Study of Rational Medicine Use Pattern by Practitioners in An NGO-Managed Health Center Versus Private Practitioners

Subhash C. Mandal, Moitreyee Mandal

Abstract: Rational Use of Medicine can be applied as a tool to improve access to medicines. To implement this 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 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. 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 ( s=1.21) and 2.36 (s =0.81) respectively in community pharmacies and the NGO. Out of these, only 1.35% and 24.33% prescriptions are for generics respectively. 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 was quite high compared with that of the NGO-managed health center, 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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