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A questionnaire-based study to assess rational prescribing practice among interns

Madhura Naik, Rajan Nerurkar, Abhishek Phatak, Sagar Panchal, Abhinay Paunikar.


Background: The subject of Pharmacology is taught to medical students in India in the second year of their undergraduate (UG) studies, and one of the crucial components of which is Clinical Pharmacology and Therapeutics (CPT). The main goal of teaching CPT is to impart knowledge, skills, and attitudes so that a clinician is able to weigh the potential benefits and risks of a treatment along with its cost-effectiveness.

Aims and Objective: To understand whether interns have sufficient knowledge to prescribing rationally.

Materials and Methods: We handed out questionnaires consisting of 15 questions on rational prescribing to 108 interns across different departments of the hospital. The completed questionnaires were then collected, and the responses were analyzed.

Result: A large number of interns reported that UG medical curriculum was inadequate to train them to prescribe rationally. A number of them affirmed that doctors should prescribe by the “essential medicines list” (48/73). Interns most commonly prescribed by generic name (68/73) and considered safety and efficacy as the most important factors while prescribing. However, a fewer number of interns (39/73) agreed with the importance of cost or knew the definition of pharmacoeconomics (38/73). Each of them experienced problems while prescribing during internship, and the commonly reported were drug dosage calculation based on weight and age and the knowledge of trade names. With regard to prescribing skills, interns felt less confident in accessing drug-related information, dosage calculation, and writing prescriptions. Most interns (65/73) were unaware of the “six steps of rational prescribing”.

Conclusion: The study highlighted some gray areas in the knowledge of rational prescribing among interns while also indicating possible areas of improvement. Hence, there is a need for a refresher course aimed at sensitizing interns to the practice of rational pharmacotherapy, so as to inculcate a balanced and safe prescribing approach.

Key words: Rational Prescribing; Interns; Clinical Pharmacology; Undergraduate Teaching; Questionnaire

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