Generic prescribing in outpatient departments in the Gampaha district

Abstract

OBJECTIVES: To determine the extent of generic prescribing and associated factors in Outpatients' Departments (OPD) of government hospitals in the Gampaha district. DESIGN: The extent of generic prescribing was determined by analyzing a sample of OPD prescriptions from 8 hospitals (2 Base, 2 District, 2 Peripheral, and 2 Rural). A questionnaire survey was carried out among medical officers/practitioners working in these OPDs to assess their knowledge and attitudes regarding generic prescribing. The data was analysed manually. The Chi squared test was used to assess statistical significance. RESULTS: 700 prescriptions were analysed. 78% of prescriptions had either 3 or 4 drugs (mean 3.4). 52% of drugs were prescribed as generic at the Base Hospitals and this percentage decreased as the hospital got smaller with only 34% of drugs being prescribed as generic at the Rural Hospitals. This decreasing trend was statistically significant (p< 0.0001). When asked to write the generic name for 5 commonly used branded products only 6 out of 76 doctors got all 5 correct. The percentage of doctors who got the generic names correct for each of the following drugs were - Brufen (ibuprofen) 84%, Flagyl (metronidazole) 59%, Piriton (chlorpheniramine maleate) 40%, Phenergan ( promethazine hydrochloride) 24%, and Maxolon (metoclopramide) 14%. None of these OPD's had a copy of the Sri Lanka formulary accessible to the doctors. CONCLUSIONS: Drugs were prescribed by their generic name less than half the time. Medical officers had neither the knowledge nor adequate facilities to implement generic prescribing.