| Abstract |
Background: The prescription of medicines is a fundamental component of the care of people, and optimization of drug prescribing for patients has increasingly become a crucial public-health issue worldwide.
Aim: This study serves two separate objectives: explore and critically appraise the current literature on interventions aiming at rational prescribing / provision by General Practitioners / Family Practitioners (GPs / FPs) or pharmacists and at improving misuse or inappropriate use of Over-The-Counter drugs (OTCs) by patients.
Study Design: Systematic Review of literature based on the PRISMA and CONSORT statements.
Methods: The electronic search was conducted during November and December 2010 in two different databases: PubMed (http://www.pubmed.com/) and the Cochrane Library (http://www.cochrane.org/) from 1978 to December 2010. The selection criteria were: English language; purely quantitative research studies, randomized controlled trials or non-randomized interventions implemented within primary care settings and addressing primary care practitioners or pharmacists or patients. The extraction of the data was based
Δημόσια Υγεία & Διοίκηση Υπηρεσιών Υγείας
Τμήμα Ιατρικής – Πανεπιστήμιο Κρήτης
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on the predefined tool of the CONSORT statements and the reporting of the systematic review was based on the PRISMA.
Results: The search strategy yielded 768 citations, 115 of which were retrieved in full text on the basis of title and abstract. Of the 115 papers reviewed fully, 92 were excluded on the basis of the preset criteria. Of the final 23 included publications, 14 full-text papers were retrieved from the PubMed database and 9 full-text papers were retrieved from the Cochrane Library database. Fourteen of the included studies reported significant results in improving on prescribing practices within the intervention groups within the framework of general medicine and Primary Health Care. Nine of the studies reported no change or no significant differentiation in improving on prescribing practices. Also, only two of the included studies examined the use and consumption of Over-The-Counter (OTC) drugs, of which only one is reported to be effective.
Conclusions: Most of the studies evaluated the effectiveness of the intervention towards the improvement of prescription patterns in general practice and in Primary Health Care (PHC). From a clinical research perspective, further robust evidence is currently needed regarding the risks of prescribing / provision and of the use of OTCs. Future trials complemented from well-designed feasibility studies, by employing evidence-based methodology, could address this serious public-health issue. From an interventional and healthcare research perspective, even though our data provides useful insights into the effectiveness of interventions in rational prescribing and the OTCs use in PHC, several questions remain unanswered and merit the attention of practitioners, researchers and policy-makers alike.
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Η αποτελεσματικότητα παρεμβάσεων που αφορούν συνταγογραφικές πρακτικές και τη χρήση των μη συνταγραφουμένων φαρμακευτικών σκευασμάτων φαρμάκων (over-the-counter drugs):συστηματική ανασκόπηση της διεθνούς βιβλιογραφίας
