Use of Drugs Subject to Controlled Prescriptions: a Retrospective Analysis

TLDR: It is demonstrated that utilization of CDs shows demographical and institutional differences, which could be of help to improve surveillance of CDs as well as to train prescribers and patients.

Abstract: Objective: Use of drugs that may lead to abuse or dependence are subject to controlled prescriptions (CPs) in many countries, and these are closely monitored by health authorities. According to national regulations in Turkey, CPs may be red coloured (RCPs) or green coloured (GCPs). The aim of this study was to evaluate the use of such drugs in Istanbul. Study Design: Retrospective case-control study. Material and Methods: During the study period (01/01-31/12 2009), 502874 CPs were reported. Among these, 4000 CPs each month were randomly selected and evaluated. Results: The majority of GCPs were issued to women (55.6%), while the majority of RCPs were issued to men (68.4%). GCPs were most frequently prescribed by physicians working in private hospitals (33.6%) while RCPs by physicians working in university hospitals (39.7%). GCPs were mostly prescribed by psychiatrists (37.6%) while for RCPs were child and adolescent psychiatrists (35.9%). Psycholeptics (ATC code N05) were the most prescribed controlled drugs (CDs) (43.8%). Methylphenidate (53.9%) was the mostly prescribed on RCPs and alprazolam (39.6%) was on GCPs. Conclusion: We demonstrate that utilization of CDs shows demographical and institutional differences. These data could be of help to improve surveillance of CDs as well as to train prescribers and patients. Turkish Baslik: Kontrole Tabi Ilaclarin Kullanimi: Retrospektif Bir Calisma Anahtar Kelimeler: Kontrole tabi receteler, Kontrole tabi ilaclar, Narkotikler, Psikotrop ilaclar, Kirmizi ve Yesil receteler Amac: Kotuye kullanilma ya da bagimliliga yol acma riski tasiyan ilaclar pek cok ulkede kontrole tabidir ve kullanimlari saglik otoriteleri tarafindan yakindan izlenmektedir. Turkiye'deki ulusal duzenlemelere gore, cogu kontrole tabi ilac (KTI) kirmizi recete (KR) ya da yesil recete (YR) formatinda islem gormektedir. Calismada, Istanbul'da bu formatta islem goren KTI'lerin kullaniminin arastirilmasi amaclanmistir. Gerec ve Yontemler: Calisma periyodu boyunca (01/01-31/12 2009), 502 874 kontrole tabi recete (KTR) Istanbul Saglik Mudurlugu'ne ulastirilmistir. Bu receteler arasindan, her ay icin rastgele secilen 4 000 KTR arastirmada incelenmistir. Bulgular: YR'lerin daha cok kadinlara (%55.6), KR'lerin daha cok erkeklere (%68.4) yazildigi saptandi. YR'lerin en sik ozel hastanelerde (%33.6), KR'lerin en sik universite hastanelerinde (%39.7) yazildigi saptandi. YR'lerin en fazla psikiyatri (%37.6), KR'lerin en fazla cocuk ve ergen psikiyatrisi (%35.9) uzmanlari tarafindan yazdigi saptandi. Psikoleptiklerin (ATC kodu: N05), (%43.8) en cok recetelenen KTI oldugu saptandi. En sik recete edilmis olan KTI'lerin KR'lerde metilfenidat (%53.9), YR'lerde alprazolam (%39.6) oldugu saptandi. Sonuc: KTI kullaniminin demografik ve kurumsal farkliliklar gosterdigi bu arastirmayla ortaya konmus oldu. Bu bilgilerin, KTI takip sistemlerinin gelistirilmesinde ve bu ilaclari yazan ya da kullanan kisilere yonelik etkinliklerde yol gosterici olmasi beklenmektedir.