Drug prescription and self-medication in India: an exploratory survey

This paper reports a study of the prescribing and dispensing of drugs in India. The drugs supplied to 2400 patients by the public and private medical sectors and by private pharmacies (over the counter dispensing) were recorded, and were analysed with respect to the patient's presenting complaint and diagnosis. The main findings discussed in this paper are: 1. Large numbers of drugs are prescribed by doctors in the private sector. Combination preparations containing 'hidden' classes of drug are often given. Anti-infectives are widely and often inappropriately used. 2. Potentially dangerous drugs are sold over the counter and prescribed for trivial or bizzare indications. Drugs which have been withdrawn as dangerous in the West remain popular first line drugs in India. 3. Food supplements and tonics of dubious nutritional and pharmacological value make up a high proportion of the total drugs bill. It is concluded that a rational drugs policy and/or an essential drugs list will be useless unless accompanied by intensive efforts to improve the education and updating of doctors and pharmacists and to reduce the commercial pressures on doctors to prescribe unnecessary drugs.