Awareness of adverse drug reactions in third M.B.B.S students practicing self-medication

Background: Students self-medicate but the extent of their knowledge regarding potential adverse drug reactions (ADRs) to drugs consumed by them is not known. This has many implications. This study has attempted to evaluate this knowledge in third MBBS students practicing self-medication.Methods: In this cross-sectional study, a self-designed, pretested questionnaire was presented to third MBBS students in a teaching hospital. Information sought:-Demographic data, self-medication drugs used within last one month, indication, duration, awareness and expected ADRs for the drugs consumed. Results were calculated as percentages.Results: 79 out of 87 third MBBS students present on the day of study were presented with questionnaire all attempted it; giving a response rate of 100%. Within the last one month 31 (39.24%) had self-medicated. There was no significant difference in self-medication between male and female students. Medication was used for adequate duration (93.87%) and for apparently correct indications (81.6%) by most students. Main group of drugs consumed were NSAIDs including antipyretics (42.59%), antibiotics (18.53%) and antihistaminics (16.66%). Fourteen (45.16%) students said they were aware of potential ADRs to the consumed drugs and 13 (43.93%) listed expected ADRs correctly .Although a wide range of drugs were consumed, the number of ADRs mentioned were few and its spectrum limited. 11 (35.48%) students mentioned only one ADR. No student mentioned more than two ADRs. Dyspepsia (56.25%) was most common ADR stated.Conclusions: Considering the wide range of drugs consumed, the numbers of ADRs mentioned were few and their spectrum limited indicating scope for improvement

Immediate impact of an educational intervention on knowledge of use of disinfectants in nurses

Background: Adequate disinfection and sterilization is crucial to prevent hospital acquired infections, this requires knowledge of various types of disinfectants and of the categories of medical and surgical devices. Nurses play a key role in supervising the use of disinfectants. Hence, they are an important target group for educational interventions for rationalization of disinfectant use. We conducted an educational intervention in nurses, related to rational use of disinfectants. The objective was to evaluate the immediate impact of this intervention on change in knowledge of nurses.Methods: This was a questionnaire‑based pre‑ and post‑test cross‑sectional study. The questions were formulated to test nurses’ ability to (1) categorize commonly used medical and surgical devices (MSDs) (2) categorize disinfectants as high, intermediate and low level disinfectants (3) to evaluate their knowledge about different aspects of disinfectant use. Results of pre and post‑test were calculated as a percentage and Z test for difference between proportions was applied to test the statistical significance.Results: A total of 72 nurses filled the pre‑test and 70 the post‑test. Percentage of correct responders for classification of MSDs improved as follows‑critical (77.77% pre‑test to 95.71% post‑test), semicritical (18.05‑54.28%), noncritical (41.66‑72.85%). Percentage of correct responders for classification of disinfectants improved from pre‑ to post‑test glutaraldehyde (48.61‑88.57%), Hydrogen peroxide (30.55‑72.85%), benzalkonium (33.33‑58.57%). Identification of chlorine concentration required for cleaning floors improved from 38.88% to 70%. There was a significant improvement seen post‑test to items related to different aspects of disinfectant use.Conclusion: A positive immediate impact was observed, but there is a need for continuing education with interventions focused on various aspects of disinfectant use

Geriatric prescription analysis with respect to “STOPP” and “START” criteria: a descriptive study in the Indian scenario

Background: Patients; sixty-five years of age and above, are a special risk group as far as drug prescribing is concerned. Prescription irregularities in such patients may be hazardous. STOPP/START criteria are considered as the most up to-date set of explicit criteria for evaluating geriatric prescriptions. To analyse geriatric prescriptions in a tertiary care centre with respect to STOPP/START criteria and WHO core drug prescribing indicators so as to get an idea of pattern of drug prescription in geriatric patients as well as frequency of potentially inappropriate prescriptions. Descriptive cross-sectional study in a tertiary care hospital.Methods: All inpatients aged 65 years and above who were prescribed at least one allopathic medication and consented to participate in the study were included and patients admitted for medical emergencies were excluded. Demographic data and details of drugs prescribed were collected from prescription chits and indoor case papers.Results: There was a high frequency of polypharmacy, prescription of antimicrobials and injections. Proportion of patients receiving at least one potentially inappropriate medication (PIM) as per STOPP criteria was 21.01%. Proportion of patients subjected to at least one potential prescribing omission (PPO) as per START criteria was 33.33%. Proportion of patients exposed to potentially inappropriate drug prescriptions as a whole (PIPs=PIMs+PPOs) was 46.37%. Statistical analysis used as descriptive statistics like numbers and percentages were used for data analysis.Conclusions: With regards to geriatric prescribing, adherence to WHO core prescribing indicators, prescription of drugs as per STOPP and START guidelines are indicative of scope for improvement

Longitudinal study of self-medication practices in 2nd year MBBS students through their internship

Background: Self-medication is common in medical students but few studies address the concern regarding knowledge of adverse drug reactions (ADRs) among them. None of the study compares the practice of self-medication among the same medical students as their level of education increases. Hence the study was planned to compare the pattern, source, reason of self- medication and assess the level of awareness about potential ADRs to the consumed drugs in medical students during second year through their internship.Methods: It was a longitudinal cross sectional questionnaire-based study conducted among under graduate second year MBBS students of a medical college and repeated during their internship few years later in order to avoid variability in questionnaire. Chi-square and Fischer’s exact test were used for testing statistical significance. p value less than 0.05 was considered to be statistically significant.Results: 80 students were present on the day of study during their IInd MBBS and 73 students during their internship. Comparatively more students self-medicated during their internship than during their IInd MBBS (68% vs 55%). Analgesics (56.8% and 80%) were most commonly used. 35(70%) of interns were aware of potential ADRs and was statistically very significant in comparison to their awareness during IInd MBBS [9(20.45%)]. Interns rely more on themselves (96%) for self-medication.Conclusions: The practice of self-medication begins early in the career of medical students and is carried forward into their future. Hence it is imperative to educate students regarding responsible self- medication very early in their curriculum