Prescribing vitamins at primary health care level: Exploration of facts, factors and solution
DOI:
https://doi.org/10.3329/bjp.v5i2.7146Keywords:
Educational intervention, Primary health care, VitaminAbstract
The impact of educational intervention on prescribing trend of vitamins at primary health care level was investigated by analyzing 2000 prescriptions containing vitamins. Prevalence of vitamin prescribing was 30.16%, 38.69% and 45.35% and contribution of vitamins in the cost of drugs prescribed in vitamin containing prescription was 27.58%, 30.40% and 41.85% at Upazilla Health Complexes (UHC), non-government organizations (NGO) and private practices (PP) respectively. Both parameters significantly (p<0.001) decreased after intervention. Prescribing of single vitamin preparations was 3.75%, 13.87% and 7.75% and appropriateness of the vitamin prescribing was 14.63%, 24.13% and 14.75% at UHC, NGO and PP respectively. Both parameters significantly (p<0.001) increased after intervention. Negligible emphasis on vitamin in pharmacology teaching at MBBS level was observed. Dependency on promotional materials of manufacturers were changed after intervention. In conclusion, knowledge deficiency due to inadequate professional training and dependency on biased information perhaps contributed in irrational prescribing of vitamins.
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References
Anonymous. Cancer and chronic disease: A systematic review for a National Institute of Health state-of-the-science conference. Ann Int Med. 2006; 145: 372-85.
Arhinful DK, Das AM, Hadiyono JP et al. How to use applied qualitative methods to design drug use interventions. INRUD Social Scientist Working Group. 1996.
Bangladesh Medical & Dental Council (BMDC). Curriculum of Pharmacology & Therapeutics Course for undergraduate medical students of Bangladesh. In: Curriculum for Undergraduate Medical Education in Bangladesh 2002. Compiled and edited by Center for Medical Education, Mohakhali, Dhaka. Approved by Bangladesh Medical and Dental Council. 2002, pp 170-205.
Bangladesh National Formulary. Directorate of Drug Administration, Bangladesh Medical Association, Bangladesh Pharmaceutical Society. Dhaka, 2006, pp 456-66.
Begum M, Rahman MS, Islam AFMS, Khan IA, Akhter N. Eleven Years of the Undergraduate Medical Curriculum 1988: Review on the Changes in Pharmacology Written Questions. Bangladesh J Physiol Pharmacol. 1999; 15: 27-30.
Bleys J, Miller ER 3rd, Pastor-barriuso R, Appel LJ, Guallar E. Vitamin-mineral supplementation and the progression of atherosclerosis: A meta-analysis of randomized controlled trials. Am J Clin Nutr. 2006; 84: 880-87.
Chowdhury AKA, Rahman MS, Faroque ABM. Studying and implementing the monitoring-training-planning strategy to ensure the rational use of injections in the hospitals of the Upazila Health Complexes of Bangladesh. Report of the 2007 Safe Injection Global Network (SIGN) annual meeting. WHO, Geneva, 2007, pp 13-14.
Drug (Control) Ordinance 1982. Bangladesh Gazette, Extraordinary. No. 354. Government of the Peoples Republic of Bangladesh. Dhaka, 1982.
Guiscafre H, Martinez H, Reyes H, PerezCeuvas R, Castro R, Mufioz O, Gutierrez G. Impact of educational strategy for physicians to improve treatment practices of common diseases. Presented in the First International Conference on improving use of medicine, Chiang Mai, Thailand. Essential Drug Monitor 1997; 23: 6-12.
Huang HY, Caballero B, Chang S, Alberg AJ, Semba RD, Schneyer CR, Wilson RF, Cheng TY, Vassy J, Prokopowicz G Barnes GJ 2nd, Bass EB. The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: A systematic review for a National Institute of Health state-of-the-science conference. Ann Intern Med. 2006; 145: 372-85.
International Medical Statistics (IMS). Switzerland 2006; 1st Quarter: Therapeutic class, p 1.
Islam MS, Rahman MS, Misbahuddin M. Impact of prescription audit & feedback on pattern of prophylactic antimicrobials in caesarean section: A cost reduction perspective. Bangladesh J Physiol Pharmacol. 2007: 23: 1-9.
Jahan K, Hossain M. Pattern of nutrient intake in Bangladesh. In: Nature and extent of malnutrition in Bangladesh. Bangladesh National Nutrition Survey. 1998a, part-1, pp 28-48.
Jahan K, Hossain M. Nutrition requirement and deficiency in intake. In: Nature and extent of malnutrition in Bangladesh. Bangladesh National Nutrition Survey, 1998b, part-1 pp 49-63.
Leppala JM, Virtamo J, Fogelholm R, Huttunen JK, Albanes D, Taylor PR, Heinonen OP. Controlled trial of ?tocopherol and ?carotene supplements on stroke incidence and mortality in male smokers. Arterioscler Thromb Vas Biol. 2000; 20: 230-35.
National Institute of Health (NIH). Multivitamin/Mineral Supplements and Prevention of Chronic Disease; May, 2006: Evidence Report (Publication No. 06-E012).
Okumura J, Umenai T. Impact of Bamako type revolving drug fund on drug use in Vietnam. Presented in the Second International Conference on Improving Use of Medicine, Chiang Mai, Thailand, April 2004.
Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen MR, Glass A, Keogh JP, Meyskens FL, Valanis B, Williams JH, Barnhart S, Hammar S. Effect of a combination of beta-carotene and vitamin A on lung cancer and cardiovascular disease. N Engl J Med. 1996; 334: 1150-55.
Rahman MS, Begum M, Haque MZ, Akhter N. Drug advertisement in medical journals: A Commentary. Bangladesh J Physiol Pharmacol. 1999; 15: 31-36.
Rahman MS. Changes required in pharmacotherapy teaching to ensure rational use of drugs. Bangladesh J Physiol Pharmacol. 1995; 11: 38-39.
Rock CL. Multivitamin-multimineral supplements: Who uses them? Am J Clin Nutr. 2007; 85: 277S95S.
Rosenberg IH. Challenges and opportunities in the translation of the science of Vitamins. Am J Clin Nutr. 2007; 85(suppl): 325S27S.
Roy J, Saha P, Hossain A, Ahmed M, Choudhury C. Prescription patterns and the use of drugs. JOPSOM 1995; 14: 6-9.
Stanner SA, Hughes J, Kelly CN, Buttriss J. A review of the epidemiological evidence for the antioxidant hypothesis. Public Health Nutr. 2004; 7: 407-22.
Suryawati S. Using the MTP approach to reduce inappropriate use of antibiotics in hospitals: Results of the field test. Presented in the Second International Conference on Improving Use of Medicine, Chiang Mai, Thailand, April 2004.
Tribble DL. Antioxidant consumption and risk of coronary heart disease: Emphasis on vitamin C, vitamin E and beta-carotene. Circulation 1999; 99: 591-95.
Umenai T, Narula IS. Revolving drug fund: A step towards health security. Bull World Health Organ. 1999; 77: 167-71.
Wirth R. Vitamins and trace elements in nutrition. Update 2005. Med Klin (Munich). 2006; 101: 163-66.
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