Abstract
Background: The World Health Organization (WHO) aims to promote strategies that ensure efficacy, safety, suitability, and
cost-effectiveness of medicine prescription. Health systems should design effective mechanisms to monitor prescription
and rational use of medicines at all healthcare settings. This study aimed to determine and analyze prescription patterns
of general practitioners and specialists in Kerman/Iran from 2005 to 2015.
Methods: This is an explanatory mixed method study. Data were gathered during two phases. At the first phase,
prescriptions issued by physicians during 2005-2015 were reviewed to extract information required to develop eight main
prescription indicators. In the second phase, the indicators trends were presented to experts participating in expert panel
to have their opinions and analyses on the data obtained in the first phase. Experts were selected based on their experience
and expertise in medicine and/or health policy and/or experience in implementation of polices to promote rational use of
medicines. Some experts attending the panel were a sample of physicians whose prescriptions were included in the first
phase.
Results: Findings revealed that two indicators of the average price of prescriptions and the maximum number of medicines
in each prescription had an increasing trend over the study period. Reasons including unprecedented devaluation of the
Iranian Rial and willingness of young physicians to prescribe more medications were proposed as the primary contributors
to the observed increasing trends. However, other indicators including types of prescribed medicines, average number of
medicines per prescription, the percentage of prescriptions with more than four medications, a percentage of encounters
with a corticosteroid prescribed, a percentage of encounters with an antibiotic prescribed, and a percentage of encounters
with an injection prescribed decreased in the study period. Reasons of controlling initiatives adopted by the Ministry of
Health, the higher responsibility of physicians, adoption of continued medical education (CME) programs, and improved
knowledge of pharmacists, physicians, and patients about irrational use of medicines were proposed by participants as the
main reasons for the decreasing trend.
Conclusion: Findings indicated that prescription indicators were better in Kerman than those of country average over
the study period based on comparing the results of this study and others in Iran. However, they were non-desirable when
compared to the international average. The number of factors contributes to the irrational use of medicines, including lack
of knowledge among healthcare providers and patients, patients’ misunderstanding about the efficacy of some particular
medicines, the high cost of drug development and manufacturing, and unavailability of effective medicines