Abstract
Purpose
We aimed to demonstrate the suitability of the Anatomical Therapeutic Chemical Classification (ATC) to describe duplicate drugs and duplicate drug classes in prescription data and describe the pattern of duplicates from public and private primary care clinics of Kuala Lumpur, Malaysia.
Methods
We analyzed prescription data year 2005 from all 14 public clinics in Kuala Lumpur with 12,157 prescriptions, and a sample of 188 private clinics with 25,612 prescriptions. As ATC Level 5 code represents the molecule and Level 4 represents the pharmacological subgroup, we used repetitions of codes in the same prescription to describe duplicate drugs or duplicate drug classes and compared them between the public and private clinics.
Results
At Level 4 ATC, prescriptions with duplicates drug classes were 1.46% of all prescriptions in private and 0.04% in public clinics. At Level 5 ATC, prescriptions with duplicate drugs were 1.81% for private and 0.95% for public clinics. In private clinics at Level 5, 73.3% of prescriptions with duplicates involved systemic combination drugs; at Level 4, 40.3% involved systemic combination drugs. In the public sector at Level 5, 95.7% of prescriptions with duplicates involved topical products.
Conclusions
Repetitions of the same ATC codes were mostly useful to describe duplicate medications; however, we recommend avoid using ATC codes for tropical products for this purpose due to ambiguity. Combination products were often involved in duplicate prescribing; redesign of these products might improve prescribing quality. Duplicates occurred more often in private clinics than public clinics in Malaysia
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Acknowledgements
We thank the Director General of Health for permission to publish findings of this study and thank all doctors and pharmacists who participated in the NMUS.
Conflict of interest
This research was conducted by data from National Medicines Use Survey (NMUS). NMUS was sponsored by a grant from Ministry of Health (MRG Grant Number 00311). The authors of this paper work in the Ministry of Health, Malaysia. Pharmaceutical Services Division manages pharmacists and the drug formulary of Ministry of Health.
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Lim, C.M., Aryani Md Yusof, F., Selvarajah, S. et al. Use of ATC to describe duplicate medications in primary care prescriptions. Eur J Clin Pharmacol 67, 1035–1044 (2011). https://doi.org/10.1007/s00228-011-1025-4
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DOI: https://doi.org/10.1007/s00228-011-1025-4