One in two medical prescriptions issued in India deviates from standard guidelines and about one in ten show “unacceptable deviations”, a study conducted by a team that includes researchers from the All India Institute of Medical Sciences (AIIMS), Delhi, has found.
The research team analyzed 4,838 prescriptions issued by doctors between August 2019 and August 2020 for compliance with standard treatment guidelines.
These prescriptions were issued by 13 Rational Use of Medicines Centres (RUMCs) set up by the Indian Council of Medical Research (ICMR) in tertiary care teaching hospitals and medical colleges across the country.
The researchers found that of 475 prescriptions judged to show unacceptable deviations from standard guidelines, pantoprazole was the most commonly prescribed drug, present in 54 of them.
Pantoprazole is known to have the effect of suppressing the secretion of stomach acid, and is sold under various names at pharmacies, such as Pan 40.
The illness diagnosed in the 54 prescriptions was shingles, a viral infection that causes a painful rash anywhere on the body.
According to a study published in the Indian Journal of Medical Research, pantoprazole 40 mg tablets were prescribed along with other medicines such as paracetamol and ointment.
Of these 475 prescriptions, the most commonly diagnosed medical conditions were found to be upper respiratory tract infections (URTIs) and hypertension.
In 35 of the upper respiratory tract infection prescriptions, the prescribed drug was rabeprazole/domperidone tablets (used to treat stomach conditions such as acid reflux), which the researchers said caused them to be considered prescriptions with “unacceptable deviations”.
This combination of tablets was prescribed along with other medicines such as paracetamol and levocetirizine (a treatment for colds and runny noses).
The authors found that rabeprazole-domperidone tablets accounted for the second highest proportion of prescriptions with unacceptable deviations, after pantoprazole.
Doctors said the most common potential consequences of irrational drug prescribing for patients were higher treatment costs and side effects from the medication.
“If patients are at risk of developing peptic ulcers, a gastroprotective agent should be prescribed. Unnecessary prescribing of pantoprazole may result in side effects such as abdominal bloating, edema, and rash,” the authors write.
The researchers said most doctors followed the disease-specific ICMR guidelines with compliance rate being around 55 per cent.
In the absence of Indian guidelines or updated versions, doctors use international guidelines such as those from the American Academy of Family Physicians and the American Heart Association, he said.
(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)
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