Usage Pattern of Fixed-dose Combinations at ICMR Network of Rational Use of Medicine Centres across India: Recommendations for Policymakers and Prescribers
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Date
2023-02
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Association of Physicians of India
Abstract
Aim: Irrational use of medicines is a global problem. In India, one contributing factor is the availability of a large number of fixed-dose combinations (FDCs). To improve rational use and to strengthen policies, it is important to assess the usage patterns and rationality of FDCs. Methods: This study was conducted as part of a 1-year prospective cross-sectional analysis of prescriptions in the outpatient clinics of broad specialities from 13 tertiary care hospitals across India. Five most commonly prescribed FDCs in each center were analyzed. In addition, all the prescribed FDCs were classified as per the Kokate Committee classification and it was noted whether any of the FDCs were irrational or banned as per the reference lists released by regulatory authorities. Results: A total of 4,838 prescriptions were analyzed. Of these, 2,093 (43.3%) prescriptions had at least one FDC. These 2,093 prescriptions had 366 different FDCs. Of the 366 FDCs, 241 were rational; 10 were irrational; 14 required further data generation; and the remaining 96 FDCs could not be categorized into any of the above. Vitamins and minerals/supplements, antibacterial for systemic use, and drugs for gastroesophageal reflux disease (GERD) and peptic ulcer were the most used FDCs. Conclusion: Based on the finding that some prescriptions contained irrational FDCs, it is recommended that a rigorous, regular, and uniform method of evaluation be implemented to approve/ban FDCs and that prescribers be periodically notified about the status of the bans.
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Ranjalkar Jaya, Jhaj Ratinder, Chandy Sujith J, Bright Heber R, Chugh Preeta K, Tripathi Chakra D, Badyal Dinesh K, Balakrishnan Sadasivam, Medhi Bikash, Kamat Sandhya K, Tripathi Raakhi, Dikshit Harihar, Roy Sukalyan S, Chatterjee Suparna, Bhattacharjee Manjari, Trivedi Niyati, Desai Chetna, Gupta Pooja, Roy Atanu, Raveendran Ramasamy, Mathaiyan Jayanthi, Kaushal Sandeep, Jain Samriti, Kaul Rajni, Kshirsagar Nilima A. Usage Pattern of Fixed-dose Combinations at ICMR Network of Rational Use of Medicine Centres across India: Recommendations for Policymakers and Prescribers. Journal of the Association of Physicians of India. 2023 Feb; 71(2): 30-36