DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20173274

Knowledge, attitude and prescriptional practice about fixed dose combinations among medical practitioners in tertiary care hospital

Aravind Ravichandran, Jayapriya Balamurugan, . Shankareshwari, Ramalingam Sekar

Abstract


Background: Fixed dose combination (FDC) are currently most prescribed and misused drug forms. Although fixed dose combinations are clinically better than single dosage forms, improper prescription and large amounts of irrational FDC flooding leads to unwanted financial burden and increased resistance. Therefore a study was carried out to know about the existing scenario about Knowledge Attitude and Practice of Fixed dose combinations among the resident doctors and devise some suggestions for improving the rationality. The objective of the study was to evaluate the knowledge, attitude and prescriptional practice regarding fixed dose combinations among resident doctors working in a Government Theni medical college, Theni.

Methods: A cross-sectional descriptive study involving 100 resident doctors was conducted using a pre validated questionnaire containing 21 questions to evaluate the knowledge and prescriptional practice of Fixed Dose Combination among the study participants.

Results: Ninety-five percent of the study participants were aware of the Fixed dose combination. Increased compliance and synergistic drug effect are the commonly cited advantages, whereas difficulty in dose adjustment and increased side effects were the commonly told disadvantages. Only 13% of the participants could name a single banned drug. Antibiotics (63%), NSAIDS (18%) were the commonly prescribed FDCs among study participants. Internet (58%), followed by textbook (42%) and colleagues (37%) were the common sources of knowledge about FDCs. Increasing awareness about Essential Medicines List (63%), regular CME (55%) and prior notification (50%) are some of the measures recommended by study participants to improve the awareness.

Conclusions: Although the participants are aware of basic knowledge of fixed dose combinations are acceptable, prescribing FDC them often, many of the study participants lack knowledge about the rationality of these drugs. From our study, conducting regular CME’s about new Fixed dose combinations in the medical colleges and periodic notification of FDC’s are some of the suggested approaches to improve the rationality of prescription. Since Internet is listed as the most common source of knowledge about FDC, information about FDC can be sent through mails, text messages, which will play a part in improving the rationality of FDC.


Keywords


Fixed dose combinations, KAP, Prescription, Rationality

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References


WHO Expert Committee on Specifications for Pharmaceutical Preparations: thirty-ninth report. (WHO technical report series; 929). 2005.

Pillay A, Keche Y, Yegnanarayan R, Patil V, Patil G, Dangare R. Evaluation of prescribing patterns of teaching and non teaching hospitals by undergraduate medical students in Pune, India

Sharma K, Sharma A, Neemawat K. An audit of prescription for rational use of fixed dose drug combinations at a tertiary care dental setting. J Sci Innovative Res. 2014;3:491-4.

Tripathi, KD. Essentials of Medical Pharmacology. 6th edition. New Delhi: Jaypee Brothers, 2008.

Gulhati CM. Irrational fixed-dose drug combinations: a sordid story of profits before patients. Issues Med Ethics. 2003 Jan;11(5).

Gupta YK, Ramachandran SS. Fixed dose drug combinations: Issues and challenges in India. Indian journal of pharmacology. 2016 Jul;48(4):347.

Dalal K, Ganguly B, Gor A. Assessment of rationality of fixed dose combinations approved in CDSCO list. Journal of clinical and diagnostic research: JCDR. 2016 Apr;10(4):FC05.

The Ministry of Health and Family Welfare. List of fixed dose combinations (FDC) banned 10/3/2016. Available at: www.drrohanjshenoy.com/wpcontent/.../2016/.../FDCs-banned-on-10-March-2016.p

Goswami N, Gandhi A, Patel P, Dikshit R. An evaluation of knowledge, attitude and practices about prescribing fixed dose combinations among resident doctors. Perspectives in clinical research. 2013 Apr 1;4(2):130.

Manu G, Narasimhamurthy KM, Padmanabha TS. An evaluation of knowledge, attitude and practices about prescribing fixed dose combinations among postgraduates of a rural tertiary health care teaching hospital. Int J Basic Clin Pharmacol. 2016;5:2476-80.

George B. Evaluation of Awareness about Fixed Dose Combination among the Practitioners in Dentistry: A Question Based Study. International Journal of Chemical and Life Sciences. 2017 Feb 10;3(5):1322-4.

Jain NK, Akarte A, Deshmukh PT, Kannojia P, Garud N, Yadav A. Rationality of fixed dose combinations: an Indian scenario. Pharma Res. 2009;1:158-68.

Rayasam SP, Dudhgaonkar SS, Dakhale GN, Hire RC, Deshmukh PS, Gaikwad NN. The irrational fixed dose combinations in the Indian drug market: an evaluation of prescribing pattern using WHO guidelines.

McGettigan P, Roderick P, Mahajan R, Kadam A, Pollock AM. Use of fixed dose combination (FDC) drugs in India: central regulatory approval and sales of FDCs containing non-steroidal anti-inflammatory drugs (NSAIDs), metformin, or psychotropic drugs. PLoS Med. 2015 May 12;12(5):e1001826.

Patil PJ, Patil MJ, Patil VR, Deshmukh TA, Band SS. A survey on awareness of Fixed Dose Combinations (FDCs) among patients, physicians and pharmacists at Pune and Beed (India). Indian Journal of Pharmacy Practice. 2013;6(3).

Gautam CS, Saha L. Fixed dose drug combinations (FDCs): rational or irrational: a view point. British journal of clinical pharmacology. 2008 May 1;65(5):795-6.

Diwedi P. Regulatory control on banned drug: A review article. Critical review in pharmaceutical sciences. 2012;1(3):1-2.

Atal S, Phadnis P, Gudsurkar G. A study to assess and increase awareness regarding fixed dose combinations among medical undergraduates at Indore and Sagar, Madhya Pradesh, India. International Journal of Basic & Clinical Pharmacology. 2016 Dec 28;5(2):300-6.

Kshirsagar M, Langade D, Patil S, Patki PS. Prescribing patterns among medical practitioners in Pune, India. Bulletin of the World Health Organization. 1998;76(3):271.