[Use of drugs in a medical polyclinic]

The medical prescriptions of 18 house officers working at the Policlinique Universitaire de Médecine in Geneva were analyzed for a period of 17 working days and provide insight into drug therapy chosen for 2194 outpatients at 2694 consultations. These patients were prescribed an average of 1.39 drugs each or 1.13 per call. Of the 298 different drugs thus prescribed, the following were chosen most frequently (in decreasing order): Digoxin, Hygroton, Lexotanil, Metamucil, Voltaren, Aspirin, different insulins and Aldomet. Antimicrobial agents accounted for only 2.5% of all prescriptions, while vitamins and "fortifiers" represent an even lower percentage. It would be possible to limit the number of drugs, since half of the prescriptions cover 23 drugs and 90% of all prescriptions cover 119 drugs. Prescription patterns vary markedly from one subspecialty of internal medicine to another, but also between physicians working in the same field. House officers in charge of given sectors of the city (internists not working in a subspecialty) may thus prescribe between 1,83 and 2.9 drugs per patient, whereas the number of drugs chosen may vary between 81 and 134. Some quaint individual preferences for drugs were also noted and the trend is analyzed. The data is compared with results of the few existing similar studies and offers food for thought on prescription habits, directed ultimately towards a more rational approach to drug therapy for outpatients.