Background: The world’ s population is growing older. Inappropriate and irrational use of drugs in the elderly is a considerable health concern due to consequences such as increased morbidity and adverse drug events. This study aimed to evaluate the rationality of prescribing and determining the extent of inappropriate prescribing in a sample of geriatric patients in Tehran. Methods: This cross sectional study was performed on 1512 prescriptions of patients aged ≥ 65 years from 5 pharmacies affiliated to Tehran University of Medical Sciences in 2014. Prescription of potentially inappropriate medications (PIMs) was investigated using the Beers Criteria along with WHO prescribing indices. Date were analyzed using SPSS software, and significance level was set at less than 0. 05. Results: Mean (SD) age of patients was 73. 9(6. 7) years. A total of 472 (31. 2%) patients received at least 1 PIM. Benzodiazepines were the most frequent drug class and general practitioners (GPs) were the most frequent prescriber of PIMs. The highest and the lowest percentage of prescriptions containing brand-names were prescribed by subspecialists (62. 5%) and GPs (42. 2%), respectively. Antibiotics and injectable medications were prescribed for 26. 8% and 28. 5% of patients by GPs. Mean (SD) number of drugs per prescription was 3. 57 (1. 92). Prescriptions containing systemic antibiotics and PIMs had significantly higher mean number of drugs compared to those without these items (both P < 0. 001). Conclusion: There is a need for interventions to improve the quality of prescribing for elderly patients, especially by GPs. Also, there are still some problems in rational use of drugs based on prescribing indices, especially, prescribing brand-names and injectable medications.

Dear Editor-in-ChiefHealth is known as one of the main precondi-tions for the social welfare system, people to achieve the level of health in the incidence of sickness, in addition, to keep appropriate lifestyle, use health services and on the other way, they try to buy those services. Taking advantage of these services impose different financial pressures on people in different societies, these fees paid di-rectly out of pocket sometimes may cause finan-cial problems for patients and their families (1).....

Research continually produces new findings that can improve safe, efficient, and economic use of medications. Studies have been conducted to get insight into pattern of medication utilization and prescribing. Identifying problems in use of medications or generating new evidence alone is not sufficient to make changes(1). We need to uptake research findings and evidence-based approaches into routine practice, to achieve successful and consistent changes.

Providing and distributing the medicine as a strategic production is affected by variouse factors such as import, internal production, distribution, currency affairs, forms of consuming, ... and so on. In general it plays an important role in health economy of society.Parallel to other problems, rational prescribing and uses of medicine is one of the most important difficulties in medical sciences, This problem not only makes the real medication immposible by increasing the side-effects, but also entail the increase of economical loss, inappropriate distribution and shortage of neccessary drugs, Variouse patterns of irrational prescribing have been shown in different studies, in different countries. All of the studies in Iran Proved the irrational pattern of drug prescription, which containes a reasonable percent of the cases.Education plus improvement of the knowledge in this realm leads to changing in attitude and performance. Reviewing the effect of education has a signifcant effect in prescription of the doctors. CME as a component of education is directly involved with medical community and thus has an outstanding influences here. CME is generally involved with improvment of Knowledge, attitude and performance, which effects directly or indirecrly on the rational prescribing of medicine. Paying special attention to the programmes about pharmaceutical education and rational use of drugs from 1374 to 1378 (1991-1999), shows a reasomablly higer trends including: 2 seminars in 1374 increased to 17 in 1378 (%63 pharmaceutical seminars in 1378), - Conferences about rational prescribing of drugs contained in average %7 of pharmaceutical conferences.- Short Periods programmes are %15 of the all programmes.- Pharmaceutical workshops shows %100 increase relative to the years 1370-1377 (1991-1999), which %50 was directly about rational prescribing.- %4 of composed programmes for GPs, and %5 of total composed pharmaceutical programmes were about rational prescribing. Altough education of rational prescribing of medicine from 1374 to 1378 had an increasing improvement, but still, parallele to dept. of CME it demand more attempts for improvement of quality of the actions by scientific groups.

Background: Medicine is considered as strategic goods worldwide and, therefore, a huge amount of health care budget is spent on it. To prepare universal access to appropriate health services and achieve the health-related millennium development goals, rational use of drugs is an essential goal in the health system. This study aimed to investigate the proportion of drug prescription in three categories of injections, antibacterials agents and corticosteroids in a 10 year period. Methods: This is a descriptive study using data from an Iranian national insurance organization and National Center of Drug Use. The data about prescribed drugs during 2003 to 2013 were collected and analyzed by Excel Microsoft software, version 2010. Result: Results indicated that injections were decreased from 49. 25% in 2003 to 46% in 2013; also, antimicrobials had a decrease from 64. 25% in 2003 to 42. 2% in 2013. Totally, it was reduced about 16% in the period of 10 years. Corticosteroids increased 10 % from 13% to 23% in 2013. Conclusion: According the present findings that indicate irrational and increasing use of corticosteroids and antimicrobials, it seems necessary for Iranian policy makers to pay specific attention to customizing clinical and pharmaceutical guidelines along with improvement of medical education system and rational prescription, holding scientific committees of prescription supervision, arranging continuous and effective education of health personnel, and improving public culture and community education.

