Healthy Skepticism Library item: 4124

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Tomson G, Angunawela I.
Patients, doctors and their drugs. A study at four levels of health care in an area of Sri Lanka
European Journal of Clinical Pharmacology 1990; 39:463-467

Abstract:

(Limited to parts of article dealing with promotion.) Doctors in four health care institutions-two teaching hospitals, a base hospital and a pheripheral health centre-were interviewed about their prescribing practices. In the peripheral unit drug representatives and literature from drug companies were considered to be the most important source of drug information. In the hospitals, discussions with consultants were ranked as the number one source.
Few drug utilization studies have been conducted in Sri Lanka and they were register based. We wished to combine records with interviews to study drug use before hospital admission and drug prescribing in wards among 850 randomly chosen inpatients. Four institutions representing different levels of health care were studied. At the end of the study, all 25 practitioners involved were interviewed about how they perceived their prescribing practices. During the 48 h before admission drugs were used by 84% of the patients, of whom 73% took Western and 29% Ayurvedic drugs: combinations were common. The drugs most commonly named were aspirin and paracetamol. The medical records were an unreliable source of information in this respect. Infectious and parasitic disorders, together with respiratory diseases, constituted 40% of the diagnoses. The total number of prescriptions was 3,226. The number of drugs prescribed per patient varied between the institutions, the two extremes being the University (2.7) and the peripheral unit (5.1). Analgesics—antipyretics was the most commonly prescribed class at all institutions, 45.7% and 86%, respectively, of the patients being exposed to these drugs at the two institutions. The prescribing of antibiotics (53%) and antihistamines (65%) was considerably more common in the peripheral unit. The most commonly prescribed single drug products were paracetamol (31.3%), aspirin (20.9%), diazepam (21.8%), chloroquine (14.5%), ampicillin and multivitamins (both 12.6%). Most practitioners indicated deliberate use of active drugs as placebos, one drug chosen being vitamin. They were aware of the need for drug information from sources other than the industry.(ABSTRACT TRUNCATED AT 250 WORDS)

Keywords:
*analytic survey/Sri Lanka/developing countries/source of information/doctors/sales representatives/ promotional literature/PROMOTION AND HEALTH NEEDS: PROMOTION IN DEVELOPING COUNTRIES/PROMOTION AS A SOURCE OF INFORMATION: DOCTORS/PROMOTIONAL TECHNIQUES: DETAILING Adult Drug Utilization/trends* Female Humans Male Middle Aged Prescriptions, Drug/statistics & numerical data Research Support, Non-U.S. Gov't Sri Lanka