Journal of Preventive Medicine and Public Health

Brief Report

Drug Prescription Indicators in Outpatient Services in Social Security Organization Facilities in Iran: Afsoon Aeenparast, Ali Asghar Haeri Mehrizi, Farzaneh Maftoon, Faranak Farzadi; J Prev Med Public Health. 2024;57(3):298-303. Published online April 4, 2024; DOI: https://doi.org/10.3961/jpmph.23.424

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Objectives
The aim of this study was to estimate drug prescription indicators in outpatient services provided at Iran Social Security Organization (SSO) healthcare facilities.
Methods
Data on all prescribed drugs for outpatient visits from 2017 to 2018 were extracted from the SSO database. The data were categorized into 4 main subgroups: patient characteristics, provider characteristics, service characteristics, and type of healthcare facility. Logistic regression models were used to detect risk factors for inappropriate drug prescriptions. SPSS and IBM Modeler software were utilized for data analysis.
Results
In 2017, approximately 150 981 752 drug items were issued to outpatients referred to SSO healthcare facilities in Iran. The average number of drug items per outpatient prescription was estimated at 3.33. The proportion of prescriptions that included an injection was 17.5%, and the rate of prescriptions that included an antibiotic was 37.5%. Factors such as patient sex and age, provider specialty, type of facility, and time of outpatient visit were associated with the risk of inappropriate prescriptions.
Conclusions
In this study, all drug prescription criteria exceeded the recommended limits set by the World Health Organization. To improve the current prescription patterns throughout the country, it would be beneficial to provide providers with monthly and annual reports and to consider implementing some prescription policies for physicians.

Summary

Key Message
In present research all drug prescriptions in Iran Social Security outpatient facilities were assessed. In all 45,312,540 studied prescriptions, the average number of drug items per prescriptions was 3.33 items. 17.5% of prescriptions contained injection and 37.5% contained antibiotic. Patient sex and age, provider specialty, type of facility were associated with the risk of inappropriate prescriptions. It seems that correct policy making and proper supervision alongside health education will be core basis for improving drug prescription and use.

Citations

Citations to this article as recorded by

A Cross-Sectional Investigation on Drug-Drug Interactions in Prescriptions of Pediatric Outpatient Clinics at a Referral Center in Southern Iran
Sara Asadi, Omid Moradi, Hossein Amini, MReza Goodarzian, Maryam Babaei, Maral Goodarzian
Journal of Comprehensive Pediatrics.2024;[Epub] CrossRef

Systematic Review

Food is Medicine Initiative for Mitigating Food Insecurity in the United States: Vidya Sharma, Ramaswamy Sharma; J Prev Med Public Health. 2024;57(2):96-107. Published online March 8, 2024; DOI: https://doi.org/10.3961/jpmph.23.505

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Abstract Summary PDF

Objectives
While several food assistance programs in the United States tackle food insecurity, a relatively new program, “Food is Medicine,” (FIM) initiated in some cities not only addresses food insecurity but also targets chronic diseases by customizing the food delivered to its recipients. This review describes federal programs providing food assistance and evaluates the various sub-programs categorized under the FIM initiative.
Methods
A literature search was conducted from July 7, 2023 to November 9, 2023 using the search term, “Food is Medicine”, to identify articles indexed within three major electronic databases, PubMed, Medline, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Eligibility criteria for inclusion were: focus on any aspect of the FIM initiative within the United States, and publication as a peer-reviewed journal article in the English language. A total of 180 articles were retrieved; publications outside the eligibility criteria and duplicates were excluded for a final list of 72 publications. Supporting publications related to food insecurity, governmental and organizational websites related to FIM and other programs discussed in this review were also included.
Results
The FIM program includes medically tailored meals, medically tailored groceries, and produce prescriptions. Data suggest that it has lowered food insecurity, promoted better management of health, improved health outcomes, and has, therefore, lowered healthcare costs.
Conclusions
Overall, this umbrella program is having a positive impact on communities that have been offered and participate in this program. Limitations and challenges that need to be overcome to ensure its success are discussed.

