Prescribing patterns in primary health care in Taiwan

To identify the prescribing patterns in public group practice centers (GPCs), 84,453 prescription sheets written by primary care physicians in 168 GPCs during the period from December 7-12, 1992, were collected and analyzed. The average number of drugs per script was 4.3 and the ratio of drug to total medical expense was 44%. The 5 most common diagnoses were, in a descending order, upper respiratory tract infection, skeletomuscular and joint disease, hypertension, functional gastrointestinal disorder (including peptic ulcer) and diabetes mellitus. The top 5 most commonly dispensed drug categories were antacids and anti-ulcer drugs, anti-cough and anti-cold preparations, vitamins, simple analgesics and non-steroidal anti-inflammatory drugs, accounting for 48.8% of total prescriptions. In view of the frequency of relevant diagnoses, the overuse of antacids, vitamins, intravenous nutrient and electrolyte solutions, anti-cold preparations and antibiotics was apparent, as was that of drugs of questionable pharmacological value. These data indicate that polypharmacy is a widespread phenomenon and confirms our long-term concern over irrational drug use in GPCs in Taiwan. Both administrative and educational intervention should be implemented to improve prescribing quality at the primary health care level.