Audit of prescribing patterns in Saudi primary health care: What lessons can be learned?

The prescription of drugs is one of the most important factors in the rising costs of health services. The lack of proven benefit, and the definite cost and side effects of many prescriptions, have been found in many studies. The aim of the present study is to assess the prescribing pattern of primary health care (PHC) physicians in Riyadh city, the capital of Saudi Arabia.

Prescriptions issued from eight PHC centers over two weeks (six months apart) were analyzed. The health centers were randomly selected to represent the geographical parts of Riyadh city.

A total of 17,067 prescriptions were analyzed. The most frequently prescribed drugs were antihistamines (25%), paracetamol (20.3%) and antibiotics (14.7%). Upper respiratory tract infection (URTI) was the diagnostic label used on more than half of the prescriptions. On the other hand, drugs for chronic illnesses such as diabetes mellitus (DM) and hypertension were written in a minority of the prescriptions. Antibiotics were prescribed for 26% and antihistamines for 28% of patients with URTI. Although it is well known that a large proportion of patients seen in PHC have a significant psychological or psychiatric disorder, no diagnoses of mental disorders were made.

There is a pressing need for education of both patients and doctors regarding the benefit of treatment and control of chronic illnesses, and the limited contribution that the doctor or an antibiotic can make to many self-limiting conditions like URTI. Doctors should be educated on more appropriate and cost-effective prescribing. The detection and management of psychological disorders need special emphasis.