Assessment of Health Care Service in terms of Rational Use of Medicines Delivered to Patients in Primary Health Care Centres and Public Hospitals
Objective: To assess physicians’ and patients’ attitudes about the therapy in terms of rational use of medicines (RUM) contributes to the elimination of problems. This study evaluated the health care service in terms of RUM delivered to patients in primary and secondary health care centres.
Method: A questionnaire was applied to a total of 4470 patients from primary health care centres (PHCs) and public hospitals (PHs) in 12 provinces of Turkey. Briefly, patients’ knowledge, attitude and experiences about RUM were questioned and answers were compared with socio-demographic characteristics.
Results: Of the patients, 72.8% in PHCs, 89.9% in PHs reported that they had physical examination. The number of patients who had physical examination decreased with increasing age and low educational level (p<0.001). Although the examination time was “≤5 minutes” for 40.5% of the patients, 74.1% of them in PHCs, 50.1% in PHs reported that they were “definitely” satisfied with the allocated examination time. Eleven per cent of the patients stated that they did not know “how to use their drugs on prescription” and 45.4% reported that “the information given by physicians about their drugs was partly enough or not enough”. Patients stated that waiting time for examination was 13.5±14.2 minutes in PHCs and 45.3±50.5 minutes in PHs.
Conclusion: In contrast to patients’ general satisfaction in health care services, some problems were detected about the examination time and waiting time for examination, informing patients about their drugs. Even though, these problems seem to be derived from physicians, the effects of infrastructural inadequacies and other reasons should be examined with further studies.
References
- World Health Organization (WHO). Promoting Rational Use of Medicines: Core Components. World Health Organization (WHO). Promoting rational use of medicines: core components. WHO Policy Perspectives on Medicines, Geneva, 2002. http://apps.who.int/medicinedocs/pdf/h3011e/h3011e.pdf. adresinden 19/03/2015 tarihinde erişilmiştir.
- Akıcı A. “Akılcı ilaç kullanımı”. T.C. Sağlık Bakanlığı Sağlık Araştırmaları Genel Müdürlüğü Yayını. 1. baskı. Ankara, 2013;31-74;155- 162.
- De Vries TPGM, Henning RH, Hogerzeil HV, Fresle DA. Guide to Good Prescribing. WHO/Action Programme on Essential Drugs, Geneva, 1994. [İnternet]. http://apps.who.int/medicinedocs/pdf/ whozip23e/whozip23e.pdf. adresinden 19/03/2015 tarihinde erişilmiştir.
- Akıcı A, Uzuner A. “Birinci Basamak Sağlık Kurumlarında Çalışan Hekimlere Yönelik Akılcı İlaç Kullanımı”. (ed) Akıcı A. T.C. Sosyal Güvenlik Kurumu Başkanlığı, 1.baskı. Ankara, SGK Yayın No:112. 2013;26-93.
- Akıcı A, Kalaça S. “Topluma Yönelik Akılcı İlaç Kullanımı”. (ed) Akı- cı A, T.C. Sosyal Güvenlik Kurumu Başkanlığı, Ankara, SGK Yayın No:93. 2013;40-55.
- Holloway K, van Dijk L. The World Medicines Situation 2011-Rational Use of Medicines. WHO, Geneva, 2011. http://apps.who.int/medicinedocs/documents/s18064en/s18064en.pdf adresinden 19/03/2015 tarihinde erişilmiştir.
- Akıcı A. Akılcı Tedavi sürecinde hekimlere yol gösterecek pratik yaklaşımlar. Turkish Family Physician 2013;4(2):1-7.
- T.C. Sağlık Bakanlığı, Refik Saydam Hıfzıssıhha Merkezi Başkanlığı, Hıfzıssıhha Mektebi Müdürlüğü. Toplumun Akılcı İlaç Kullanımına Bakışı. (ed) Akdağ R. 1.Baskı. Sağlık Bakanlığı Yayın No: 856, Ankara; 2011;1-84.
- Kaya ÇA, Akıcı A. Birinci Basamakta Yaşlılarda İlaç Kullanımı İlkeleri. “Aile Hekimleri için Yaşlı Sağlığına Bütüncül Yaklaşım” içinde. (ed) Çifçili S. 1.baskı. Deomed Yayıncılık, İstanbul, 2011;115-25.
- Oktay Ş, Akıcı A. Yaşlılarda ilaç kullanımı ve rasyonel farmakoterapi kararı verme süreci. Geriatri 2001;4(3):127-33.
- Akici A, Kalaça S, Uğurlu MÜ, Karaalp A, Çali Ş, Oktay Ş. Impact of a short postgraduate course in rational pharmacotherapy for general practitioners. Br J Clin Pharmacol 2004;57(3):310-21.
- Örün E, Yalçın SS, Yurdakök K. Akut solunum yolu enfeksiyonu ile getirilen çocuklara Dünya Sağlık Örgütü kriterlerine göre hekim yaklaşımı. Çocuk Sağlığı ve Hastalıkları Dergisi 2007;50:16-24.
- Irving GJ, Holden J. 15 Minute consultations as standard benefit patients and GPs. BMJ 2012;344:e3704.
- Vançelik S, Çalıkoğlu O, Güraksın A, Beyhun E. Pratisyen hekimlerin reçete yazımını şekillendiren faktörler ve akılcı ilaç kullanım kriterlerini önemseme durumları. AÜTD 2006;38:7-12.
- Şensoy N, Özmen A, Doğan N, Ercan A, Karabekir HS. Afyonkarahisar il merkezinde birinci basamak sağlık hizmetlerinde hasta memnuniyeti araştırması. J Clin Anal Med 2014;5(1):29-34.
- Basaran NF, Akici A. Patients’ experience and perspectives on the rational use of drugs in Turkey: a survey study. Patient Prefer Adherence 2012;6:719-24.
- Petek Ster M, Svab I, Zivcec Kalan G. Factors related to consultation time: experience in Slovenia. Scand J Prim Health Care 2008;26(1):29-34.
- Howie JG, Heaney DJ, Maxwell M, Walker JJ, Freeman GK, Rai H. Quality at general practice consultations: cross sectional survey. BMJ 1999;319(7212):738-43.
- Akici A, Kalaça S, Gören MZ, et al. Comparison of rational pharmacotherapy decision-making competence of general practitioners with intern doctors. Eur J Clin Pharmacol 2004;60(2):75-82.
- Brown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc 2011;86(4):304-14.
- Karaalp A, Akıcı A, Kocabaşoğlu Y E, Oktay Ş. What do the graduates think about the two-week rational pharmacotherapy course in the fifth year of medical education? Medical Teacher 2003;25(5):515-21.
- Akici A, Gören MZ, Aypak C, Terzioğlu B, Oktay S. Prescription audit adjunct to rational pharmacotherapy education improves prescribing skills of medical students. Eur J Clin Pharmacol 2005;61:643-50.
- Ross S, Loke YK. Do educational interventions improve prescribing by medical students and junior doctors? A systematic review. Br J Clin Pharmacol 2009;67(6):662-70.
- Kamarudin G, Penm J, Chaar B, Moles R. Educational interventions to improve prescribing competency: a systematic review. BMJ Open 2013;3(8):1-18.