ABSTRACT
Background: The aim of this study was to evaluate knowledge, attitude and practices of practitioners in the medicine department of tertiary care teaching rural hospital with respect to antihypertensives and find out the disparity between the recommended and actual practices for pharmacological management. Methods: It was survey type of study, carried out using feedback questionnaire related to use of antihypertensives. Total 25 consultants were included in the study. Results: It was found that in mild hypertension single drug and two drugs in combination were preferred by 15 and 10 practitioners respectively. In moderate hypertension single drug, two drugs in combination, and greater than two drugs were preferred by 3, 13, and 7 practitioners respectively. In severe hypertension two drugs in combination and greater than two drugs were preferred by 16 and 9 practitioners respectively; none preferred single drug. Angiotensin converting enzyme inhibitors /angiotensin receptor blockers, beta blockers, Calcium channel blockers, diuretics were preferred as first line drug by 7, 4, 8, and 16 practitioners respectively. Most commonly preferred combination was Losartan and amlodipine by 16 practitioners. In pregnancy nifedipine was preferred as the first line drug while in elderly diuretics were preferred. In hypertensive patients with age less than 40 years all practitioners preferred ACEIs/ARBs. In diabetics ACEIs/ARBs was preferred by all practitioners. Each practitioner claimed to follow Joint National Committee (JNC) 7 criteria. Cost of drug was an important consideration in all their prescribing patterns. Conclusion: The knowledge, attitudes and practices followed by the practitioners of Dhiraj hospital were satisfactory and guidelines oriented.
ABSTRACT
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.