Patients’ expectations behind prescribing injections: Doctors

Psychological relief to the patients and their expectations of a faster relief can supersede the rational reasons for the doctor while prescribing injections.

Written by Neelam Sharma | Chandigarh | Published: February 11, 2009 1:57:53 pm

Psychological relief to the patients and their expectations of a faster relief can supersede the rational reasons for the doctor while prescribing injections,reveal a PGI survey.

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

The survey also revealed that nearly 7 per cent of the surveyed doctors feel that sometimes injections are administered due to “doctors’ push” and 3.4 per cent doctors feel that injections are given due to “patients’ demand.”

As many as 36.2 per cent doctors felt that they prescribe injections to meet the “patients’ expectations” while 1.7 per cent said that they would prescribe injections to provide “psychological relief to the patients.”

Interestingly,the survey also recorded the response of 3.4 per cent doctors who said 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 the tri-city of 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 oral medicine. This is huge gap which needs to be addressed,’ says Dr A K Aggarwal of the School of Public Health,PGI.

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

Conversely,only 12.1 per cent of these doctors feel that patients use the rational reason for asking for an injection while an equally effective oral medicine is available. A whopping 77.6 per cent of the doctors said in the survey that patients prefer injections over oral medicines due to their expectation of an early cure.

The findings come as a matter of concern for the experts who feel that the injection usage in India is already more than the desired,with each individual in the country getting injected for some ailment or the other at least 6 times a year (as per a nationwide survey conducted by IPEN study).

“There is nothing in giving injections per se,but the related infections,unsafe practices and the bio medical waste generated by the injection usage can be curtailed if the injections are given on rational basis,” adds Dr Aggarwal.

BOX: the burden of injections in the country and gap between the public and the private sector.

As per the nationwide IndiaCLEN Program Evaluation Network (IPEN) study,34.2 per cent of the injections in the public sector hospitals in the country are given for cough/fever and diarrhoea. The corresponding figure in the private sector for the same ailments is 49 per cent.

As high as 40 per cent injections are given for weakness in the country’s public sector hospital,against 53 per cent in 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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