Objective Infections caused by parasitic worms are among the most common diseases in the world. Considering the parasitic infections resistant to treatment, drug side effects and the emergence of new immunological diseases, it seems more necessary to pay attention to the views and therapeutic experiences of physicians in Iranian Traditional Medicine (ITM). Methods As A review study, data related to parasitic diseases and worms were first collected from Avicenna’ s the Canon of Medicine book and other ITM books, and then underwent content analysis. Avicenna’ s approach in the treatment of these diseases was studied based on the rational prescribing model. Results Avicenna’ s approach in the treatment of parasitic diseases is based on problem-solving model and according to the summary of patients’ conditions in terms of disease severity and prioritization of causes. It varies from person to person. Conclusion Awareness of the causes of parasitic diseases, categorization of their clinical symptoms based on ITM, knowledge of natural and herbal medicine and various methods of prescribing them according to the health principals along with diagnostic and therapeutic methods of classic medicine can be helpful in control and prevention of parasitic diseases...

Background :Educational interventions are effective methods for promoting knowledge and awareness among physicians to reduce irrational antibiotic prescriptions. Objectives :This study was designed to evaluate the effect of an educational intervention conducted by pharmacists on rational antibiotic prescribing in an outpatient emergency department (ED). Methods :This pre-post pilot intervention study was conducted in the outpatient ED of Shahid Bahonar Hospital, affiliated with Kerman University of Medical Sciences, Kerman, Iran, from February to June 2020. Non-random (convenience) sampling was used. All patients sent to the outpatient ED at triage who were prescribed antibiotics were included in this study. The pre-intervention phase was observational, during which a pharmacist assessed irrational antibiotic prescriptions over one month. Educational topics were determined based on the most common diagnoses related to irrational antibiotic prescriptions, in consultation with a clinical pharmacist and an infectious disease specialist. An educational video was then prepared and provided to the doctors prescribing antibiotics. Subsequently, the post-intervention phase was conducted in the same manner as the pre-intervention phase for one month. Results :During the pre-intervention phase, out of 314 prescriptions, 100 (31.85%) contained antibiotics. In the post-intervention phase, among a total of 235 prescriptions, 100 (42.55%) contained antibiotics. The mean age of the patients was 36.65 ± 15.73 years in the first phase and 37.30 ± 15.71 years in the second phase. Analyses revealed that the educational intervention had a statistically significant effect on reducing irrational antibiotic prescribing with respect to indication (P = 0.0001), dose (P = 0.005), and duration (P = 0.0001). Conclusions :The pharmacists’ educational intervention effectively reduced irrational antibiotic prescribing in the outpatient ED.

Background and purpose: Drug interactions are one of the serious subsets of medication errors and occur when the effects or toxicity of one drug are affected by another. This study aimed to investigate drug interactions and the role of pharmacist in reducing drug interactions in Ramsar Imam Sajjad Hospital, Iran. Materials and methods: This cross-sectional study was performed in all prescriptions of medicinal products by specialist physicians in Ramsar Special Clinic from March to May 2019. Drug interactions were determined based on Drug Interaction Facts (2014) and Drugs website (www. drugs. com). A list of drug interactions prescribed by each physician was compiled and discussed in face-to-face visits with physicians. They were then provided with a list of unsafe combinations of medications. Prescriptions of physicians who had previous history of prescriptions with drug interactions were reviewed within two months in January and February 2020. Results: In first phase, 2864 prescriptions were studied of which 268 (9. 3%) were detected with drug interactions. There were 40 (14. 9%) cases of major drug interactions and 228 (85%) cases of moderate drug interactions. After providing feedback to physicians about drug interactions, the rate of drug-drug interactions decreased from 9. 3% to 6. 4%. Conclusion: Many drug interactions are preventable and communications between physicians and pharmacists can help identifying drug interactions and minimizing their incidence.

Background & Aims: Inappropriate prescribing of drugs such as corticosteroids is known all over the world y especially in developing countries as a major health care system problem. There are few studies about the prescription pattern of corticosteroid across our country and this subject has not been studied in West Azerbaijan province. The aim of this study is to evaluate the pattern of prescribing corticosteroids among outpatients by specialist physicians in West Azerbaijan. Materials & Methods: In this retrospective cross-sectional descriptive study, data were collected from two million prescriptions of ear, nose and throat (ENT), internal medicine, general surgery, obstetrics and gynecology, , pediatrics cardiology, neurology, infectious disease, orthopedic and urology specialists using prescription-processing software “ NoskhehPardaz” (Rx Analyzer). Microsoft Excel software (2016) was applied to prepare the appropriate graphs. Results: Obstetrics and gynecology specialists, pediatrics and internists had the most percentage of prescriptions (23. 65%, 20. 21% and 15. 67% respectively). The ENT specialists, orthopedists and internists were more likely to prescribed corticosteroids than others. All, physicians with the exception of cardiologists and gynecologists, prescribed injectable corticosteroids more than other forms of this drug. The injectable corticosteroid was the highest and inhaled corticosteroid was the lowest prescribed drug. Conclusion: The prescribing practices in this study are not satisfactory. Our data confirmed that ENT, orthopedic and internal medicine specialists are more likely to prescribe corticosteroids than others. . Injectable corticosteroids were the most commonly prescribed drug.