A comparative survey study on current prescribing trends in non-steroidal anti-inflammatory drugs among practitioners in private set up and tertiary care teaching rural hospital.

Background: The study was conducted to compare the current prescribing trends of Non-Steroidal Anti-inflammatory drugs (NSAIDS) among private practitioners and practitioners at tertiary care teaching rural hospital. Methods: The prospective survey study was carried out by obtaining response to feedback questionnaire related to use of NSAIDs from 25 private & 25 tertiary care practitioners. Results: NSAIDs use was routine amongst private (66%) and tertiary care (77.6%) practitioners. Preferences of tertiary care practitioners were paracetamol (36%), diclofenac (20%), aceclofenac (20%), ibuprofen (20%) and etoricoxib (4%) while that of private practitioners were ibuprofen (40%), paracetamol (32%), diclofenac (16%) and aceclofenac (12%). Use of Fixed Dose Combinations (FDC) was 72% in private and 68% in tertiary care practitioners. While prescribing FDCs, private practitioners preferred NSAIDs + NSAIDs (100%) over NSAIDs + muscle relaxants (44.44%), NSAIDs + Serratiopeptidase (55.56%), and NSAIDs + antacids (44.44%) similarly tertiary care practitioners also preferred NSAIDs + NSAIDs (100%) over NSAIDs + muscle relaxants (47.06%), NSAIDs + Serratiopeptidase (36%), and NSAIDs + antacids (28%). Of the NSAIDs + NSAIDs combination ibuprofen + paracetamol (70%) was preferred by private practitioners and diclofenac + paracetamol (61%) by tertiary practitioners. Paracetamol was safely used during pregnancy by both groups. Adverse effects observed included gastritis (98%), urticaria (32%), and anaphylaxis (2%), although no fatality was observed. Conclusion: Not much of a difference was observed in prescribing habits of both groups. Though beneficial and routinely prescribed, NSAIDs with equal risk potential were observed to be cautiously used with appropriate knowledge amongst both the groups.

Pattern of prescription and drug use in psychiatry out patient department of private practitioners of Central India.

Background: Psychotropic drugs have had a remarkable impact in psychiatric practice. The continuous monitoring of prescription and drug utilization studies may help to identify the problem involved in therapeutic decision and promote rational prescribing. Very few studies from India have evaluated the prescription pattern of Psychiatrists. Present study was undertaken to analyze the prescription pattern and drug used in psychiatric Out Patients of private practitioners of Central India. Methods: One thousand prescriptions were collected by undergraduate students from chemist and analysed. Study parameter like demographic profile of patients viz. age, sex, diagnosis were recorded. Basic drug indicators, the prescribing pattern of antipsychotics and other categories of drugs were also recorded. The most common and, top brands of anti psychotics were analyzed .Inappropriate prescription if any were recorded and analyzed further. Result: The most common psychotropic drugs were anti-anxiety in 361(36.1%) and antidepressants 130 (13%) prescribed for various psychiatric disorder. Usage of Sedative Hypnotics 104(10.4%), anti-psychotics 90(9%) and anticonvulsants 80 (8%) drugs in prescriptions. The incidence of polypharmacy (22%) was common occurrence in prescriptions. The commonest combination prescribed was of tricyclic antidepressant with benzodiazepines. Central anti-cholinergic was commonly prescribed with anti psychotics. Conclusions: Anti-anxiety drug (benzodiazepines) was the most frequently prescribed class of psychotropic drugs in various psychiatry disorders. The prescribing prevalence of Alprazolam with different brand names was more than that of other benzodiazepines. The combination of different psychotropic drugs were also prescribed.

Evaluation of Prescribing Pattern of the Private Practitioners in Bangladesh.

A prescription order is a written instruction of doctors to pharmacist to supply drugs in particular form to a patient and the directions to the patients regarding the use of medicines. This study was undertaken to observe the prescribing patterns of the private practitioners in Bangladesh, 430 prescriptions were collected randomly from Dhaka city and analyzed using WHO/INRUD indicators. There were average 3.40 drugs per prescription. Drugs were prescribed in generic name only in 0.20%. About 46.31% drugs were prescribed from the Essential Drug List, only 19% of prescriptions were complete in respect to patient medication information. Antibiotics were prescribed in 70.33% of the prescriptions; injections were prescribed in about 8.35% of the prescriptions.

Renewed Thoughts on What is Being Required of Kampo / 日本東洋医学雑誌

At present, some 70% of physicians prescribe Kampo medicines in our country, and most medical departments and medical universities hold courses in Kampo. This was quite unthinkable just a half century ago. Be that as it may, Kampo now stands at a crossroads. EBM, RCT and scientification are being required of Kampo, while moreover it is being threatened by the tempest of globalization. Then there is the problem of crude drug resources. Without a proper response to these threats, Kampo will be swallowed up by modern medicine, left behind, and fade away. I, a simple private practitioner, do not hold the key to any solutions. Just from having been long involved with Kampo, however, I have my own thoughts and feelings, and I have shared them. And one thing I can saw with certainly is that Kampo should not lose sight of its origins, and should hold them dear. I have stated that “Kampo medicines essential treat the diseased, not diseases”. I have also touched on the word-of-mouth esotericism of Kampo, commented on the role of private practitioners, and, would very much like The Japan Society for Oriental Medicine to continue to be a place where we local practitioners too can speak out openly and with confidence.

Private sector involvement in tuberculosis control in Chandigarh.

Background: Private practitioners in India treat a substantial proportion of the TB cases. The present study is an attempt to find out the extent of private sector involvement in the control of tuberculosis in the Union Territory of Chandigarh. Methodology: The study was conducted in Union Territory of Chandigarh, during 2003-04. This study was a cross-sectional study involving 20 per cent of private practitioners practising allopathic system of medicine in Chandigarh. A questionnaire was used for collection of data after pre-testing. Results: Out of 114 doctors interviewed, 71 per cent dealt with TB patients. In response to a question as to how many sputum samples were required for routine microscopy, 72 per cent stated 3 samples but only 6 per cent knew the correct timing of sputum collection. 8.6 per cent of the practitioners followed the recommended guidelines of RNTCP treatment. As to reasons for not following the standard guidelines, 46.6 per cent said that they were not aware of these guidelines. About 82 oer cent were willing to be partners for implementation of RNTCP. A case history was given to practitioners to assess their knowledge regarding DOTS. It was observed that only 7.8 per cent knew the correct dosage and 21per cent knew the correct duration of treatment. Conclusion: Knowledge of private practitioners regarding RNTCP and DOTS strategy was poor and they were not following recommended guidelines for control of tuberculosis, but they were willing to participate in the programme.