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AKICI, AHMET

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2013 - 201912020 - 20232
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Now showing 1 - 3 of 3
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    PublicationOpen Access
    Investigation of prescribing trends and prescriptions for common diagnoses in primary care: Nationwide data of Turkey
    (CUKUROVA UNIV, FAC MEDICINE, 2020-06-30) AKICI, AHMET; Bayram, Dilara; Vizdiklar, Caner; Aydin, Volkan; Isli, Fatma; Akici, Ahmet
    Purpose: This study aimed to examine the details of prescriptions issued in primary care and the changes over the years in Turkey. Materials and Methods: We analyzed all electronic prescriptions registered to Prescription Information System by primary care physicians in Turkey between 2013 and 2016. The mean number of drugs per prescription (nDPP) was determined by patients' sex and age groups. The percentages of the prescriptions containing the top twenty most frequently encountered drugs were determined for each year of the study. In the four-year period, the percentage of prescriptions with the ten most common diagnoses among prescriptions with single diagnosis and nDPP were examined. Results: A total of 1.457.034.275 drugs were prescribed in 518.335.821 prescriptions and nDPP was 2.81 for the four-year period. The most commonly used drugs in all prescriptions were other cold preparations (19.2-19.7%) and amoxicillin+beta-lactamase inhibitor (9.9-10.5%). The diagnosis of hypertension (6.9%, nDPP: 2.00) and acute upper respiratory tract infection, unspecified (URTI), (6.5%, nDPP: 2.61) were in the top ranks in single-diagnosis prescriptions during four-year period. Conclusion: Primary care prescriptions appear to be mostly generated for women and elderly populations, with a tendency for URTI and hypertension indications. Overprescriptions of cold preparations, NSAIDs, PPIs, analgesics, and broad-spectrum antibiotics imply existence of important problems in the primary care regarding rational prescribing behavior.
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    PublicationOpen Access
    Use of Drugs Subject to Controlled Prescriptions: a Retrospective Analysis
    (AVES YAYINCILIK, 2013-03-05) AKICI, AHMET; Demircan, Dilek; Gulmez, Sinem Ezgi; Donertas, Basak; Topcu, Ibrahim; Yilmaz, Huseyin; Berkman, Kemal; Akici, Ahmet
    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.
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    PublicationOpen Access
    Comparison of primary care prescriptions for old and very old hypertensive patients
    (2023-01-01) KAŞKAL, MERT; AKICI, AHMET; Tülü Çolak S., Vizdiklar C., KAŞKAL M., AYDIN V., ATAÇ Ö., AKICI A.
    Background/aim: Elderly and very elderly individuals might be subject to different approaches for the treatment of hypertension. We aimed to compare drug utilization in hypertensive old patients and very old patients in primary care, along with the evaluation of potentially inappropriate drug prescribing. Materials and methods: In this cross-sectional study, we compared prescriptions of 65–79-year-old (old patient prescriptions [OPP], n = 433,988) vs. ≥80-year-old (very old patient prescriptions [VOPP], n = 134,079) with \"essential hypertension\" diagnosis, issued by 3:1 systematically-sampled primary care physicians (n = 1431) in İstanbul throughout 2016. Drug utilization patterns and distribution of antihypertensives based on drug class and combination status were evaluated. Frequency of potentially inappropriate drugs per Beers Criteria were identified and compared. Results: Antihypertensive monotherapy practice was less common in OPP than VOPP (43.3% vs. 45.3%; p < 0.001). In both groups, the most commonly prescribed drugs were beta-blockers for monotherapy (37.4% vs. 33.1%, p < 0.001) and thiazide diuretics for combined therapy (69.8% vs. 67.4%, p < 0.001). Metoprolol was the most commonly prescribed antihypertensive both in OPP and VOPP (15.3% vs. 14.8%). Furosemide was ranked 10th in OPP and 3rd in VOPP (2.7% vs. 5.5%). Cardiovascular system drugs were the most commonly encountered potentially inappropriate medications in both groups (263.9 vs. 283.4 per 10,000 prescriptions, p = 0.004). Regarding antihypertensive drugs, 2.2% of those in OPP and 2.4% of those in VOPP were identified as potentially inappropriate (p = 0.002). Conclusion: Prescribing preferences to old and very old patients mostly showed slight differences. Almost half of prescriptions comprising antihypertensive monotherapy might imply hesitancy to prescribe combinations. Overuse of risky drugs such as furosemide in both groups, especially in the very elderly, requires more attention.