A study on awareness about package inserts among postgraduate medical students: an observational questionnaire based study

Background: A package insert is a document approved by the administering licensing authority, which is provided with the package of a drug. A good package insert can prove to be of immense help to doctors as they are evidence based and are updated from time to time. The objective to study the awareness about package inserts among postgraduate medical students.Methods: The present study was a cross-sectional observational study carried out on 68 postgraduate medical students of Acharaya Shri Chander College of Medical Sciences and Hospital Sidhra, Jammu (J & K) in the month of February 2017 after taking approval from the institutional ethical committee. Pre-validated self-administered questionnaire was used to elicit responses from the students. The questionnaire consisted of specified questions regarding knowledge and opinion about package inserts.Results: In the present study, 86.7% of the students understand the relevance of Package inserts (PIs). About 72% of the students think that PIs are a necessary add-on to drug information and 70.6% of the students think that information given on package inserts is necessary for the patients. However, only 2.9% of the students had the knowledge of Drug Acts governing the information to be provided on PIs in India. About 86.8% of the students think that PIs should also be in regional language apart from in English language.Conclusions: It was found from the present study that the majority of the postgraduate students were aware about the package inserts available with the medicines but the information provided on package inserts was not optimally used by them. To achieve the target of optimally utilization of information provided in the package inserts, the PIs should be designed by considering the needs and information of two differently educated target groups i.e; patients and doctors

A study on determinants of underreporting of adverse drug reactions among resident doctors

Background: Adverse Drug Reactions (ADRs) are global problem with significant morbidity and mortality. Health care providers/professionals (HCPs) play a critical role in ADR surveillance. However, only 6% of all ADRs are reported and under-reporting acts as great impedance in exchange of drug information. Thus, spontaneous reporting of suspected adverse drug reactions requires greater commitment from healthcare professionals. The aim was to determine the reasons of underreporting of ADRs among resident doctors.Methods: This was a cross-sectional observational study with self-administered questionnaire assessing the reasons for underreporting of ADRs among resident doctors.Results: Very low level of awareness about ADR reporting was found among doctors. Eighty eight percent of doctors did not know the authority and the procedure for ADR reporting. About 32.8% were not sure with the reaction and the drug, while 46.3% doctors felt that there is no need of reporting the recognized reactions again. Other factors responsible for under reporting were lack of time in 73% and cumbersome procedure in 45% of the participants.Conclusions: A poor level of awareness of pharmacovigilance was seen among doctors. Measure to improve awareness, accessible systems for reporting and effective National Programme are required to improve reportin

A study on assessment of awareness on generic drugs among doctors in a tertiary care teaching hospital in north India

Background: The assessment of doctors’ perceptions and understanding about generic medicines may help in recognizing the key areas which may act as hurdle to mass scale use of generics. The primary objective of this study was to explore the knowledge, attitude, and practice (KAP) of doctors toward generic medicines.Methods: A cross-sectional study was carried out using a pretested questionnaire in a tertiary care teaching hospital of Jammu (J and K). The questionnaire was designed to assess the KAP about generic medicines. The doctors working in this institute during the study period were included. Data was compiled and analysed using online website, http://www.graphpad.com. P-values of < 0.05 were considered to indicate statistical significance.Results: A 62.9% doctors agreed to the fact that generic medicines were intended to be interchangeable with a branded drug (p=0.0139). Among the doctors, 77.5% were aware that generic drug manufacturers need to conduct studies to show bioequivalence between the generic medicine and their branded counterparts (p =0.0001). 88.8% of the doctors agreed that importance of generic medicines should be taught in early part of internship. 80.9% doctors did not think that switching a patient from a brand-name to generic drug may change the outcome of the therapy (p <0.0001).Conclusion: The present study showed that a good percentage of doctors were well aware of generic medicines’ usage. However due to concerns expressed by a certain fraction of participants, further work is needed on how interventions for medical professionals and for the public can lead to increase in the awareness and acceptability of generic medicines

Assessment of rational prescribing practice among interns: a questionnaire based observational study

