title: Prescribing behavior of diabetes treating physicians in selected health care facilities of the diabetic association of Bangladesh.
abstract: BACKGROUND
  Practicing behavior of the physicians varies from population to population due to diverse socioeconomic, cultural, and professional factors. Evidence on these issues is almost nonexistent in the developing countries.
  
  
  OBJECTIVE
  The prescribing behavior of diabetes treating physicians working in selected hospitals of the Diabetic Association of Bangladesh was studied along with the factors affecting those behaviors.
  
  
  METHODS
  This was an observational study on 818 prescriptions given by 49 physicians working in 16 health care facilities, which were photocopied by a portable photocopier. The various components of the prescription were scrutinized for presence and absence, and evaluated independently by two expert Diabetologists for their qualitative aspects.
  
  
  RESULTS
  The mean ± standard deviation of the total prescribing score (expressed as percentage) was 60 ± 11. Physicians scoring around or below 60% belonged more to lower age (<40 years), less experienced (<7 years) and mid-position (Senior Medical Officers) groups. Most of them also had public medical college background. Physicians with Certificate Course on Diabetology (CCD) had significantly higher score compared with the Non-CCD group (P < 0.001). Direction and duration of drug use were absent in majority of prescriptions (72.0% and 61.6%), respectively. Symptoms were not written in 78.0% and the family histories were not recorded in 98.5% prescriptions. Diet (49.4%) and exercise (51.0%) related advices were not mentioned in a large number of prescriptions. Appropriate change of drug (78.2%) and proper use of drug (99.1%) and brand (93.8%) were found rational, but still, 22.4% of the prescriptions found illegible.
  
  
  CONCLUSIONS
  A large proportion of prescriptions in Bangladesh related to diabetes care still lack standardization and acceptable quality. Nondrug related issues (such as history, symptoms, and dietary/exercise-related advices) are the most neglected ones in a prescription.
authors.affiliation: Lecturer, Department of Health Promotion and Health Education, Bangladesh Institute of Health Sciences (BIHS), Dhaka, Bangladesh.
authors.forename: Bilkis
authors.initials: B
authors.lastname: Banu
authors.forename: Md Shah Jalalur Rahman
authors.initials: MS
authors.lastname: Shahi
authors.forename: Kausara
authors.initials: K
authors.lastname: Begum
authors.forename: Tofail
authors.initials: T
authors.lastname: Ahmed
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Choudhury
authors.forename: Liaquat
authors.initials: L
authors.lastname: Ali
mesh_terms: D000328:Adult; D000367:Age Factors; D001459:Bangladesh; D003920:Diabetes Mellitus / Q000188:drug therapy*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D012959:Socioeconomic Factors
chemical_list: D007004:Hypoglycemic Agents