Reducing use of injections through interactional group discussions: A randomized controlled trial

Bhunia, Rama; Hutin, Yvan; Ramkrishnan, R.; Ghosh, Pramit; Dey, Suranjana; Murhekar, Manoj

doi:10.1007/s13312-010-0076-4

Cited by 13 publications

(9 citation statements)

References 9 publications

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“…Both providers and patients felt that injections were necessary for common ailments. The high injection demand and provision seen in our study were consistent with prior experience from Pakistan (22) or the surrounding region (13,(23)(24)(25)(26)(27). Patients expect to receive injections for minor ailments such as fever or influenza-like symptoms and willingly pay for these, on the mistaken belief in the efficacy of injections to overcome common symptoms that eventually abate with time (10).…”

Section: Discussionsupporting

confidence: 89%

Reuse of syringes for therapeutic injections in Pakistan: rethinking determinants

Khan¹,

Altaf

Qureshi

et al. 2020

East Mediterr Health J

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Background: Frequent reuse of syringes during medical injections is fuelling epidemics of human immunodeficiency virus and hepatitis C virus infections in many low-and middle-income countries including Pakistan. Aims: To explore specific factors related to syringe reuse during therapeutic injections. Methods: We randomly surveyed 319 healthcare providers from 2 socioeconomically diverse districts in Pakistan, along with 625 of their patients. Results: Providers see 12-25 patients per day, and provide 7-14 therapeutic injections or intravenous drips. Comparing daily stocks with injections provided, we estimated that 38% of providers (Rawalpindi: 14%, Tando Allah Yar: 44%) likely reuse syringes 2 or 3 times. Rural location and longer duration of practice predict a higher likelihood of reuse. Physicians and non-physicians were equally likely to reuse. Most patients were unaware when a syringe had been reused. Conclusions: High rate of syringe reuse is driven by high injection demand by patients, to which providers comply. Patients are generally unaware of the harm of injections with syringe reuse or that reuse happens. Our findings suggest that patient focused approaches may help reduce syringe reuse.

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Section: Discussionsupporting

confidence: 89%

Reuse of syringes for therapeutic injections in Pakistan: rethinking determinants

Khan¹,

Altaf

Qureshi

et al. 2020

East Mediterr Health J

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“…These results reveal that the overuse of injections, particularly the excessive unrestricted use of multiple injections, has become a big problem at the rural healthcare facilities in Sichuan. This overuse of injection phenomenon was also reported in other developing countries in recent years, such as in Cambodia, India and Pakistan [26-30]. Some scholars speculated that the abuse of injections was inextricably linked to the medical consumption concept of the consumers [26,31].…”

Section: Discussionmentioning

confidence: 57%

Outpatient prescription practices in rural township health centers in Sichuan Province, China

Jiang

Ying

et al. 2012

BMC Health Serv Res

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BackgroundSichuan Province is an agricultural and economically developing province in western China. To understand practices of prescribing medications for outpatients in rural township health centers is important for the development of the rural medical and health services in this province and western China.MethodsThis is an observational study based on data from the 4th National Health Services Survey of China. A total of 3,059 prescriptions from 30 township health centers in Sichuan Province were collected and analyzed. Seven indicators were employed in the analyses to characterize the prescription practices. They are disease distribution, average cost per encounter, number of medications per encounter, percentage of encounters with antibiotics, percentage of encounters with glucocorticoids, percentage of encounters with combined glucocorticoids and antibiotics, and percentage of encounters with injections.ResultsThe average medication cost per encounter was 16.30 Yuan ($2.59). About 60% of the prescriptions contained Chinese patent medicine (CPM), and almost all prescriptions (98.07%) contained western medicine. 85.18% of the prescriptions contained antibiotics, of which, 24.98% contained two or more types of antibiotics; the percentage of prescriptions with glucocorticoids was 19.99%; the percentage of prescriptions with both glucocorticoids and antibiotics was 16.67%; 51.40% of the prescriptions included injections, of which, 39.90% included two or more injections.ConclusionsThe findings from this study demonstrated irrational medication uses of antibiotics, glucocorticoids and injections prescribed for outpatients in the rural township health centers in Sichuan Province. The reasons for irrational medication uses are not only solely due to the pursuit of maximizing benefits in the township health centers, but also more likely attributable to the lack of medical knowledge of rational medication uses among rural doctors and the lack of medical devices for disease diagnosis in those township health centers. The policy implication from this study is to enhance professional training in rational medication uses for rural doctors, improve hardware facilities for township health centers, promote health education to rural residents and establish a public reporting system to monitor prescription practices in rural township health centers, etc.

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“…This belief may be another important reason for the overuse of injections. The “interactional group discussions” conducted in Indonesia and India suggested that better communication between patients and physicians can result in physicians to prescribe fewer injections [40] , [41] . Therefore, communication between patients and physicians should be strengthened to reduce the overuse of injections.…”

Section: Discussionmentioning

confidence: 99%

Effect of Publicly Reporting Performance Data of Medicine Use on Injection Use: A Quasi-Experimental Study

et al. 2014

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BackgroundInappropriate use of prescribing pharmaceuticals, particularly injections, not only affects the quality of medical care, but also leads to an increase in medical expenses. Publicly reporting performance data of medical care is becoming a common health policy tool adopted to supervise medical quality. To our knowledge, few studies about public reporting applied to medicine use have been reported. This study intended to introduce public reporting in the field of medicine use, and evaluate the effect of publicly reporting performance data of medicine use on the use of injections.MethodsThe research sites were 20 primary healthcare institutions in Q City, Hubei. By matching, the institutions were divided into the intervention group and control group. A quasi-experimental design was applied in this study. In the intervention group, the performance data of medicine use were publicly reported. The injection prescribing rates of the two groups before and after intervention were measured and compared. Difference-in-difference method and logistic regression were employed to estimate the effect of public reporting on injection use.ResultsPublic reporting led to a reduction of approximately 4% in the injection prescribing rate four months after intervention (OR = 0.96; 95%CI: 0.94, 0.97). The intervention effect was inconsistent in each month after intervention, and it was most positive in the second month after intervention (OR = 0.90; 95%CI: 0.89, 0.92).ConclusionsIn general, publicly reporting performance data of medicine use may have positive effects on injection use to some extent. Further research is needed to investigate the mechanism by which public reporting influences injection use. Comprehensive measures are also necessary to promote the rational use of injections.

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Reducing use of injections through interactional group discussions: A randomized controlled trial

Abstract: Interactional group discussions reduce prescription of injections.

Cited by 13 publications

References 9 publications

Reuse of syringes for therapeutic injections in Pakistan: rethinking determinants

Reuse of syringes for therapeutic injections in Pakistan: rethinking determinants

Outpatient prescription practices in rural township health centers in Sichuan Province, China

Effect of Publicly Reporting Performance Data of Medicine Use on Injection Use: A Quasi-Experimental Study

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