Factors affecting physicians prescription and pattern of prescription in the management of secondary infertility

摘要

The management of infertility is a medical and social need and the drugs are usually not in common use and are quite expensive. Several factors may affect choice of drugs and prescription pattern. This work assessed the factors that influence physicians’ prescribing decisions for this specialized condition and the prescription pattern in its management. Commonly prescribed drugs and prescribing indicators were evaluated using patients’ cases notes and prescriptions for 12 months while a structured questionnaire was administered on the physicians in the unit to assess the factors guiding them in prescription. Data obtained was analyzed using Chi-square statistics. Effectiveness of drugs and costs are major factors that guided the physicians’ choice of drugs but the patient’s income level however did not have any effect on drug choice. Physicians relied mainly on medical textbooks, journals and the internet for technical information. Generic drugs were perceived as above average quality by the physicians (89.5%), but the years of experience significantly affected their perception of quality of generic drugs and the sources of information. On the filled prescriptions, 51.57% of the drugs were in generics, 96.86% from the essential drug list and an average of 3 drugs appeared per prescription. 51.41% contained antibiotics, while no injection was prescribed. The causes of infertility, effectiveness of the medication and affordability to patients are major factors affecting prescription decisions. Years of experience of physicians greatly influenced decision making. Prescription indicators however fall short of WHO standards.