An evaluation of knowledge, attitude and practices about prescribing fixed dose combinations among postgraduates of a rural tertiary health care teaching hospital

Abstract

Background: Fixed dose combinations (FDCs) is a combination product of two or more active pharmacological ingredients (APIs) in a single dosage form. There is lot of debate over rationality and irrationality of FDCs presently. This study was focused on medical postgraduates to evaluate their knowledge, attitude and practices about prescribing fixed dose combinations as they are the physicians who are future practitioners and it is up to them to misuse it or use it judiciously by prescribing rationally. The objective of the study was to evaluate knowledge, attitude and practices about prescribing fixed dose combinations among postgraduate medical students. Methods: A cross-sectional questionnaire based study was conducted among postgraduate medical students of AIMS, B G Nagar, Nagamangala, Mandya, Karnataka, India. Results: Total respondents were 124. 81 participants (65.32%) were males and 43 participants (34.67%) were females. 73.38% of participants were aware of the term FDCs. Improvement in patient's compliance (68.54%) and improved efficacy of individual drugs (62.09%) were the advantages of using FDCs and irrational prescription of FDCs leading to drug resistance (70.96%) and difficulty in dose adjustments of individual drugs (54.83%) were the disadvantages mentioned. Knowledge of banned FDCs was lacking. More than half (58%) of them were not able to mention a single banned FDC in India. Medical representatives (45.16%), Internet (27.41%), textbooks (15.32%) were the most common sources of information of FDCs. Amoxicillin with clavulanic acid was the most common prescribed FDC (60.2%). Conclusions: Majority of the postgraduates have the knowledge about general aspects of FDCs, their advantages and disadvantages. However, knowledge about rational or irrational drugs, banned FDCs and availability of essential list is lacking. It is required that the concepts of rational drug use should be implemented in undergraduate curriculum vigorously and to strengthen their knowledge and skills to prescribe rationally.