Description:
Potentially inappropriate medications are medications for which the risks outweigh the benefits, especially in the presence of more effective alternatives. Potentially inappropriate medications are associated with an increased risk of adverse drug reactions, hospitalisation, morbidity, and mortality. Overuse, underuse or misuse of medicines result in wastage of scarce resources and widespread health hazards.
To address these issues, ICMR constituted a National Task Force along with 15 “Rational Use of Medicine Centres” and few other ICMR centres in 2019 and carried out prescription research, developed prescribing skills course and other ad-hoc projects to generate evidence for informing policy makers as well as prescribers across India.
The purpose of the project is to improve prescription practices, training of interns, Indian Medical Graduates (IMGs) and Registered Medical Practitioners (RMP) and finally improve patient safety by reducing avoidable medication-related harm.
It is an umbrella project with multiple projects/studies being carried out with the primary aim of encouraging rational use of medicines.
i. Carry out prescription audit/research for gaps and errors, contribute to national data base, analyses, interpret and recommend corrective steps (expected 600 prescriptions per year)
ii. Develop curriculum for training rational use of medicines/prescribing skills based on MCI curriculum, university curriculum, publications (for 3 modules, review 2 modules)
iii. Develop training modules based on treatment guidelines and resources for ICMR online program (for 3 modules, review 2 modules)
iv. Develop prioritization (additional training) based on published literature, experience (for 3 modules, review 2 modules)
v. Develop assessment questions, validate (for 3 modules, review 2 modules)
Activities carried out under the project
Prescription Research: At St. John’s Medical College Hospital, we collected over 1900 prescriptions in 3 years and analysed 1000 prescriptions. Analysis was done both quantitatively as well as qualitatively. Quantitatively analysis was done as per WHO drug prescribing indicators and qualitative analysis of rationality and appropriateness was done by clinicians/subject matter expert based on standard treatment guideline.
Prescriber Skill Course: We also developed following 3 modules for online training course for prescribing skills as a part of the National Virtual Centre for Clinical Pharmacology.
HCQ Cross-sectional study: St. John’s led and carried out a cross-sectional study assessing safety of HCQ among 1303 participants in the peak of COVID-19 pandemic and contributed to evidence for HCQ use in COVID-19.
HCQ Cohort study: Since the cross-sectional design has its limitations, cohort study was conducted to ascertain HCQ use in COVID-19. Data management and co-ordination was carried out by St. John’s. Data was collected from 12089 participants over a period of 127 days from 45 centers. A total of 19,739 forms were (12,089 forms for baseline data and 7,650 forms for follow-up data).
We also participated in few key studies initiated by other centres such as COVID-19 sequelae among HCWs and Tele-prescription Study.
Completed Projects:
1. Safety of Hydroxychloroquine in health care workers for COVID 19 prophylaxis’- A cross sectional study
2. Hydroxychloroquine for SARS CoV2 prophylaxis in healthcare workers – A multi-centre cohort study assessing effectiveness and safety.
3. ICMR – RUMC COVID-19 Sequelae Study among Health Care Workers
d) Study update: completed on 16 Sep 2022
e) Publication status (Name & year) & link:
f) Updated as on: 13th Dec 2023