Background: Rational use of medicines (RUM) is recognized as an important factor in health policy. Prescribing appropriate drugs in right doses is an integral part by which a physician can influence the patient’s health and well‑being. Rational prescription writing is a skill which should be mastered at the earliest. Understanding the knowledge and perception of interns will help us to identify the problems in clinical pharmacology teaching, and the method to implement RUM. Objective was to assess the rational prescribing practice among interns in a tertiary care teaching hospital.Methods: This cross-sectional, questionnaire-based study was carried out in 92 interns of Acharaya Shri Chander College of Medical Sciences and H, Sidhra, Jammu (J and K). Interns posted in different departments of the hospital in the year 2016 (n = 92) were approached and explained the purpose of the study. 88 gave consent to participate in the study. Out of 88 only, 82 duly filled questionnaires were used for final analysis. Those who were not willing to participate in the study and those whose questionnaires were not duly filled were excluded from the study. The completed questionnaires were then assessed for responses of the students on principles of good prescribing.Results: Of the 92 interns, 88 gave consent to participate in the study while 82 of them returned the duly completed questionnaires (response rate was 89.1%). The mean age of the respondents was 24.1 years. Out of 82 interns, 95.1% respondents were aware about the term RUM, only 8.5% had National List of Essential Medicines of India (NLEMI) available at their work place. Though 41.5% interns were aware of the term P-drug, only 3.7% were aware about STEP criteria. Majority of interns 62.1% relied on information from standard text books whereas 24.3% rely on Medical representatives (MR) for obtaining information about various drugs and regimens.Conclusions: In conclusion, it is encouraging finding that higher percentages of interns were aware about essential medicines (EM) and also prescribe it. However, level of understanding related to personal drug (P-drug) concept and existence of Essential medicine list (EML) are much below par. Furthermore, prescribing by trade name and dependency on MR for drug information is the matter of concern. Hence, there is a need to strengthen the mechanism for continuing professional development of interns to update their knowledge and skills to prescribe rationally

An observational study to assess the knowledge of migraine among patients with migraine at a tertiary care teaching hospital

Background: Migraine is a common debilitating headache the exact cause of which is not known. Efficient and proper treatment of migraine involves accurate diagnosis, educating the patients and to make them aware of the disorder and finding the best medication for the management of pain. This will also increases the patients’ adherence to medication and will help in improving their quality of life. The objective of the study was to assess the awareness of migraine patients towards various aspects of migraine in a tertiary care teaching hospital.Methods: This was a cross-sectional observational questionnaire-based study conducted from January to March 2017 in ASCOMS&H, Sidhra, Jammu. The self-administered pre-validated questionnaires pertaining to various aspects of migraine were distributed among the patients diagnosed of having migraine and attending the Neurology Out patient department (OPD). Patients of either sex with a diagnosis of migraine and age ≥18 years were included in the study. The data was analyzed with the help of descriptive statistics.Results: In the present study, majority of the patients suffering from migraine were in the age group of 18-40 years (58.6%) and females were more commonly affected about 60.9% than males. There was no family history of migraine in 78.1% of the patients. About 87.4% of the patients had 2-6 attacks of migraine per month. The most common triggering factor cited by the patients was lack of sleep in 29.9% followed by stress in 27.6% and less water intake in 26.4% of the patients.Conclusions: From the present study, it can be concluded that the patients were aware about the associated signs and symptoms but they had inadequate knowledge about all the aspects of the disease. Therefore, it is important to make patients more aware of the disease to increase their compliance to treatment and to improve their quality of life

Study of prescription pattern of drugs used in the treatment of osteoarthritis in a tertiary care teaching hospital: an observational study

