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Another painful truth: Injections overused

A positive psychological effect on the patients and their expectation of a quicker relief can supersede the rational reasons for a doctor while prescribing injections,reveals a PGI survey.

Written by Neelam Sharma | Chandigarh | Published: February 16, 2009 3:01 am

PGI survey finds only 87.9% govt doctors in Tricity follow rational reasons while prescribing injection over oral medicine; the rest go by the ‘demand’ of patients

A positive psychological effect on the patients and their expectation of a quicker relief can supersede the rational reasons for a doctor while prescribing injections,reveals a PGI survey.

Responses of doctors in the survey conducted by the School of Public Health,PGI,highlight that over one-third of the doctors feel that their prescription of injection over oral medicine is driven by the patients’ expectations,demand and psychological relief,rather than any rational reason.

The survey also reveals that while nearly 7 per cent doctors feel that sometimes injections are administered due to the “doctor’s push”,3.4 per cent feel injections are given on the “patient’s choice”.

As many as 36.2 per cent doctors feel that they prescribe injections to meet the “patients’ expectations” while 1.7 per cent of them say they opt for the needles to provide “psychological relief to the patients”.

The survey also records the response of 3.4 per cent doctors who say they are “not sure/do not know” when to prefer to prescribe injections.

“Our survey has revealed that 87.9 per cent doctors in the government set-up in Chandigarh,Panchkula and Mohali follow rational reasons while deciding to prescribe injections. Ideally,this figure should be 100 per cent as to why should a doctor go by the expectation or demand of the patients while preferring an injection over an oral medicine. This is a huge gap which needs to be addressed,” says Dr A K Aggarwal of the School of Public Health.

In its programme of promoting safe injection practices,the school has compiled the responses of 58 government doctors and 283 nurses along with pharmacists to gauge the response and attitude towards safe injection practices.

Conversely,only 12.1 per cent of these doctors feel that patients use the rational reason while asking for an injection though an equally effective oral medicine is available. As much as 77.6 per cent doctors surveyed say patients prefer injections to oral medicines because they feel it will cure them faster.

The findings come as a matter of concern as experts feel the usage of injection in India is already more than what is required,with each individual getting injected for some ailment or the other at least six times a year,according to a nationwide survey conducted by IndiaCLEN Program Evaluation Network (IPEN).

“There is nothing wrong with administering injections per se,but the related infections,unsafe practices and the biomedical waste generated by them can be curtailed if injections are given on rational basis,” adds Dr Aggarwal.

Pricking figures
Here is a look at the burden of injections in the country and the gap between the public and the private sector.
* According to the nationwide IPEN study,in the public sector hospitals 34.2 per cent injections are given for cough/fever and diarrhoea. The corresponding figure in the private sector for the same ailments is 49 per cent
* In public sector hospitals,as high as 40 per cent injections are given for “weakness”,against 53 per cent in the private sector
* 46 per cent injections in public hospitals and 52 per cent in private hospitals are given for “other symptoms”

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