Prescription of medicines by medical students of Karachi, Pakistan: A cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Prescription of medicines by non-doctors is an issue with serious global implications. To our knowledge prescription of drugs by medical and non-medical students has not been studied before. We aimed to determine the practice and attitudes of drug prescription by medical students and: a) how non-medical students respond to this practice, b) How this compares with the attitudes and practices of non-medical students.</p> <p>Methods</p> <p>A cross-sectional study was conducted on a sample of 600 students randomly selected from 2 medical and 2 non-medical universities. Ethical requirements were ensured and data was collected using self administered questionnaires. The Chi square tests and logistic univariate regression analyses were performed using SPSS v 14 to identify associations and differences.</p> <p>Results</p> <p>A total of 572 forms were completed and the sample consisted of 295 medical students and 277 non-medical students with no significant difference in their demographic profile. Of the 295 medical students 163 (55.3%) had prescribed a medicine independently and most (48.5%) said that they did this 2–3 times a year. The commonest reasons for this were 'previous experience' (68.7%), 'problem too trivial' (34.4%) and 'we knew everything about the condition' (31.3%). One-third (33.6%) of the undergraduate medical students thought that it was alright to independently diagnose an illness while a vast majority (78.3%) thought that it was alright for them to prescribe medicines to others. Common prescriptions were pain-killers, antipyretics, antiallergics and antibiotics. Medical students who prescribed medicines were of lesser age (CI = 1.366–1.887) and more likely to belong to the 1^st(CI = 3.588–21.731), 2^nd(CI = 2.059– 10.869) or 3^rd(CI = 4.331–26.374) year of medical college. One-third (33.9%) of the non-medical students reported that a medical student had prescribed medicines to them and 21.3% said that they trusted medical students and would follow their advice blindly. Many students thought it alright for medical students to diagnose and treat illnesses. A similar proportion of non-medical students (58.5%) reported prescribing medicines to others.</p> <p>Conclusion</p> <p>Prescription of medicines by non-doctors is rampant and urgent corrective measures are warranted. We have highlighted areas for future research and intervention and have given a few recommendations.</p

Evaluation of pharmaceutical industry - Sponsored educational events attended by physicians in Pakistan

The objectives of this study were to identify and document various medical educational events attended by physicians in Pakistan. A cross-sectional study using a structured questionnaire was undertaken with a representative sample of physicians in four major cities: Bahawalpur and Lahore in Punjab province and Loralai and Quetta in Balochistan province. All the data were analyzed using SPSS version 15. Frequencies and percentages were used to summarize the data, and Chi-squared tests, Fisher Exact tests, and Spearman rho were used whenever appropriate. The main study finding indicated that most of the physicians (i.e. general practitioners (GP), GP/specialists and specialists) had attended industry-sponsored educational events. It was found that 173 (69.2%) of 250 respondents attended 727 educational events during the last 1 year. Of these 727 events, 222 (30.54%) were lectures, 207 (29.47%) were scientific conferences, 112 (15.41%) were drug launching ceremonies, 58 (7.98%) were seminars, 38 (5.23%) were training courses and 29 (3.99%) were discussion forums. Out of 173, most of the doctors attended educational events organized by professional organizations of the medical community and sponsored/co-organized by the pharmaceutical industry (n = 115, 67.3%; p = 0.001). Some of them (n = 27, 15.8%) attended the events which were organized by pharmaceutical companies independently, without involvement of professional organizations. The pharmaceutical industry was the largest sponsor source for physicians (n = 123, 71.9%) to attend educational events. The type of expenses paid for attending the educational events included meals (n = 162, 94.7%), accommodations (n = 118, 96%; p < 0.001), airfare (n = 96, 56%; p < 0.001), registration fees (n = 96, 56%; p < 0.001), taxi fare (n = 75, 43.9%; p = 0.012), and participation fees (n = 14, 8.2%). Educational events are extensively being used as a promotional tool for pharmaceutical products. The findings of the current study reflect the significant role of the pharmaceutical industry in the organization of doctor-led educational events.Imran Masood, Mohamed Izham Mohamed Ibrahim, Mohamed Azmi Ahmad Hassali, Mahmood Ahmad and Peter R Mansfiel