TY - JOUR
T1 - Use of drugs not listed in the National List of Essential Medicines
T2 - Findings from a prescription analysis by the Indian Council of Medical Research-Rational Use of Medicines Centres Network in tertiary care hospitals across India
AU - Jhaj, Ratinder
AU - Banerjee, Aditya
AU - Kshirsagar, Nilima Arun
AU - Sadasivam, Balakrishnan
AU - Chandy, Sujith J
AU - Bright, Heber Rew
AU - Chugh, Preetha Kaur
AU - Tripathi, C D
AU - Badyal, Dinesh Kumar
AU - Samuel, Madhulika Peter
AU - Medhi, Bikash
AU - Prakash, Ajay
AU - Joshi, Rupa
AU - Kamat, Sandhya
AU - Tripathi, Raakhi
AU - Parmar, Urwashi Indrakumar
AU - Dikshit, Harihar
AU - Mishra, Hitesh
AU - Roy, Sukalyan Saha
AU - Trivedi, Niyati
AU - Chauhan, Janki
AU - Chatterjee, Suparna
AU - Bhattacharya, Manjari
AU - Desai, Chetna K
AU - Sheth, Shamil
AU - Gupta, Pooja
AU - Roy, Atanu
AU - Raveendran, Ramasamy
AU - Mathaiyan, Jayanthi
AU - Jeevitha, G
AU - Kaushal, Sandeep
AU - Gupta, Kanchan
AU - Jain, Samriti
AU - Kaul, Rajni
PY - 2022
Y1 - 2022
N2 - BACKGROUND: The concept of listing essential medicines can lead to improved supply and access, more rational prescribing, and lower costs of drugs. However, these benefits hinge on the prescription of drugs from an Essential Medicines List (EML). Several studies have highlighted the problem of underutilization of EMLs by prescribers. Therefore, as part of prescription research by the Indian Council of Medical Research-Rational Use of Medicines Centres Network, we evaluated the extent of prescription of drugs not listed in the National List of Essential Medicines (NLEM).MATERIALS AND METHODS: Prescriptions of outpatients from participating centers were included after obtaining verbal/written informed consent as approved by the Ethics Committee, and evaluated for prescription of drugs from the NLEM 2015.RESULTS: Analysis of 4838 prescriptions from 13 tertiary health-care institutes revealed that 2677 (55.33%) prescriptions had at least one non-NLEM drug prescribed. In all, 5215 (31.12%) of the total 16,758 drugs prescribed were not in NLEM. Of these, 2722 (16.24%) were single drugs and 2493 (14.88%) were fixed-dose combinations (FDCs). These comprised 700 different drug products - 346 single drugs and 354 FDCs. The average number of non-NLEM drugs prescribed per prescription was 1.08, while the average number of all drugs prescribed was 3.35 per prescription. It was also found that some of the non-NLEM drugs prescribed had the potential to result in increased cost (for example, levocetirizine), increased adverse effects (dextromethorphan), and less effectiveness (losartan) when compared to their NLEM counterparts. Nonavailability of an essential drug (oral hydroxocobalamin) was another important finding of our study.CONCLUSION: This study highlights the extent and pattern of drugs prescribed from outside the NLEM at the tertiary health-care level and the need for training and enhanced awareness among prescribers for greater utilization of the NLEM.
AB - BACKGROUND: The concept of listing essential medicines can lead to improved supply and access, more rational prescribing, and lower costs of drugs. However, these benefits hinge on the prescription of drugs from an Essential Medicines List (EML). Several studies have highlighted the problem of underutilization of EMLs by prescribers. Therefore, as part of prescription research by the Indian Council of Medical Research-Rational Use of Medicines Centres Network, we evaluated the extent of prescription of drugs not listed in the National List of Essential Medicines (NLEM).MATERIALS AND METHODS: Prescriptions of outpatients from participating centers were included after obtaining verbal/written informed consent as approved by the Ethics Committee, and evaluated for prescription of drugs from the NLEM 2015.RESULTS: Analysis of 4838 prescriptions from 13 tertiary health-care institutes revealed that 2677 (55.33%) prescriptions had at least one non-NLEM drug prescribed. In all, 5215 (31.12%) of the total 16,758 drugs prescribed were not in NLEM. Of these, 2722 (16.24%) were single drugs and 2493 (14.88%) were fixed-dose combinations (FDCs). These comprised 700 different drug products - 346 single drugs and 354 FDCs. The average number of non-NLEM drugs prescribed per prescription was 1.08, while the average number of all drugs prescribed was 3.35 per prescription. It was also found that some of the non-NLEM drugs prescribed had the potential to result in increased cost (for example, levocetirizine), increased adverse effects (dextromethorphan), and less effectiveness (losartan) when compared to their NLEM counterparts. Nonavailability of an essential drug (oral hydroxocobalamin) was another important finding of our study.CONCLUSION: This study highlights the extent and pattern of drugs prescribed from outside the NLEM at the tertiary health-care level and the need for training and enhanced awareness among prescribers for greater utilization of the NLEM.
KW - Drugs, Essential
KW - Tertiary Care Centers
KW - India
KW - Biomedical Research
KW - Prescriptions
U2 - 10.4103/ijp.ijp_878_21
DO - 10.4103/ijp.ijp_878_21
M3 - Article
C2 - 36722552
SN - 0253-7613
VL - 54
SP - 407
EP - 416
JO - Indian journal of pharmacology
JF - Indian journal of pharmacology
IS - 6
ER -
