Doctor couple who authored study based it on WHO indicators

Asmall study run by an allopathic couple on the faculty of two different medical colleges in the city – DY Patil Medical College and BJ Medical College – suggests that Bachelor of Ayurveda, Medicine and Surgery (BAMS) doctors are guilty of prescribing more irrational medication than their allopathic MBBS counterparts. The study, published this month in the Medical Journal of Dr DY Patil University, used the prescribing indicators set by the World Health Organisation (WHO) as a yardstick to come to this conclusion.

Irrational prescriptions, as defined by WHO, are those that do not stick to drug utilisation appropriate to the patient’s clinical needs, in terms of quantum of dosage – including period of usage – while also ensuring the drug delivery at the lowest possible cost. In fact, WHO has proposed core prescribing indicators for this. The study checked prescriptions for overuse of anti–microbials and injections, deployment of ineffective formulations, incorrect use of effective medicines, use of combination drugs that are often costly and offer no advantage over single drug products. "We stumbled on some irrational prescriptions that got us into this study," informed Dr Sangeeta Dabhade, associate professor at BJ Medical College and co–author of the study.

Sangeeta (L) and Sanjay Dabhade, who authored the study

The study worked on the premise that irrational use of medicines leads to a decrease in the quality of therapy, expensive treatment, increases the risk of side–effects and worst of all, leads to the emergence of resistance to certain drugs. Research involved the collection of 500 leftover prescriptions from four druggists in Vishrantwadi, which were equally divided between being generated by MBBS and BAMS doctors between March 2011 and November 2012.

BAMS doctors were also found to be dependent on antibiotics, injections, gastrointestinal medications, vitamins and iron preparations, as compared to allopaths. About 57.2 per cent of BAMS doctors prescribed irrational fixed dose combinations, as against 28.6 per cent of MBBS doctors.

"Unlike countries like China, where traditional and modern medicines have been integrated, the medical curriculum in India has not been able to do this. This has led to a gap between medicines prescribed by doctors from different streams," said Dr Sanjay Dabhade, professor at D Y Patil Medical College and co–author of the study.

"I don’t prescribe allopathic drugs but I know other BAMS doctors do. But let’s not forget these are doctors with rural reach. Moreover, WHO guidelines are not always practicable. Patients insist on quicker antibiotic medication," said Dr Sunita Ahire, BAMS MD Ayurveda, who practices in Viman Nagar.