Anomalies in prescriptions at top govt hospitals: ICMR
Doctors at some of India’s top government-run hospitals stray from established guidelines while prescribing medicines, an Indian Council of Medical Research (ICMR) investigation has found.
Many of these are junior doctors unable to prioritize and multi-task while seeing a large number of patients in limited time at outpatient departments (OPDs), found the study, which was published in the Indian Journal of Medical Research.
While prescribing, doctors are supposed to adhere to guidelines of by the World Health Organization and the Union health ministry. But nearly 10% of prescriptions showed “unacceptable deviations,” from the guidelines, and 45% departed from normal treatment standards, found the study, which was conducted as part of the ICMR's Rational Use of Medicines (ICMR-RUM) task force project.
The study titled “Evaluation of prescriptions from tertiary care hospitals across India for deviations from treatment guidelines and their potential consequences”, found that the prescriptions with unacceptable deviations could have been written by junior doctors who have to cater to a large number of patients and are unable to prioritize and multitask within the fixed time allotted for OPD duties.
“Besides this, inadequate emphasis on rational prescribing in medical curriculum and drug promotion by pharmaceutical industries may also have contributed to the inappropriate prescribing and noncompliance to guidelines,” the study noted.
The study is based on 4,838 prescriptions s from outpatient departments which were analyzed from 13 RUMCs of 13 tertiary care hospitals and medical colleges, including the prestigious All India Institutes of Medical Sciences (AIIMS) in New
Delhi and Bhopal,
KEM Hospital in Mumbai, Post Graduate Institute of Medical Education & Research (PGIMER) in Chandigarh, and Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) in Puducherry.
Dr Rima Dada, media in-charge, AIIMS Delhi, said, “Our prescriptions are comprehensive, we write generic medicines—the dosage and duration of the medicines properly explained in prescriptions. And not only that, we explain that clearly to patients in OPD. Some of the OPD are running till 11pm and see about 20,000 patients daily. We have a floating population of junior and senior resident doctors, so we take training on regular basis so that they are also trained as to how to write prescriptions and how to explain to the patients.”
The prescriptions were for patients OPDs of different specialities, including community medicine, general medicine, surgery, obstetrics and gynaecology, paediatrics, dermatology, ophthalmology, otorhinolaryngology, psychiatry, orthopaedics, chest medicine, dentistry and superspeciality OPDs.
The study states 10% prescriptions show deviations and 45% departed from normal treatment standards