Reviewing the prescribing patterns of patients diagnosed and treated for first time asthma in a private medical aid
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Date
2016
Authors
Rens, Lauren
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Abstract
Asthma is one of the twenty-seven conditions that is a Prescribed Minimum Benefit condition that all Medical Aids have to cover (Council for Medical Schemes, 2015). The prevalence of asthma in Southern Africa is estimated to be about 8.1% (SA Pharmaceutical Journal, 2012). Asthma is a major cause of morbidity and mortality in people and therefore prescribing patterns are important to investigate. This research project looked at the prescribing patterns for asthma and compared it with the standard treatment guidelines for patients diagnosed with first time asthma which has been recorded by a private Medical Aid. The study looked at medications and recorded if they were prescribed according to the stepwise approach and standard treatment guidelines and if there are any areas where prescribing practises for asthma sufferers can be improved. This was done by analysing chronic application forms received by a private Medical Aid over a period of eight months. Descriptive statistics was used to summarise the demographic data and prescribing patterns. Prescribing patterns were analysed to determine any specific patterns for the different types of prescribers. Prescribing patterns were correlated with guidelines. Medication prescribed from the providers was reviewed and the total number of medication prescribed on each prescription for asthma was recorded. The total patient population for this study was 3639 patients; from this total 2953 patients were diagnosed with first time asthma following the stepwise approach for treatment. 686 patients were diagnosed with first time asthma and did not follow the stepwise approach for treatment which was 19% of the patient population. The patients with co-morbidities whose treatment did not following the stepwise approach was 20% so the fact that patients diagnosed with other chronic conditions did not influence prescribing patterns too much compared to the whole patient population. In all age groups general practitioners followed the stepwise approach best but in all cases they had the most variation in terms of reasons why this provider type did not follow the stepwise approach. In the age group 0-4 years, pulmonologists followed the stepwise approach the worst but again these are specialists in pulmonology and may be seeing complicated patients. In the age group 5-11 years, paediatricians had the highest percentage
of prescriptions that did not follow the stepwise approach. In the age group 12 years and older, specialist physicians had the highest percentage of prescriptions that did not follow the stepwise approach. In the adult population other prescribers like gastroenterologists, neurologists and nephrologist may have diagnosed patients with asthma as they were treating these patients for other conditions.
Description
A Research Report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Medicine – Pharmacotherapy. Department of Pharmacy and Pharmacology School of Therapeutic Sciences Faculty of Health Sciences University of the Witwatersrand
October 2016