October 31, 2011

Docs to spend more time with patients soon

The Medical Council of India (MCI) may soon specify how much time doctors should spend with their patients so that the regimen of medicines being prescribed to them is clear. A recent World Medicines Situation 2011 report brought out by the World Health Organization (WHO) — as reported by TOI first — had recently said that doctors, on an average, in developing countries spend less than 60 seconds in prescribing medicines and explaining the regimen to their patients. Consequently, only half of the patients receive any advice on how to take their medicines and about one-third of them don't know how to take drugs immediately on leaving the facility. Union health minister Ghulam Nabi Azad said on Friday that the government proposes to issue an advisory to the MCI to disseminate appropriate instructions among all registered medical practitioners. According to WHO, the dispensing process greatly influences how medicines are used. The WHO database shows that the dispensing time is a minute. "In such circumstances it is not surprising that patient adherence to medicines is poor," the report said. Azad said, "The doctor population ratio is not favourable in our country. Hence, there is tremendous pressure on the doctors serving in public sector hospitals. This may be the major reason for patients getting less than adequate time for consultation." MCI's own assessment says India has just one doctor for 1,700 people. In comparison, the doctor population ratio globally is 1.5:1,000. MCI has set a target to have 1 doctor for 1,000 people by 2031. The assessment note, available with TOI, also looked at the situation in other countries. Somalia has one doctor for 10, 000; Pakistan has 1:1,923 and Egypt 1: 1,484. China's doctor population ratio stands at 1:1,063; South Korea 1:951; Brazil 1:844, Singapore 1:714, Japan 1:606; Thailand 1:500; UK 1:469; the US 1:350 and Germany 1:296. Kathleen Holloway from WHO's department of essential medicines and pharmaceutical policies said, "Irrational use of medicines is a serious global problem that is wasteful and harmful. In developing countries, in primary care, less than 40% of patients in public sector and 30% of patients in private sector are treated in accordance with standard treatment guidelines." The report cites, only about 60% countries train their medical students on various aspects of prescribing medicines and only about 50% require any form of continuing medical education. The basic training for nurses and paramedical staff, who often do a bulk of prescribing, was even less — only about 40% of countries give them any basic training on how to prescribe. The report shows, though around 80% of all prescribed medicines are dispensed — usually, they are done by untrained personnel — and as many as 20%–50% of medicines dispensed are not labelled. WHO feels many countries are making relatively little investment in promoting rational use of medicines. The report had also said that two-thirds of all antibiotics are sold without prescription through unregulated private sectors. Low adherence levels by patients are common and many patients are taking antibiotics in less than the prescribed dose or for a shortened duration — like three instead of five days. Link: Original Article

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