Knowledge attitude and practice of haemovigilance among doctors in tertiary care hospital in Nagpur, Maharashtra, India

Background: Haemovigilance program of India was launched on December 2012 and is a comprehensive, and a well-structured approach to collect, collate, and analyse data to address the issues of adverse reactions associated with blood transfusion. The information thus collected would facilitate corrective and preventive actions to be taken to minimize the potential risk associated blood collection processing and transfusion to patients. Considering the deep concern over the under-reporting of transfusion reactions prevailing among the doctors, the present study was done to know the knowledge attitude and practice (KAP) of haemovigilance among doctors.Methods: The present study was a cross sectional questionnaire based study, which included doctors of a tertiary care hospital. The purpose of the questionnaire was to know awareness of doctors regarding haemovigilance programme of India. With this study we also tried to   identify the factors responsible for underreporting of transfusion reactions and to find out the possible ways to improve reporting of transfusion reactions.Results: (38.88%) and (30%) of the responders were aware of the haemovigilance programme and transfusion reaction reporting centre respectively. Reporting of transfusion reaction was poor 22.22% among the respondents. According to respondents creating awareness about haemovigilance by conducting continuing medical education (CMEs), and   training to healthcare professionals would lead to improvement in reporting of transfusion reactions. Complacency and ignorance were the main factors which discouraged transfusion reaction reporting by doctors.Conclusions: Increasing awareness of haemovigilance among doctors and training on reporting transfusion reactions would likely improve spontaneous reporting and help to strengthen the blood transfusion system

Knowledge and perception about generic drugs in patients coming to OPD of tertiary care centre

Background: In an era of rapidly rising health care costs generic medicines provide a less expensive alternative to branded medicines. In addition to reducing the overall health care expenditure, it has been shown to improve adherence. Objective was to study knowledge and perception about generic drugs among patients coming to outpatient department of tertiary care centre.Methods: After ethical approval a cross sectional questionnaire based study was conducted. Patients (n=71) were interviewed according to questionnaire in vernacular language by investigator to fill questionnaire.Results: About 28% people think that price of generic drug is less than a branded drug while nearly 61% of people don’t know of it. Only 18.85% participants had taken generic medicine. Trusting efficacy of generic drugs only 30 participants were in favour it. Even they have not seen or heard publicity of generic drugs (61.97%). They (60.56%) opined that generic drugs never prescribe in our country.Conclusions: Limitation in knowledge and perception about generic medicines has been seen among participants

Study of variation in price of various antidiabetic drugs available in Indian market

Background: Diabetes mellitus in early age is on the alarming rise in India, requiring lifelong treatment. There is a wide range of variation in the prices of antidiabetic drugs marketed in India. Hence, we decided to study price variations in the oral antidiabetic drugs available, either singly or in combination, and number of manufacturing companies for each, and to evaluate the difference in cost of different brands of same active drug by calculating percentage variation of cost.Methods: Cost of a particular drug being manufactured by different companies, in the same strength and dosage forms was obtained from “Current Index of Medical Specialties” July-October 2014 and “Indian Drug Review” July 2014. The difference in the maximum and minimum price of the same drug, manufactured by different pharmaceutical companies and percentage variation in price was calculated.Results: Percentage price variation among different group of drugs was found to be as follows: in sulfonylureas, it was highest in glimepiride 2 mg 836.44%, among biguanides - metformin 500 mg 245.55%, among thiazolidionediones-pioglitazone 15 mg 600%, among α glucosidase inhibitors - voglibose 284.61% and meglitinides - repaglinide 0.5 mg 181.40%. Among combination therapy glimepiride 1 mg + metformin 500 mg 366.66%, pioglitazone + metformin 207.51%, pioglitazone + glimepiride 268.42% showed maximum variation in price.Conclusion: The average percentage price variation of different brands of the same oral antidiabetic drug manufactured in India is very wide. The appropriate changes in the government policy, sensitizing the prescribers about cost of therapy and proper management of marketing drugs should be directed toward maximizing the benefits of therapy and minimizing negative economic consequences

