Trends of Extemporaneous Drug Prescription in Latvia in 2017

Despite the numerous industrially manufactured medicines available in the market, extemporaneously prepared drugs still have their niche among the services offered by the pharmacies. The physicians prescribe extemporaneously prepared drugs for special patient groups that require custom approach. Therefore, physicians' knowledge about extemporaneously prepared drugs and experience in prescribing them is the main precondition for satisfying patients' needs. The purpose of this article is to analyze the prescribing practice for extemporaneous formulations prepared in pharmacies in Latvia in order to identify the healthcare specialists who prescribe extemporaneously prepared drugs most frequently and the most common dosage forms. A database was created that includes the following data on each prescription form: 1) the name of the pharmacy where the medicine was prepared; 2) the region or the city where the pharmacy is located; 3) the month when the prescribed medicine was prepared; 4) the speciality of the healthcare professional who prescribed the medicine; 5) the dosage form; 6) all the active ingredients; 7) the number of active ingredients in the dosage form; 8) all the excipients. Data on 2,647 extemporaneously prepared drug prescriptions from 15 pharmacies in Latvia were collected. The extemporaneously prepared drugs were prescribed by physicians of 24 specialities, as well as dentists and physician assistants. The majority of the extemporaneously prepared drug prescriptions (87.5%) were from these 4 specialities: 1) general practitioners, 2) dermatovenereologists, 3) otorhinolaryngologists, and 4) pediatricians. General practitioners most commonly prescribed nasal drops, solutions for cutaneous application, and semisolid dosage forms. Dermatovenereologists mostly prescribed semi-solid dosage forms, suspensions, and solutions for cutaneous application. Otorhinolaryngologists most commonly prescribed nasal drops and semi-solid dosage forms. Pediatricians, as well as general practitioners and otorhinolaryngologists, favored nasal drops. To find out the opinion of general practitioners, dermatovenereologists, otorhinolaryngologists, and pediatricians on extemporaneously prepared drugs and the factors that hinder or facilitate their prescription, an extension of the study is planned that will include partially structured, in-depth, qualitative interviews.