake of essential medicines of all drugs prescribed which ultimately neared 95%. In total, 38 151 prescriptions (68%) involved antibiotics, and we found no evidence of reduction after the NEMP interventions. A high percentage (59-66%) of prescription drugs were administered through parenteral routes and no reduction was found after the NEMP interventions. Although the average number of medicines per prescription remained unchanged (nearly four), the average cost per prescription declined significantly after the NEMP interventions (yen 44.67 vs yen 26.67 CNY, P < 0.03).Conclusions The NEMP interventions reduced the average cost per prescription; however, the irrational use of antibiotics and unnecessary parenteral administration remains prevalent. The goals of the NEMP are partially achieved; we therefore recommend a strategic approach involving all stakeholders to comprehensively achieve all aspirations.