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Injectable diclofenac: a painful shot into Iran's health system
1Department of Pharmacology, University of Bagiyatallah Medical Sciences, Aghdasyyeh, Tehran 19945, Islamic Republic of Iran. m.cheraghali@bmsu.ac.ir
Social Science & Medicine (1982)
|June 20, 2006
Summary
Irrational injection prescribing in Iran led to increased Diclofenac adverse drug reactions (ADRs). Interventions controlled Diclofenac ADRs, but prescribers now use other injectable drugs.
Area of Science:
- Pharmacovigilance
- Drug safety
- Health systems research
Background:
- Irrational prescribing of injections is prevalent in Iran, with over 40% of patients receiving them.
- Diclofenac injection use surged in Iran after its 1993 market introduction, reaching 85 million ampoules sold by 1998.
Purpose of the Study:
- To analyze adverse drug reactions (ADRs) associated with Diclofenac injection in Iran.
- To evaluate the impact of interventions on Diclofenac-related ADRs.
- To observe trends in injectable medicine prescribing following interventions.
Main Methods:
- Analysis of 176 ADR reports submitted to Iran's pharmacovigilance center between 1996 and 2002.
- Review of multi-interventional policies (educational, regulatory, managerial) implemented to control ADRs.
- Monitoring of prescribing patterns for injectable medicines post-intervention.
Main Results:
- A significant number of ADRs, specifically 176 major issues from intramuscular Diclofenac, were reported.
- Multi-interventional policies successfully reduced ADRs linked to Diclofenac injection.
- Prescribers are shifting towards alternative injectable medications, indicating a potential rise in new ADR concerns.
Conclusions:
- While Diclofenac injection ADRs were managed, the shift to other injectables warrants further pharmacovigilance.
- Addressing irrational injection practices requires ongoing monitoring and adaptive strategies in healthcare systems.
- The study highlights the dynamic nature of drug utilization and the need for continuous safety surveillance.
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