DRUG USE PROFILES IN AN NGO-MANAGED HEALTH CENTRE VERSUS PRIVATE HEALTH PRACTITIONERS

1. DRUG USE PROFILES IN AN NGO-MANAGED HEALTH CENTRE VERSUS PRIVATE HEALTH PRACTITIONERS Mandal SC: Indian Pharmaceutical Association, Bengal Branch, Kolkata; Mandal M: Dept. of Pharmacy, J.C.Ghosh Polytechnic, Kolkata

2. AbstractStudy of Rational Drug Use Profiles in an NGO-Managed Health Center versus Private Health PractitionersMandal SC: Indian Pharmaceutical Association, Bengal Branch, Kolkata; Mandal M: Dept. of Pharmacy, J.C.Ghosh Polytechnic, Kolkata. • It is a fact in India that a section of the populace is receiving drugs, often even unnecessary and avoidable ones, which leads to national wastage of funds and drugs as well as drug resistance. On the other hand, another section is deprived of even basic health care, resulting in access to modern medicines by only 30% of the population. Moreover the cost of health care is spiralling day by day. Health administrators and policy makers need to urgently redesign the existing health infrastructure to extend health care to a greater section of people at an affordable cost. For this purpose 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 compare drug utilization patterns (DUPs) in different health-care setups for assessing rational use of medicines, 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 and 2.36 respectively in community pharmacies and the NGO. Out of these, only 1.35% and 24.33% prescriptions are for generics. 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 (3.6) was quite high compared with that of the NGO-managed health center (2.36), 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.

3. Introduction • It is a fact in India that a section of the populace is receiving drugs, often even unnecessary and avoidable ones, which leads to national wastage of funds and drugs as well as drug resistance. • On the other hand, another section is deprived of even basic health care, resulting in access to modern medicines by only 30% of the population.

4. Introduction cont. • Moreover the cost of health care is spiraling day by day. • Health administrators and policy makers need to urgently redesign the existing health infrastructure to extend health care to a greater section of people at an affordable cost. • For this purpose 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.

5. Objective • General: To compare drug utilization patterns (DUPs) in different health-care setups for assessing rational use of medicines. • Particular: • To measure the degree of polypharmacy. • To measure the tendency to prescribe by generic name. • To measure the overall level of use of antibiotics & injections, but commonly overused and costly forms of drug therapy. • To measure the use of FDCs.

6. Methods • 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.

7. Setting and Population • 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.

8. Outcome Measures • No. of medicines prescribed per encounter; • % of prescriptions for generics; • % of prescriptions for antibiotics; • % of prescriptions for vitamin tonics; • % of prescriptions for Fixed-Dose Combinations; • % of prescriptions for injections

9. Results • Results show that the number of medicines prescribed per encounter is 3.60 and 2.36 respectively in community pharmacies and the NGO. • Out of these, only 1.35% and 24.33% prescriptions are for generics.

10. Results cont. • 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).

11. Trend of Drug Use

12. Trend of Drug Use

13. Conclusion • 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 (3.6) was quite high compared with that of the NGO-managed health center (2.36), 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.