Assessment of knowledge, attitude and practices among the residents and interns about rational fixed drug combinations in tertiary health care centre in Central India

Pallavi Admane, Sachin Hiware, Mohini Mahatme, Sujata Dudhgaonkar, Mukunda Bargade, Swapnil Deshmukh


Background: Fixed drug combination (FDC) is a combination of two or more active drugs in a single dosage form. Rational fixed drug combination improves patient compliance, enhances the efficacy of combination and minimizes side effects. But unfortunately, many FDCs introduced in Indian market are irrational. Prescription of irrational FDCs increases morbidity, mortality, treatment failure, emergence of resistance and financial loss to community. Since junior doctors like residents and interns are the backbone in patient care in the tertiary care hospital, knowledge of FDC in them has paramount importance.

Methods: A prospective, cross sectional, observational study was carried out to assess the knowledge, attitude and practice about the use of FDC by junior resident doctors and interns. A pre-validated questionnaire was given to two hundred doctors from various departments and data was analyzed. Questions were based on knowledge of National Essential List of Medicine (NELM), rational FDC and criteria of rationality.

Results: Seventy six percent health care professionals had the knowledge of FDC. Only 48% were aware about FDCs mentioned in WHO Essential List of Medicine. Most of them were aware of advantages and disadvantages of FDCs. Common sources of information were medical representatives, textbooks and Current Index Of medical Specialities (CIMS). Fifty eight percent doctors preferred to prescribe FDC, and ninety two percent avoid use of irrational FDCs. Most commonly prescribed rational fixed drug combination was amoxicillin + clavulanic acid. Paracetamol + ibuprofen was the most commonly prescribed irrational FDC.

Conclusions: There is need to improve knowledge of rational fixed drug combination, NELM list.



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