Common prescriptions in ambulatory care in Lebanon

OBJECTIVE: To describe prescribing practices of family physicians in a staf f model health maintenance organization at a university health center in Le banon and estimate costs of such practices for common diseases. METHODS: All prescriptions issued between July 1, 1997, and June 30, 1998, were prospectively collected, The diagnoses made by physicians at each enco unter were recorded, and the total price of medications prescribed was calc ulated. The core prescribing indicators as defined by the World Health Orga nization and the mean annual prescription price per person for the 25 most common diagnoses were calculated. RESULTS: Prescribing occurred in 27.1% of encounters, with a mean of 1.6 me dications per encounter; 17.5% of all prescriptions included an antibiotic. Generic drugs and essential drugs each accounted for 2.9% of all medicatio ns. Approximately 50% of the consultations for either respiratory or ear in fections resulted in a prescription. Cervical spine syndromes and lipid met abolism disorders cost most among recorded diagnoses, with mean annual pres cription prices per person of US $2016 and $1128, respectively. CONCLUSIONS: The low rate of generic and essential drug prescribing, as wel l as the frequency of prescribing in respiratory infections, highlight the need for initiatives to help rationalize prescribing in primary care in Leb anon. Together with the diagnostic categories incurring high cost per perso n, these issues can be part of physician education or treatment guideline d evelopment. These measures may aid the government in its subsidy of primary health care centers.