Abstract

The objective of study was to evaluate the pattern and practice of consultants especially antimicrobials in the allopathic health sector in Pakistan to assess the magnitude of the problem and suggesting corrective measures. A cross-sectional survey in various cities of Pakistan was conducted which was developed in line with WHO and has so far been implemented in 12 developing countries. A total of 4923 prescriptions of 197 consultants were collected and analyzed. Drugs dispensed were 480142; average number of drugs per prescription for all disciplines was 3.13±1.5. The number of encounters with antibiotics in medicine department was 20.17% of the total antibiotic while ophthalmology had no encounter with injectables. Cost of 23.79% of prescriptions was below Rs.100 and 4.9% above 500 rupees. Therapeutic categories of the drugs prescribed were 14.6% antimicrobial followed by 12.5% cardiovascular or renal drugs. The age of the patient, severity of disease, socio-economic status, previous experience of treating similar patients were important factors that determined choice of drugs. EDL was not available in most of the facilities. Around 80% drugs were prescribed by brand name. The drugs prescribed from the essential list were around 30%. Concern of losing patients to others practitioners was considered among the top three factors by only 18% of providers. Age of the patient, severity of disease, socio-economic factors were important factors that determined choice of drugs. Prescribing and dispensing practices are inappropriate and irrational in Pakistan like many developing countries. Managerial and regulatory interventions are proposed to improve the rational use of drugs.

Key words:  Prescribing behavior, consultants, antimicrobials, Pakistan.