[india-drug] Re: Teaching Pharmacology and Therapeutics (16)

["Dr. Sandeep Kaushal" <skaushal1@yahoo.co.in>]

Teaching Pharmacology and Therapeutics (16)
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Dear All,

The need to prescribe rationally is the need of the hour as it makes sense therapeutically and financially. A few suggestions for the same:
 
  1. Catch the doctors when they are young i.e. target the intervention or exercises for rational use of drugs during the internship period (make the posting in Clinical Pharmacology mandatory as other clinical postings). This would also include training to analyse the literature provided by the med rep. of the pharma companies so that they can develop the insight for the same. Re-registrations with MCI/ State councils would again require a certificate for proficency in rational drug use for at least the drugs for use in diseases of national/regional importance. Despite so much of an effort for control of TB at times, it is shameful to see wrong prescriptions of ATT drugs.

  2.Thereafter the concept of prescription audit must be mandatory in the institutions (Secondary/Tertiary) and clinicians should take the lead as the purpose of the drug audit is not to find mistakes of someone but learn from our own experience in a scientific way. A training of the post graduates would go a long way to achieve this. They should be able to choose their P_drugs, with inputs from dept of Pharmacology as they are being trained in a particular speciality/super-speciality and hence need to do better than their less fortunate colleagues who elect not to do post graduation.

  3.The various professional societies can tie up with Dept of pharmacology to recomend the same to their fellow members in their speciality by giving guidelines (Opthalmological society is currently undertaking such endavour for the use of topical antibiotics).

  4.Strengthening of information sources with toll free numbers to DIC might also help. 

  5.The industry should also take the lead because irrational use of drugs e.g of antimicrobials would result in resistance and though they may have quick sales (short term benifit) in the begining but the long term benifit would be lost because of resistance due to irrational use. They should be categorical in mentioning the approved indications. They can hold regular programes with Dept of pharmacology and IMA to provide correct info to the prescriber at the level of the Institution/City/District as to have maximum covearge and thus have their point of view but in a rationale and scientific way.  

  Above all the NEED has to be emphasised and all the suggestions for the same should be welcome at all levels.

Regards,   

Sandeep Kaushal, M.D.
Associate Professor,
Department of Pharmacology, &
Consultant, Comprehensive Epilepsy Care Clinic 
Dayanand Medical College and Hospital, 
Ludhiana-141001, Punjab, India.
Tel: 91 161 276 0470(R); Fax: 91 161 247 2620;Mob: 98766 35367
Email: "Dr. Sandeep Kaushal" <skaushal1@yahoo.co.in>