ABSTRACT
Background: Prescription quality can be a direct predictor of the net outcome of a health care deliveryeffort. Quality of prescription may be considered as a cumulative matrix of multiple components of aprescription on the basis of their relative importance. Prescription quality index is a recognized tool inclinical medicine for multiple purposes including the prediction of health care intervention outcome.Objectives: Considering the importance of prescription quality among every system of medicine, anattempt was made to design a prescription quality index for Ayurveda.Materials and methods: The Prescription Quality Index for Ayurveda was designed through item selectionfollowing a thorough literature search and was validated through multiple peer group discussions. Finaldraft of index containing 38 individual items carrying different scores as per their importance in theprescription was subjected to a pilot test upon 1576 indoor prescriptions generated in 2015 at StateAyurvedic College Hospital, Lucknow.Results: The study revealed large information gaps in the components of the prescription where it wassupposed to be noted by the prescribers. These gaps in the Ayurvedic prescriptions were most significantin the areas pertaining to Ayurvedic fundamentals of clinical examination, disease diagnosis and Ayurvedic drug intake methods.Conclusion: Prescription Quality Index for Ayurveda was found useful in underlining the gaps betweenthe ideal and generated prescriptions. This can be utilized as a useful tool to evaluate the quality ofAyurvedic prescriptions by seeing their adherence to the standard prescription template.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
ABSTRACT
Introducción: el uso inadecuado de los medicamentos supone un importante problema sanitario y económico, más sensible en el caso de los niños, ancianos y las embarazadas. Existen una gran diversidad de medicamentos y sobre muchos de ellos no se tiene un criterio definitivo de su inocuidad, por lo que la información disponible para la prescripción de fármacos en mujeres embarazadas, es muy escasa. Objetivo: evaluar la calidad en el uso racional de antimicrobianos en las gestantes ingresadas en el Hogar materno Doña Leonor Pérez Cabrera durante el período 2007- 2009. Métodos: este trabajo constituye un estudio de utilización de medicamento del tipo indicación prescripción, retrospectivo y descriptivo. Se revisaron las historias clínicas y se obtuvieron las variables biosociales edad materna, edad gestacional al ingreso, ocupación, diagnóstico que precisó el uso de antimicrobianos, forma de diagnóstico más utilizado así como los antimicrobianos más prescritos. Resultados: a través del análisis de las variables y de los esquemas terapéuticos se pudo evaluar la calidad de la prescripción de los antimicrobianos. Los resultados obtenidos permitieron constatar que predominaron las gestantes con edades entre 21 y 30 años, con edades gestacionales al ingreso entre 21 y 30 semanas y trabajadoras. La patología que mayormente motivó la utilización de antimicrobianos fue la sepsis vaginal, diagnosticada de forma clínica en casi la totalidad de los casos y los antimicrobianos más prescritos fueron la azitromicina, metronidazol, clotrimazol y nistatina. Conclusiones: con excepción de algunos antimicrobianos prescritos, la calidad de la prescripción en su mayoría resultó adecuada, la efectividad del tratamiento en su mayor parte fue buena y en general el uso racional de los antimicrobianos clasificó como alta y aceptable
Introduction: the misuse of drugs is a major health and economic problem, which is more sensitive in the case of children, the elderly and pregnant women. There is a great variety of medications and many of them do not have a definitive view of their safety, so the available information for prescription of drugs in pregnant women is poor. Objective: to assess quality in the rational use of antimicrobials in pregnant women admitted to Doña Leonor Perez Cabrera home for pregnant women during the 2007 to 2009 period. Methods: retrospective and descriptive, indication-prescription type study of drug use. The review of medical records allowed the study of social variables such as maternal age, gestational age on admission, occupation, diagnosis requiring the use of antimicrobials, most commonly used form of diagnosis and the most prescribed antimicrobials. Results: through the analysis of the variables and of treatment regimens, it was possible to evaluate the quality of prescribing antimicrobials. The results led to evidence that pregnant women aged 21 to 30, with gestational ages on admission between 21 and 30 weeks and working women predominated. The pathology that primarily motivated the use of antimicrobials was clinically diagnosed vaginal sepsis in almost all the cases and the most prescribed antimicrobials were azithromycin, metronidazole, clotrimazole and nystatin. Conclusions: the prescribing quality was generally adequate, the effectiveness of treatment was good and the rational use of antimicrobials was rated as high and acceptable