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.

This study aimed to utilize structural equation modeling (SEM) techniques to determine the effects of dietary calcium, protein and vitamin D on adiposity and lipidemia and to assess mediatory effects of parathyroid hormone (PTH) and 25-hydroxyvitamin D (25(OH)D) in patients with type 2 diabetes. In this cross-sectional study, a total of 150 diabetic patients (93 females and 57 males) were randomly selected. Anthropometric measures, biochemical analyses, and fat mass percent were recorded. Nutritional data were collected. SEM was performed. Based on the primary hypothesis, adiposity and lipidemia were fitted in a model. The direct effects of dietary calcium (λ = –0.165, p value = 0.002) and PTH (λ = –0.143, p value = 0.011) were significantly associated with lipidemia. There were no significant effects for dietary protein on PTH (λ = –0.270, p value = 0.057), 25(OH)D (λ = –0.071, p value = 0.613), lipidemia (λ = –0.044; p value = 0.638) or adiposity (λ = –0.009, p value = 0.949) as well as for dietary vitamin D on PTH (λ = –0.119, p value = 0.194), 25(OH)D (λ = 0.023, p value = 0.806), lipidemia (λ = 0.034, p value = 0.587) or adiposity (λ = –0.221, p value = 0.118). The correlation between calcium intake and lipidemia, and adiposity are not mediated by 25(OH)D and PTH. There were the direct effects of dietary calcium on adiposity in patients with type 2 diabetes. The model can be tested in future longitudinal and intervention studies to identify the predictors of obesity.

This study aimed to utilize structural equation modeling (SEM) techniques to determine the effects of dietary calcium, protein and vitamin D on adiposity and lipidemia and to assess mediatory effects of parathyroid hormone (PTH) and 25-hydroxyvitamin D (25(OH)D) in patients with type 2 diabetes. In this cross-sectional study, a total of 150 diabetic patients (93 females and 57 males) were randomly selected. Anthropometric measures, biochemical analyses, and fat mass percent were recorded. Nutritional data were collected. SEM was performed. Based on the primary hypothesis, adiposity and lipidemia were fitted in a model. The direct effects of dietary calcium (λ = –0.165, p value = 0.002) and PTH (λ = –0.143, p value = 0.011) were significantly associated with lipidemia. There were no significant effects for dietary protein on PTH (λ = –0.270, p value = 0.057), 25(OH)D (λ = –0.071, p value = 0.613), lipidemia (λ = –0.044; p value = 0.638) or adiposity (λ = –0.009, p value = 0.949) as well as for dietary vitamin D on PTH (λ = –0.119, p value = 0.194), 25(OH)D (λ = 0.023, p value = 0.806), lipidemia (λ = 0.034, p value = 0.587) or adiposity (λ = –0.221, p value = 0.118). The correlation between calcium intake and lipidemia, and adiposity are not mediated by 25(OH)D and PTH. There were the direct effects of dietary calcium on adiposity in patients with type 2 diabetes. The model can be tested in future longitudinal and intervention studies to identify the predictors of obesity.