Summary

Key Message
In 2023, the United States Department of Health & Human Services (HHS), developed a "Food is Medicine" (FIM) initiative to address food insecurity and chronic diseases by providing healthy food options tailored to recipients' specific health needs. Programs categorized under the FIM initiative include Medically Tailored Meals, Medically Tailored Groceries, and Produce Prescriptions, which are described in this review. Overall, the program appears to have had a positive impact by improving health outcomes and enhancing the overall quality of life.

Citations

Citations to this article as recorded by

Seniors and Sustenance: A Scoping Review on Food Security in the Elderly
Nor Faiza Mohd. Tohit, Roselawati Mat Ya, Mainul Haque
Advances in Human Biology.2025;[Epub] CrossRef
Development of a statewide network hub for screening, referral, and enrollment into food as medicine programs across Kentucky
Christa Mayfield, Carolyn Lauckner, Joshua Bush, Ethan Cosson, Lauren Batey, Alison Gustafson
Frontiers in Public Health.2025;[Epub] CrossRef
The evolution of animal-based dietary structure has contributed to the increase of healthcare expenditures in China
Yuanyuan Zhu, Yan Zhang, Xiaohua Zhu, Yuan Luo, ZhenFa Tu
Humanities and Social Sciences Communications.2024;[Epub] CrossRef
Will a Programmatic Framework Integrating Food Is Medicine Achieve Value on Investment?
Lynn Fredericks, Olivia Thomas, Anthony Imamura, Julia MacLaren, Auden McClure, Joy Khalil, Jennifer Massa
Journal of General Internal Medicine.2024;[Epub] CrossRef
Implementing Food Security Screening in all Pregnant Women: Call to Action
Jennifer Woo, Divya Parmar, Valeria Millinga, Tracie Kirkland
Journal of Midwifery & Women's Health.2024; 69(6): 826. CrossRef

Original Articles

Annual Visit Days, Prescription Days and Medical Expenses of Hypertensive Patients.: Bu Dol Lim, Byung Yeol Chun, Sin Kam, Jeong Soo Im, Soon Woo Park, Jung Han Park; Korean J Prev Med. 2002;35(4):340-350.

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Abstract PDF: OBJECTIVES
To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. METHODS: The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. RESUJLTS: The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I,IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses, 453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). CONCLUSIONS: The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.; Summary

The Study of Prescription Behaviors of Practicing Pharmacists with Simulated Patients of Arthritis.: Hong Jun Cho, Kwang Su Uh, Jin Wook Choi; Korean J Prev Med. 1999;32(3):343-346.

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Abstract PDF: OBJECTIVES
In Korea, pharmacists can dispense medicines without doctor's prescription. This causes the high proportion of pharmaceutical expenditures. The study shows the prescribing behaviors of practicing pharmacists with the simulated patient of arthritis. We select the arthritis as a subject of simulation, because the arthritis is one of the major health problems and the abuse of cortico-steroids is usual in treatment of arthritis patients. METHODS: Twenty drug stores among the 320 drug stores in a district, Seoul, Korea were randomly selected. One of the researchers visited the drug stores and received the medicines from the pharmacists after explaining standardized scenario of arthritis. The simulated patient recorded the practice behaviors of pharmacists. RESULTS: The mean number of prescribed drugs are four and half. Among the twenty pharmacists, the nineteen prescribed non-steroidal anti-inflammatory drugs and the seven(35%) prescribed the cortico-steroids. The antacids were prescribed by the fourteen(70%) pharmacists. The five(25%) pharmacists only recommended the simulated patients to visit the medical doctors, and the three(15%) performed physical examination to the simulated patients. The three pharmacists(15%) asked the past history of the drug adverse effects and no pharmacist explained the adverse effects of prescribed medicines. CONCLUSIONS: The research shows that the cortico-steroids are frequently prescribed and the pharmacists commonly do not give the explanations of the prescribed medicines to the arthritis patients.; Summary

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