A cross-sectional survey on the attitudes and interests of rural population towards expanded pharmacist prescribing in India.

Background Shortage of qualified medical doctors and little or no access to basic medicines and medical facilities are the major rural health concerns in India. Expanding the role of pharmacists to provide prescribing services could improve rural health outcomes. Objective To assess the attitudes of rural population towards pharmacist prescribing and their interest in using expanded pharmacist prescribing services. Setting Rural population of Assam, India. Methods A descriptive, cross-sectional survey was conducted for a period of 2 months from March to April 2016 in the State of Assam, India. A multi-stage sampling was used to recruit (n = 410) eligible participants. Main outcome measure Rural population attitudes towards, and interests in using, pharmacist prescribing services. Results The attitudes of participants were generally positive towards pharmacist prescribing. A large proportion of participants (81.5%) agreed that pharmacists should have a prescribing role in rural India. Participants indicated their interest in using expanded pharmacist prescribing services, with greater interests in receiving medications in emergency situations (79.7%) and getting a treatment plan for their medical problem (75.6%). Participants with low income and tertiary education had better attitudes and showed more interest towards expanded pharmacist prescribing services (p < 0.05). Conclusions Most participants had positive attitudes towards pharmacist prescribing and were interested in using expanded pharmacist prescribing services.

Prescription patterns and appropriateness of antibiotics in the management of cough/cold and diarrhea in a rural tertiary care teaching hospital.

BACKGROUND: Acute gastroenteritis and respiratory illnesses are the major causes of morbidity and mortality in children under 5 years of age. The objective of this study was to evaluate the prescription pattern of antibiotic utilization during the treatment of cough/cold and/or diarrhea in pediatric patients. METHODS: A descriptive, cross-sectional study was conducted for 6 months in pediatric units of a tertiary care hospital in South India. Children under 5 years of age presenting with illness related to diarrhea and/or cough/cold were included in this study. Data were collected by reviewing patient files and then assessed for its appropriateness against the criteria developed in view of the Medication Appropriateness Index and Guidelines of the Indian Academy of Pediatrics. The results were expressed in frequencies and percentages. Chi-square test was used to analyze the data. A P < 0.05 was considered statistically significant. RESULTS: A total of 303 patients were studied during the study period. The mean age of the patients was 3.5 ± 0.6 years. The majority of children were admitted mainly due to chief complaint of fever (63%) and cough and cold (56.4%). The appropriateness of antibiotic prescriptions was higher in bloody and watery diarrhea (83.3% and 82.6%; P < 0.05). Cephalosporins (46.2%) and penicillins (39.9%) were the most commonly prescribed antibiotics, though the generic prescriptions of these drugs were the lowest (13.5% and 10%, respectively). The seniority of prescriber was significantly associated with the appropriateness of prescriptions (P < 0.05). Antibiotics prescription was higher in cold/cough and diarrhea (93.5%) in comparison to cough/cold (85%) or diarrhea (75%) alone. CONCLUSIONS: The study observed high rates of antibiotic utilization in Chidambaram during the treatment of cough/cold and/or diarrhea in pediatric patients. The findings highlight the need for combined interventions using education and expert counseling, targeted to the clinical conditions and classes of antibiotic for which inappropriate usage is most common.