Coding infections in primary careBMJ 2019; 367 doi: https://doi.org/10.1136/bmj.l6816 (Published 11 December 2019) Cite this as: BMJ 2019;367:l6816
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Motivated by the work published in BMJ: Coding infections in primary care, by Alastair D Hay, Professor of Primary Care, we wish to express our considerations in such an important and current public health issue.
The prescription of medications is the most frequent medical act, while medications are the most widely used medical technology worldwide. This is intended to contribute to the restoration of lost health among people demanding health services at any level, however, for this purpose to be fulfilled, the prescription of medications must be rational or adequate.
The proper prescription of a medication is one in which the doctor indicates "the correct medication for the disease, at the correct dose, in the correct route, at the correct interval and during the correct time, at the lowest possible cost."
Antibiotics constitute the inappropriate prescription of all medications that doctors prescribe.
It is recognized that worldwide more than 50% of medications are prescribed improperly by doctors at all levels of health care. This decreases the effectiveness of medications and increases the exposure of health service users to side effects and adverse effects of medications, as well as interactions between them, which adds to other problems related to medications that have their origin in patients, such as self-medication and lack of adherence to drug treatment. In the case of antibiotics, antimicrobial resistance is developed and promoted, which has a direct impact on morbidity and mortality due to diseases of infectious origin. This set of problems has a direct negative impact on health systems, in terms of inappropriate use of material resources, inefficient planning of services and insufficient financing of them, which have been recognized for more than two decades.
This problem is especially important in primary health care, given that 85% of the population's health problems are addressed at this level of care, while the second corresponds to 10% and the third corresponds to 5%.
Various interventions have been carried out and documented to improve the quality of the prescription of medicines in primary care that have demonstrated variable effectiveness, without knowing a consensus on which is the most effective for the solution of this problem.
It has been recognized that one of the most effective interventions has been to have a comprehensive coding system is essential for the effective administration of antimicrobials, the basis of the work published in BMJ.
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Competing interests: No competing interests