Vitamin D: prescription audit in tertiary health care centre

Background: Vitamin-D is critically important for development, growth and maintenance of health of human being. Many evidences show association between vit-D deficiency and several serious health conditions. Data collection on use of drugs is being obtained with the aim of optimizing drug therapy. So far till date only few studies about prescription pattern of vit-D have been found. Hence it is very important to do audit of prescriptions of vit-D. The aim of the study is to provide concise and updated information about the use of vit-D in tertiary care hospital and to record demographic details of patients.Methods: After ethical approval, this cross sectional study was conducted at tertiary health centre. Patient and drug data (name of drug, dose, dosage form and route of administration) was collected from the patient’s prescriptions in OPD.Results: Highest prescriptions of vit-D were found in orthopedic department (22% of total prescriptions of that department). Prescribing percentage of vit-D in medicine department was 4.6%, dermatology 1.5% and in psychiatry 0.8% of total prescriptions. Prescriptions of vit-D in combination with calcium were found in orthopedics (52%), medicine (7%) and obstetrics and gynecology (10%) departments.Conclusions: Highest prescriptions of vit-D alone and with calcium found in orthopedic department. Periodic therapeutic audit is necessary to rationalise the use of vit D

Item analysis as tool to validate multiple choice question bank in pharmacology

Background: Multiple choice questions (MCQs) are a common method for formative and summative assessment of medical students. Item analysis enables identifying good MCQs based on difficulty index (DIF I), discrimination index (DI), distracter efficiency (DE). The objective of this study was to assess the quality of MCQs currently in use in pharmacology by item analysis and develop a MCQ bank with quality items.Methods: This cross-sectional study was conducted in 148 second year MBBS students at NKP Salve institute of medical sciences from January 2018 to August 2018. Forty MCQs twenty each from the two term examination of pharmacology were taken for item analysis A correct response to an item was awarded one mark and each incorrect response was awarded zero. Each item was analyzed using Microsoft excel sheet for three parameters such as DIF I, DI, and DE.Results: In present study mean and standard deviation (SD) for Difficulty index (%) Discrimination index (%) and Distractor efficiency (%) were 64.54±19.63, 0.26±0.16 and 66.54±34.59 respectively. Out of 40 items large number of MCQs has acceptable level of DIF (70%) and good in discriminating higher and lower ability students DI (77.5%). Distractor efficiency related to presence of zero or 1 non-functional distrator (NFD) is 80%.Conclusions: The study showed that item analysis is a valid tool to identify quality items which regularly incorporated can help to develop a very useful, valid and a reliable question bank

Knowledge, attitude and practice of adverse drug reactions reporting among nurses in a tertiary care centre

Background: Adverse drug reactions are one of the major medicine related problem related to pharmacotherapy which may lead to increased morbidity and mortality causing increased hospital stay and financial burden on the society. Spontaneous voluntary reporting of adverse drug reaction can play a vital role in generating safety signals in which nurses can play important role, hence this study was undertaken to evaluate the knowledge attitude and practice of ADR reporting along with factors affecting reporting among nurses.Methods: The present study was a cross sectional questionnaire based study, which included nurses of a tertiary care hospital in central India. We tried to find out the possible ways to perk up spontaneous reporting of ADR and factors responsible for scarce reporting of ADRs.Results: After analyzing the data, we observed few of responders were aware of the ADR reporting system and the most encouraging finding was that majority of the responders were of the view that this reporting system is necessary. However, response to practice related questions was below average. Main factors which discouraged ADR reporting by nurses was thinking that reporting would lead to extra work and non availability of forms.Conclusions: The deficiencies in ADR reporting require awareness so as to perquisite spontaneous reporting and improve safety of patients. Training to nurses will lead to improvement in reporting of ADR

Knowledge attitude and practice of haemovigilance among doctors in tertiary care hospital in Nagpur, Maharashtra, India

Background: Haemovigilance program of India was launched on December 2012 and is a comprehensive, and a well-structured approach to collect, collate, and analyse data to address the issues of adverse reactions associated with blood transfusion. The information thus collected would facilitate corrective and preventive actions to be taken to minimize the potential risk associated blood collection processing and transfusion to patients. Considering the deep concern over the under-reporting of transfusion reactions prevailing among the doctors, the present study was done to know the knowledge attitude and practice (KAP) of haemovigilance among doctors.Methods: The present study was a cross sectional questionnaire based study, which included doctors of a tertiary care hospital. The purpose of the questionnaire was to know awareness of doctors regarding haemovigilance programme of India. With this study we also tried to   identify the factors responsible for underreporting of transfusion reactions and to find out the possible ways to improve reporting of transfusion reactions.Results: (38.88%) and (30%) of the responders were aware of the haemovigilance programme and transfusion reaction reporting centre respectively. Reporting of transfusion reaction was poor 22.22% among the respondents. According to respondents creating awareness about haemovigilance by conducting continuing medical education (CMEs), and   training to healthcare professionals would lead to improvement in reporting of transfusion reactions. Complacency and ignorance were the main factors which discouraged transfusion reaction reporting by doctors.Conclusions: Increasing awareness of haemovigilance among doctors and training on reporting transfusion reactions would likely improve spontaneous reporting and help to strengthen the blood transfusion system