DRUG USE PROFILES IN AN NGOMANAGED HEALTH CENTRE VERSUS PRIVATE HEALTH PRACTITIONERS

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DRUG USE PROFILES IN AN NGO-MANAGED HEALTH
CENTRE VERSUS PRIVATE HEALTH PRACTITIONERS

• Mandal SC Indian Pharmaceutical Association,
  Bengal Branch, Kolkata
• Mandal M Dept. of Pharmacy, J.C.Ghosh
  Polytechnic, Kolkata

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AbstractStudy of Rational Drug Use Profiles in
an NGO-Managed Health Center versus Private
Health PractitionersMandal SC Indian
Pharmaceutical Association, Bengal Branch,
Kolkata Mandal M Dept. of Pharmacy, J.C.Ghosh
Polytechnic, Kolkata.

• It is a fact in India that a section of the
  populace is receiving drugs, often even
  unnecessary and avoidable ones, which leads to
  national wastage of funds and drugs as well as
  drug resistance. On the other hand, another
  section is deprived of even basic health care,
  resulting in access to modern medicines by only
  30 of the population. Moreover the cost of
  health care is spiralling day by day. Health
  administrators and policy makers need to urgently
  redesign the existing health infrastructure to
  extend health care to a greater section of people
  at an affordable cost. For this purpose it is
  essential to collect data to assess the drug
  utilization patterns in the country and to make
  necessary interventions and policy changes to
  eliminate the shortcomings
• To compare drug utilization patterns (DUPs) in
  different health-care setups for assessing
  rational use of medicines, a model study was
  conducted at community pharmacies and an
  Non-Governmental Organization (NGO)-managed
  health-care setup in West Bengal, India. The
  survey took three months and involved 10
  community pharmacies serving mainly private
  practitioners and one NGO-run health center. Data
  were collected over a two-hour period per day
  from the prescription-serving pharmacies. We
  analyzed 720 prescriptions from community
  pharmacies and 480 from the health center.
• Results show that the number of medicines
  prescribed per encounter is 3.60 and 2.36
  respectively in community pharmacies and the NGO.
  Out of these, only 1.35 and 24.33
  prescriptions are for generics. Percentage of
  prescriptions for antibiotics, vitamin tonics,
  fixed dose combinations and injections are quite
  high in community pharmacies (52.3, 45.1,
  85.75 and 9.1 respectively) in comparison to
  the NGO health center (40.93, 6.00, 41.70 and
  0.4 respectively).
• Frequent use of fixed-dose combinations,
  antibiotics, and vitamin tonics and polypharmacy
  were the trends identified by this survey. The
  average number of drugs prescribed per encounter
  (3.6) was quite high compared with that of the
  NGO-managed health center (2.36), posing
  increased chances of adverse drug reaction
  incidents and increased cost of treatment. Use of
  antibiotics and injections was also higher in
  community pharmacies. Use of generics was more
  common at the health center.

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Introduction

• It is a fact in India that a section of the
  populace is receiving drugs, often even
  unnecessary and avoidable ones, which leads to
  national wastage of funds and drugs as well as
  drug resistance.
• On the other hand, another section is deprived of
  even basic health care, resulting in access to
  modern medicines by only 30 of the population.

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Introduction cont.

• Moreover the cost of health care is spiraling day
  by day.
• Health administrators and policy makers need to
  urgently redesign the existing health
  infrastructure to extend health care to a greater
  section of people at an affordable cost.
• For this purpose it is essential to collect data
  to assess the drug utilization patterns in the
  country and to make necessary interventions and
  policy changes to eliminate the shortcomings.

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Objective

• General To compare drug utilization patterns
  (DUPs) in different health-care setups for
  assessing rational use of medicines.
• Particular
• To measure the degree of polypharmacy.
• To measure the tendency to prescribe by generic
  name.
• To measure the overall level of use of
  antibiotics injections, but commonly overused
  and costly forms of drug therapy.
• To measure the use of FDCs.

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Methods

• To determine the DUPs, a model study was
  conducted at community pharmacies and an
  Non-Governmental Organization (NGO)-managed
  health-care setup in West Bengal, India.

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Setting and Population

• The survey took three months and involved 10
  community pharmacies serving mainly private
  practitioners and one NGO-run health center.
• Data were collected over a two-hour period per
  day from the prescription-serving pharmacies.
• We analyzed 720 prescriptions from community
  pharmacies and 480 from the health center.

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Outcome Measures

• No. of medicines prescribed per encounter
• of prescriptions for generics
• of prescriptions for antibiotics
• of prescriptions for vitamin tonics
• of prescriptions for Fixed-Dose Combinations
• of prescriptions for injections

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Results

• Results show that the number of medicines
  prescribed per encounter is 3.60 and 2.36
  respectively in community pharmacies and the NGO.
  
• Out of these, only 1.35 and 24.33 prescriptions
  are for generics.

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Results cont.

• Percentage of prescriptions for antibiotics,
  vitamin tonics, fixed dose combinations and
  injections are quite high in community pharmacies
  (52.3, 45.1, 85.75 and 9.1 respectively) in
  comparison to the NGO health center (40.93,
  6.00, 41.70 and 0.4 respectively).

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Trend of Drug Use
12
Trend of Drug Use
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Conclusion

• Frequent use of fixed-dose combinations,
  antibiotics, and vitamin tonics and polypharmacy
  were the trends identified by this survey. The
  average number of drugs prescribed per encounter
  (3.6) was quite high compared with that of the
  NGO-managed health center (2.36), posing
  increased chances of adverse drug reaction
  incidents and increased cost of treatment. Use of
  antibiotics and injections was also higher in
  community pharmacies use of generics was more
  common at the health center.