Fixed Dose Combinations (FDCs) are being widely used now-a-days. The use of FDCs has decreased the incidence of drug resistance, improved patient compliance, has made individual drugs more efficacious and there has been a decline on pill burden on patients. But there is an impending threat to health and economy sector of a country leading to drainage of resources due to irrational prescribing practice of FDCs. For limiting irrational FDCs prescribing, a proper prescription audit is mandatory.
Objectives: This study is aimed to study about the drug utilization pattern of fixed dose combination and to evaluate the rationality of FDCs prescriptions in the department of Medicine in Gauhati Medical College and Hospital; Guwahati.
Methods and Materials: This study is a prescription based non-comparative, observational prospective study. After taking permission from the Institutional Ethical Committee; a total of 600 prescriptions of patients were analysed for over a period of 6 months from 1st August 2016 to 31st January 2017.The rational use of FDCs was evaluated by analyzing the drug prescriptions. Data was analysed by descriptive studies.
Results: Amongst the total 600 prescriptions evaluated, FDCs were prescribed in 524 (87.3%) prescriptions with an average of 1.8 per prescription. The age group in which FDCs were most commonly prescribed is 31 to 40 years (26.33%).FDCs were prescribed in higher number in case of male patients (54.58%).The most common route of administration of FDCs was oral route (54.45%). FDCs were most commonly prescribed for respiratory and gastro-intestinal system ailments. Out of the 944 FDCs only 23.41% FDCs were included in WHO Essential Medicines Lists (EML) (2017) and National List of Essential Medicines (2015).Nutritional supplements were the most commonly prescribed FDCs (66.53%). While evaluating the prescribed FDCs, 66.31% were irrational FDCs while 33.69% were considered as rational. Adverse drug reactions in the form of diarrhea (6 no. of cases) has been observed upon administration of Amoxycillin-Clavulanic acid. The management of these 6 cases have been done conservatively.
Conclusion: Our study on FDCs have emphasized upon the fact that it is of utmost necessity both on the part of health care professionals as well as patients to follow proper prescription writing format, adhere to Essential List of Medicines, dispose proper dosages of FDC and prescribing generic names as far as practicable. Health care professionals should have regular orientation programme regarding recent upcoming changes in Essential List of Medicine and acquire recent inputs from relevant journals, newsletters and gather all sorts of recent information regarding drugs and their pharmacokinetic, pharmacodynamic properties and various interactions.