Prescription auditing: an important tool for sensitization of resident doctors for rationale prescription and utilization of drug

Background: The main objective of the Maharashtra Health Systems Development Project (MHSDP) is to enhance the quality of care by improving health care; in the hospitals, in the state. Improvement in the prescribing practice of resident doctors working in the hospitals is one of the initiatives taken up, to improve the rationalizing service delivery. A prescription audit may become an important tool for sensitizing resident doctors for rational prescription and utilization of drug.Methods: An observational study was carried out during the period of March 2017 to May 2017 in tertiary care teaching hospital, Kolhapur. Total 247 first prescriptions written by resident for in-door-patient department were collected, scrutinized and analysed. Prescriptions were evaluated for completeness of prescription format while legibility was graded. Prescriptions were also analysed as per World Health Organization prescribing indicators.Results: In study 247 prescriptions with 1091 drugs with average 4.42% drugs per prescription, 49.8 % prescriptions wrote the drugs by generic name. We found that 44.1 % prescriptions written with drugs included in essential medicines list while antibiotics prescribed were 27.1%. In prescription format 34% had incorrect dosage, 67% of prescriptions omitted the duration of treatment. Direction for drug use was not mentioned in 25% of prescriptions. Weight was not mentioned on any prescriptions even for paediatric group.Conclusions: Through prescription auditing, sensitizing resident doctors for rational prescription and utilization of drug can be done to achieve the goal of the MHSDP of enhancing the quality of care by improving health care; in the hospitals, in the state.

Cost comparisons of five leading brands of the Antiplatelet drug, Clopidogrel, available in an Indian town

Background: Antiplatelet drugs need to be prescribed lifelong, for most of the selected patients, once started. Price disparity can lead to large financial stress on the patients, especially when cost related aspects are not paid heed to by the prescribing physician. This study was conducted to compare the cost, to the patient, of five most commonly prescribed preparations of different brands of Clopidogrel seventy five milligram, in Kolhapur city.Methods: The present study was undertaken during February 2019 to June 2019. Authors purchased a strip of 10 tablets each of the five leading brands of Clopidogrel seventy five milligram. The prices of the strip of 10 tablets of each of the five chosen brands were compared. Finally, the yearly cost of each of these five different preparations, was compared directly as well as using percentages. The data was collected, analyzed and presented in tabular forms and figures.Results: The data of the cost of five different brands of a single antiplatelet drug, Clopidogrel seventy five milligram shows that the annual cost of the costliest among the five brands of this drug is almost three times that of the cheapest brand, or in other words almost 300 percent that of the cheapest brand.Conclusions: The cost differences between the five brands were not negligible. India, with a major part of the population being very sensitive to the cost of medications, the prescribing physician must select the preparation wisely. The most costly preparation of Clopidogrel can significantly add to the the financial stress on the patient’s yearly expenditure. Thus, Pharmaco economic considerations must take a front seat while making a decision to prescribe medicines, especially in a country like India.

Cost comparisons of seven leading brands of the Hypolipidemic drug, Rosuvastatin available in an India city

Background: Hypolipidemic drugs need to be prescribed lifelong for most of the selected patients, once started. Price variation can lead to huge financial strain on the patients, especially when cost associated issues are not considered by the prescribing medical practitioner. This study was conducted to compare the cost, to the patient, of seven most commonly prescribed preparations of different brands of Rosuvastatin ten milligram, in Kolhapur city.Methods: Authors purchased a strip of 10 capsules each of the seven leading brands of Rosuvastatin ten milligrams. The prices of the strip of 10 capsules of each of the seven chosen brands were compared. Finally, the cost of each of these seven brands for one year, was compared directly as well as using percentages. The data was collected, analysed and presented in tabular forms and figures.Results: The data of the cost of seven different brands of a single hypolipidemic drug, Rosuvastatin ten milligram shows that the cost of the costliest among the seven brands of this drug for one year is almost two times that of the cheapest brand, or in other words almost 200 percent that of the cheapest brand.Conclusions: The cost differences between the cheapest and the costliest brands were substantial. The cost of remaining five brands was dispersed in between these two extremes. India, with a major part of the population being highly concerned about the cost of medications, the prescribing medical practitioner must select the preparation wisely . The most costly preparation of Rosuvastatin ten milligram can substantially add to the financial strain on the patient’s yearly expenses. Thus, Pharmaco economic considerations must be a prime concern while making a decision to prescribe medicines, especially in a country like India.

Cost comparisons of five leading brands of the antihypertensive drug, Telmisartan, available in an Indian city

Background: Antihypertensive drugs have to be taken lifelong, after initiation of the treatment. Price variation can lead to huge economic burden on the patients of hypertension, especially when cost considerations are not undertaken by the prescribing physician . This study was undertaken to compare the annual cost , to the patient , of five different most commonly prescribed brands of Telmisartan 40 mg, in Kolhapur city.Methods: Authors purchased a strip of 10 tablets each of the five leading brands in one city, Kolhapur, India, of Telmisartan 40 milligram. The prices of the strip of 10 tablets of each of the five selected brands were compared. In turn the annual cost of each of these five, was compared directly as well as using percentages. The data was collected, analysed and presented.Results: The data of the cost of the preparations of five different brands of a single antihypertensive drug, Temisartan 40 milligram shows that the annual cost of the costliest among the three brands of this drug is almost three times , that of the cheapest brand, or in other words almost 300 percent that of the cheapest brand.Conclusions: the cost variation amongst the five brands was considerable. India being a country with a major chunk of the population being very price sensitive, the prescribing physician must select the brand carefully. The most costly preparation of Temisartan can significantly add to the burden on the patient’s annual budget. Thus, Pharmacoeconomics must take an important place while prescribing medicines, especially in a country like India.

A study to compare perception of weight training as an equally useful and proper exercise modality as compared to walking in obese men.

Background: This study was intended to evaluate perception of the young adult obese men towards weight training as a proper and useful modality as compared to walking. Methods: The study was a questionnaire based and conducted in a weight management clinic in Maharashtra state, India. Obese men between 18-40 years of age during their first visit were studied for their perception about weight training. Results: There was no significant difference between the scores with walking and weight training. Conclusions: Our results clearly indicate that weight training is perceived to be an equally proper and useful modality of exercise as compared with walking amongst obese men.