Abstract
In Fiscal year 2013, Comptroller General’s Department (CGD) had launched the Non-essential Drug
Prescription Criteria (NPC) measure (A-F measure) to encourage the rationale drug use and control drug
cost for patients under civil servant medical benefit scheme (CSMBS) in 168 public hospitals. The measure
indicated that NPC must be notified for each non-essential drug (NED) prescribing. This study aimed to
monitor and assess implementation of the measure. Data were collected in the study hospital which NPC
were notified for all prescribing of NEDs. The selected NED in this study were celecoxib and candesartan.
For each drug, 110 prescriptions and patient medical records of the out-patient department were reviewed.
The study was divided into two parts. For the first part, consistency between information in medical
records and reasons specified in prescriptions and rationale of prescribing based on the Ministry of Public
Health criteria were assessed during November 2012 to January 2013. For the second part, trend of prescribing
was monitored before and after the measure was implemented (August 2012 to October 2012 and
November 2012 to April 2013). Descriptive statistics were used in data analysis. Reasons for drug prescribing
were not completely specified in medical records. Therefore, the consistency between information
in medical records and reasons specified in prescriptions could be assessed in only 52 patients (47.3%)
who received celecoxib and 57 patients (51.8 %) who received candesartan. Data in medical records and
the notified NPC in prescriptions were consistent in only 7 patients (6.4%) who received celecoxib and 54
patients (49.1%) who received candesartan. Rational of prescribing could not be assessed for more than
40% of prescriptions. Prescribing was rational in 54 patients (49.1%) who received celecoxib and 7 patients
(6.4%) who received candesartan. Most common indicated reason for celecoxib prescribing was an intolerance
to side effect or allergy to drugs in essential drug (ED) list (N=74, 67.3%). For candesartan prescribing,
most common indicated reason was failure to achieve therapeutic goals (N= 100, 90.9%). After an
implementation of the NPC measure, prescribing of 35 patients (31.8%) who received celecoxib and 36
patients (32.7%) who received candesartan were changed to other ED drugs. In conclusion, the efficiency
of the measure was quite low as the completeness of NPC documentation and the change of prescribing to
ED were about 49 and 32 percent, respectively. Measure should be supported and promoted to enhance its
efficiency and precipitate into rationale drug use.
