Evaluation of drug prescribing pattern among pregnant women attending antenatal clinic at the 34 military hospital, Freetown, Sierra Leone

Background: Management of medical conditions in pregnancy is a challenge to clinicians. As a result, clinicians are faced with a quagmire in making evidence-based therapeutic decisions regarding patient management. No study has been conducted in Sierra Leone to determine drug prescription patterns among pregnant women.

Objective: This study assessed the prescribing pattern of drugs among pregnant women who attended antenatal care clinic at the 34 Military hospital in Freetown from May 1st, 2019 to October 31st, 2019.

Methods: A hospital-based cross-sectional retrospective study was conducted by reviewing medical charts of 314 pregnant women who attended antenatal clinic at the study site. The cases selected by simple random sampling were women who encountered at least one drug prescribed during their visit. The World Health Organisation (WHO) prescribing indicators and the United States Food and Drug Administration (FDA) pregnancy risk classification of medicines were used to assess drug prescribing patterns and contraindication in pregnancy respectively.

Results: Excluding minerals and vitamins, 99 (31.5%) of pregnant women from the 314 sampled for this study received at least one drug. Multivitamins/minerals 216 (40.3%) were the most frequently prescribed medicines. The average number of drugs prescribed per encounter was 1.7 with an index of polypharmacy of 0.86. The percentage encounters with an antibiotic and injection prescribed and drugs prescribed by generic names were 27.4%, 11.1%, and 40.0% respectively. About 221 (41.2%) of the drugs prescribed were from the FDA category A. No drug was prescribed from category X.

Conclusions: The prescribing pattern among prescribers was relatively rational, as three of the indicators met the WHO standard, with room for more improvement. The occurrence of contraindicated medicines was low as a high proportion of drugs were prescribed from FDA category A

背景：妊娠期疾病的临床管理对临床医师而言是一项棘手挑战。临床医师常陷入两难困境，难以基于循证依据制定患者诊疗的合理治疗决策。目前塞拉利昂尚未开展针对孕妇药物处方模式的相关研究。

目的：本研究针对2019年5月1日至2019年10月31日期间，于弗里敦第34军区医院产前保健门诊就诊的孕妇，评估其药物处方模式。

方法：本研究采用基于医院的横断面回顾性研究设计，通过回顾研究地点314名产前门诊就诊孕妇的病历资料开展研究。采用简单随机抽样法选取研究对象，纳入标准为就诊期间至少被开具1种药物的孕妇。本研究分别采用世界卫生组织（World Health Organisation, WHO）处方指标及美国食品药品监督管理局（United States Food and Drug Administration, FDA）妊娠药物风险分级，对药物处方模式及妊娠期用药禁忌情况进行评估。

结果：排除矿物质与维生素类药物后，本次抽样的314名孕妇中，有99名（31.5%）至少接受过1种药物治疗。多维生素/矿物质制剂（共216例次，占比40.3%）为最常开具的药物。单次就诊的平均处方药物数量为1.7种，多重用药指数为0.86。开具抗生素、注射剂以及采用通用名开具的药物对应的就诊占比分别为27.4%、11.1%及40.0%。所开具的药物中约221种（41.2%）属于FDA妊娠风险A级，无药物属于X级。

结论：本次研究涉及的处方行为整体较为合理，其中3项指标符合世界卫生组织（WHO）标准，仍存在进一步优化空间。妊娠期禁忌用药的发生率较低，绝大多数开具的药物均属于FDA妊娠风险A级。

搜集汇总

背景与挑战

背景概述

该数据集研究了塞拉利昂弗里敦34军事医院孕妇的用药模式，基于2019年5月至10月的回顾性横断面数据，分析了314名孕妇的医疗记录。研究发现，31.5%的孕妇至少接受一种药物（排除矿物质和维生素），多维生素/矿物质是最常见处方药，平均每张处方开1.7种药物，且大多数药物属于FDA A类低风险类别，无高风险X类药物，表明处方模式相对合理但仍有改进空间。