Background: Osteoarthritis(OA) is a major cause of chronic pain and lower extremity disability among the elderly due to its predilection for lower extremity joints such as the knee and hip. Although Paracetomol is the initial drug of choice, NSAIDS are also frequently used in the symptomatic relief of osteoarthritis. But still, there is a need for safe and effective alternative treatments which would provide both symptomatic improvement and disease modifying effects in OA. The primary objective was to study the prescribing pattern of drugs used in the treatment of osteoarthritis.Methods: A cross-sectional, prospective, observational study was conducted on newly diagnosed as well as old treated patients with osteoarthritis from orthopaedic outpatient department in a tertiary care teaching hospital. A total of one hundred and eighty-eight patients were enrolled after screened for the inclusion and exclusion criteria. Data was recorded in a specially designed proforma which include information regarding the demographic profile of the patients and about the pattern of drugs prescribed.Results: Out of one hundred eighty-eight patients who were affected with Osteoarthritis, females (57.9%) were more commonly affected than males (42%). OA knee (77%) either unilateral or bilateral was most commonly affected, followed by hip joint, spine and other joints. NSAIDS were more frequently prescribed in 76.6% patients than paracetamol which was prescribed in only 34 % of patients and that only in combination with NSAIDS and opioids. Various other drugs were also used as adjunct therapies that included gastroprotective agents in 49% of patients, Calcium in 54% of patients, Vitamin D3 supplements in 51% of patients and symptomatic slow acting drugs for OA (SYSADOA) which included diacerin and glucosamine sulfate as combination in 11% of patients.Conclusions: Our study showed Osteoarthritis knee being most common among female patients. Paracetamol and SYSADOA being under prescribed and NSAIDS are the most frequently used drugs in OA. National drug policy is needed to rationalize the drug use and bring awareness among the prescribing doctors.

Study of prescribing pattern of drugs used in the treatment of hypertension in a tertiary care teaching hospital in North India: an observational study

Background: Hypertension is one of the most common chronic diseases leading to high mortality and morbidity. In order to prevent complications and to improve the patient survival, the early and efficient management of essential hypertension is very much needed. In this context, the use of established anti-hypertensives assumes paramount importance. Objective was to study the prescribing pattern of anti-hypertensive drugs in a tertiary care teaching hospital in north India.Methods: It was a cross-sectional observational study involving 205 prescriptions for patients suffering from primary essential hypertension in the Medicine Outpatient Department of Acharaya Shri Chander College of Medical Sciences and Hospital, Sidhra, Jammu, J and K. All hypertensive patients irrespective of age and sex visiting OPD and treated with at least one hypertensive drugs were included in the study. Data was obtained from the patients by scrutinizing the out patients regarding the demographic profile and details pertaining to the prescribing pattern of antihypertensive drugs used for the treatment of hypertension.Results: A total of 205 prescriptions were analysed during the study period. Out of which 131 (63.9%) were males and 74 (36.1%) were females. Maximum numbers of patients were in the age group of 50-59 years 60 (29.3%) patients. 145 (70.7%) of the patients had a family history of hypertension, (61.5%) of the patients were in stage-I hypertension and (56.1%) were of normal BMI. The results revealed that, the maximum number of 86 (41.9%) patients underwent dual therapy in 86 (41.9%) followed by monotherapy in 59 (28.7%) of patients.Conclusions: From the present study, it can be concluded that in hypertension calcium channel blockers are the most frequently prescribed classes of drugs alone and diuretics are the most commonly used class of drugs in combination. However, further studies are necessary to set up a rationale or pattern for the choice of medication; taking into consideration the demographic factors involved in the prevalence of hypertension

Comparative assessment of antibiotic resistance among first and second year undergraduate medical students in a tertiary care teaching hospital

Background: Antibiotics are one of the commonest prescribing drugs in day to day practice. However indiscriminate and irrational use of antibiotics has given rise to the emergence of antibiotic resistance. Thus, intervention in the form of educating students and making them aware about this important concept should be initiated at the gross root level right from the beginning of medical profession. Objective was to assess the comparative awareness regarding antimicrobial resistance between first and second year MBBS students.Methods: This was a comparative, cross-sectional questionnaire based study. Two forty six undergraduate medical students, 118 students from 1st year and 129 students from 2nd year MBBS were included in the study to assess the extent of knowledge and about the problem of antibiotic resistance. Self-administered questionnaire was used to collect the data from respondents. The questionnaires of both the groups were analyzed for the responses of the students and were compared using student ‘t’ test and chi-square test.Results: Majority of the participants 63.6% and 72.9% had completed the full course of antibiotics as prescribed by the physician. Statistically significant difference (p<0.05) was found between the two groups where in 58.4% of the first year and 16.3% of the second year students were of the view that antibiotics can be used for viral illnesses. Only 44.1% students of first year knew the reasons for antibiotic resistance.Conclusions: It can be concluded from the present study that second year medical students were more aware regarding antimicrobial resistance as compared to first year MBBS students who represented the general public. Thus, it is very important to educate the students in a practical manner about this concept as they are the future health care givers who can promote the rational use of antibiotics in near future