Authors: Sudar Codi R, Samiya Khan, Manimekalai K
Background: Doctor’s prescription provides vivid information and instruction to the patient. In spite of the WHO programs, irrational prescribing is still a common practice. Aim: To evaluate and compare the prescribing pattern of private practitioners and physicians of a tertiary care teaching hospital in a semi urban area and detect their rationality. Materials & methods: 150 prescriptions, each prescribed by private practitioners and physicians of a tertiary care hospital were collected over a period of two months and evaluated. Information regarding the drugs used, drugs from the essential drug list, the use of injections, fixed dose combinations, drug prescribed by generic names were observed. Results: The average number of drugs per prescription prescribed by the private practitioners was 2.47 compared to 1.58 by the physicians of a tertiary care hospital. 82% of prescriptions of private practitioners had one injection prescribed in the prescription compared to 12% by physicians of a tertiary care hospital. 30 unnecessary drugs, 46 unnecessary injections and 8 irrational fixed dose combinations were prescribed by the private practitioners, whereas only 6 unnecessary drugs and 2 unnecessary injections were prescribed by the physicians of a tertiary care hospital respectively. There was no irrational fixed dose combination prescribed by them. The private practitioners prescribed 12 (3.2%) drugs by generic names, whereas the physicians of a tertiary care hospital prescribed 72 (30.3%) drugs by generic names. (P<0.000). 36 (9.7%) drugs prescribed by the private practitioners were not included in the essential drug list and only 2 (0.8%) drugs prescribed by the physicians of a tertiary care hospital were not included in the essential drug list. Conclusion: Private practitioners prescribe more irrational prescriptions on comparison with the physicians of a tertiary care teaching hospital. This may be due to the promotional pharmaceutical incentives, lack of professional updates and lack of standard treatment guidelines to the private practitioners motivating them towards irrational drug therapy to survive the competition. Competitions can be conducted for the budding medical undergraduates to inculcate the importance of rational drug therapy at early ages.
Keywords: Prescription audit, Irrational prescriptions, Rational prescribing