Resumo

KATENDE-KYENDA, Norah L.; LUBBE, Martie; SERFONTEIN, Juan H.P.  e  TRUTER, Ilse. Are antiretrovirals prescribed according to the recommended prescribed daily doses in the private healthcare sector in South Africa. Health SA Gesondheid (Online) [online]. 2011, vol.16, n.1, pp.1-9. ISSN 2071-9736.

Current antiretroviral treatment (ART) guidelines recommend different combinations that have led to major improvements in the management of HIV and AIDS in the developed and developing world. With the rapid approval of many agents, health care providers may not be able to familiarise themselves with them all. This lack of knowledge leads to increased risk of dose- prescribing errors, especially by non-HIV and AIDS specialists. The purpose of this retrospective non-experimental, quantitative drug utilisation study was to evaluate if antiretrovirals (ARVs) are prescribed according to the recommended prescribed daily doses (PDDs) in a section of the private health care sector in South Africa (SA). Analysed ARV prescriptions (49995, 81096 and 88988) for HIV and AIDS patients were claimed from a national medicine claims database for the period 1 January 2005 through to 31 December 2007. ARV prescriptions prescribed by general practitioners (GPs) with PDDs not according to the recommended ARV dosing increased dramatically, from 12.33% in 2005 to 24.26% in 2007. Those prescribed by specialists (SPs) increased from 15.46% in 2005 to 35.20% in 2006 and decreased to 33.16% in 2007. The highest percentage of ARV prescriptions with PDDs not according to recommended ARV dosing guidelines was identified in ARV regimens with lopinavir-ritonavir at a PDD of 1066.4/264 mg and efavirenz at a PDD of 600 mg prescribed to patients in the age group of Group 3 (19 years > age < 45 years). These regimens were mostly prescribed by GPs rather than SPs. There is a need for more education for all health care professionals and/or providers in the private health care sector in SA on recommended ARV doses, to avoid treatment failures, development of resistance, drug-related adverse effects and drug interactions.

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