Prescribing Behavior of Diabetes Treating Physicians in Selected Health Care Facilities of the Diabetic Association of Bangladesh.
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Date
2014-07
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Abstract
Background: Practicing behavior of the physicians varies from population to population due to diverse socioeconomic,
cultural, and professional factors. Evidence on these issues is almost nonexistent in the developing countries. Objective:
The prescribing behavior of diabetes treating physicians working in selected hospitals of the Diabetic Association
of Bangladesh was studied along with the factors affecting those behaviors. Materials and Methods: This was an
observational study on 818 prescriptions given by 49 physicians working in 16 health care facilities, which were
photocopied by a portable photocopier. The various components of the prescription were scrutinized for presence
and absence, and evaluated independently by two expert Diabetologists for their qualitative aspects. Results: The
mean ± standard deviation of the total prescribing score (expressed as percentage) was 60 ± 11. Physicians scoring
around or below 60% belonged more to lower age (<40 years), less experienced (<7 years) and mid-position (Senior
Medical Offi cers) groups. Most of them also had public medical college background. Physicians with Certifi cate Course
on Diabetology (CCD) had signifi cantly higher score compared with the Non-CCD group (P < 0.001). Direction and
duration of drug use were absent in majority of prescriptions (72.0% and 61.6%), respectively. Symptoms were not
written in 78.0% and the family histories were not recorded in 98.5% prescriptions. Diet (49.4%) and exercise (51.0%)
related advices were not mentioned in a large number of prescriptions. Appropriate change of drug (78.2%) and
proper use of drug (99.1%) and brand (93.8%) were found rational, but still, 22.4% of the prescriptions found illegible.
Conclusion: A large proportion of prescriptions in Bangladesh related to diabetes care still lack standardization and
acceptable quality. Nondrug related issues (such as history, symptoms, and dietary/exercise-related advices) are the
most neglected ones in a prescription.
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Keywords
Behavior, Diabetes, Physicians, Prescribing, Treating
Citation
Banu Bilkis, Shahi Md Shah Jalalur Rahman, Begum Kausara, Ahmed Tofail, Choudhury Hasan Ali, Ali Liaquat. Prescribing Behavior of Diabetes Treating Physicians in Selected Health Care Facilities of the Diabetic Association of Bangladesh. Indian Journal of Public Health. 2014 Jul-Sept; 58(3): 180-185.