Prescription of "ineffective neuroprotective" drugs to stroke patients: a cross sectional study in North Indian population.
In a developing country, where patient access to tertiary care is limited and most patients have to pay out of pocket, it is imperative for the physicians to practice evidence-based medicine. Reports on prescription details and surveys are not available. The aim of this study is to describe the prescribing patterns for various medications used in the treatment of stroke among the first contact physicians in North India; to estimate the proportion of patients being prescribed the non-recommended drugs and to determine any relationship between the economic status of the patient and the prescription pattern. Details of economic status, education level, type of stroke, type of hospital, qualification of treating physician and the number and nature of medications were noted from the prescriptions and patients. Two hundred and sixteen patients with ischemic stroke (71.3% males, average age 51.5 years) were included. Among poor patients, N = (36.8%) received any of the neuroprotective drugs including citicoline 19 (27.5%), piracetam 11(15.9%) and edaravone 2(2.9%). Both specialist and private hospitals are associated with higher prescription of "ineffective neuroprotective" drugs in both poor and rich patients. Reasons for overprescribing neuroprotective medications need to be studied and remedial measures need to be taken to practice evidence-based medicine.
a Department of Neurology, All India Institute of Medical Sciences , New Delhi , India.
Kapil Kumar
KK
Singhal
a Department of Neurology, All India Institute of Medical Sciences , New Delhi , India.
Kameshwar
K
Prasad
a Department of Neurology, All India Institute of Medical Sciences , New Delhi , India.
Rohit
R
Bhatia
a Department of Neurology, All India Institute of Medical Sciences , New Delhi , India.
Amit
A
Kumar
a Department of Neurology, All India Institute of Medical Sciences , New Delhi , India.
Mamta Bhusan
MB
Singh
D002545:Brain Ischemia / Q000188:drug therapy*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards* / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine / Q000592:standards; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000706:statistics & numerical data; D012923:Social Class; D020521:Stroke / Q000188:drug therapy*
D018696:Neuroprotective Agents
antiplatelet drug; neuroprotective drug; stroke