Polypharmacy and patterns in drug prescribing at a primary healthcare centre in the Riyadh region of Saudi Arabia

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To elucidate the various patterns in drug prescribing in a non-Ministry of Health-affiliated primary healthcare centre model (Riyadh Kharj Military Hospital) in Saudi Arabia. A retrospective analysis of pharmacy records of the Riyadh Kharj Military Hospital was undertaken. A total of 4781 prescriptions archived over a period of 6 months (January-June 2001) were statistically analysed using Statistical Package for the Social Sciences (SPSS). Number, types, therapeutic duration and distribution of drugs were evaluated. Age distribution and documentation adequacy were also reviewed and monitored. Therapeutic classification of drugs was carried out according to the British National Formulary system. Of the total prescriptions, 47.8% were for male patients and 50.1% for females. Prescriptions for the paediatric population accounted for 19.5% whereas 13.7% of drugs were prescribed to the geriatric cohort. A mean of 2.7±1.6 drugs were prescribed per patient. In multidrug prescriptions, 32.3% contained two drugs and 22.1% prescriptions had four drugs or more. Mono-drug prescriptions accounted for 21.6% of prescriptions. Paracetamol (13.9%) was the most commonly prescribed drug followed by multivitamins and cough syrups with 5.0 and 3.7%, respectively. The most common therapeutic classes of drugs prescribed were analgesics, antipyretics, antihistamines, and vitamins and minerals, making up a third of all prescriptions. Dosage form, dose and routes of administration were not present in 21.7, 8.8 and 99.6%, respectively. Polypharmacy appears to be a problem in primary health care, which requires stricter pharmacovigilance and constant reviewing. We recommend the establishment of an efficient local prescribing policy through an effective practice-based Pharmacy and Therapeutic Committee, training in prescribing to be introduced in medical schools and the lending of support to continuous education programmes targeting prescribing skills.