Abstract

LOPES, Rita; YAPHE, John  and  RIBAS, Maria José. Psychotropic medication prescribing in primary care in Porto: a cross-sectional study. Rev Port Med Geral Fam [online]. 2014, vol.30, n.6, pp.368-376. ISSN 2182-5173.

Purpose: To characterize antidepressant and anxiolytic drug prescribing in primary care in Porto using a prescription registry and to analyze the variables that may be associated with psychotropic prescription. Study design: Cross-sectional Setting: Primary health care units, West Porto, Portugal. Participants: Family physicians. Methods: Data was collected using the SIARS© database, including all electronic prescriptions issued in primary care in 2009. Variables analyzed related to the physician (gender, age, number of patients and number of weighted patient units) and the health unit (type and population morbidity indicators, patients without a permanent doctor). The most frequently prescribed drugs in each group, fluoxetine and alprazolam, were studied by amount prescribed (defined daily dose per thousand patients per day - DUD) and costs. Descriptive analysis, qui-square, non-parametric Kruskal-Wallis tests and Spearman correlation were used. Significance level was set at p<0.05. Results: There were no associations found between prescription profiles and the personal characteristics of the doctor or characteristics of the health unit. The prescribing patterns of the 95 doctors from 12 health units showed considerable variability (for alprazolam DUD: mean=19.7, standard deviation (SD)=9.3, minimum=5.1, maximum=60.8; for fluoxetine DUD: mean=9.2, SD=4.4, minimum=0.7, maximum=28.4). High prescribers of alprazolam (above the 95th percentile), prescribed around 5 times more than lower prescribers (below the 5th percentile). The same was found regarding fluoxetine prescribing. Most doctors prescribed 60 tablets of alprazolam at a time. Conclusion: Results are comparable to other studies, reinforcing the potential of using the available SIARS© tool to study prescriptions. The observed variability highlights the necessity to adapt SIARS© to the internationally recognized unit, number of DUD, that will allow meaningful comparisons and quality development measures.

Keywords : Family Physicians; Drug Prescriptions; Psychotropic Drugs.

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