National Formulary of India is now available as a mobile phone download – for those who have smart phone and are capable of using this application. It would be a great tool available during consultations and at the bedside.  
    Drug Use Study through Prescription Audit in Bihar  
    We Have taken in hand a Project on “Drug Use Study through Prescription Audit in Bihar” – DFID supported Sector Wise Approach to Strengthening Health – Bihar Technical and Assistance Support Team (BTAST). The study (baseline survey) commenced at the Patna Medical College and Hospital, In January 2012, after the training of pharmacists. The survey is being conducted in a total of 22 health facilities (Medical colleges, district hospitals, sub divisional hospitals, PHCs and APHCs) in Patna, Darbhanga, Purnea, Gaya, Begusarai and West Champaran.  
    Rational Use of Drugs Training for Nurses – Rajasthan Health Systems Development Project (RHSDP), Government of Rajasthan  
    The Rajasthan Government had entrusted DSPRUD the responsibility for conducting workshops on Rational Use of Drugs to cover over 500 nurses drawn from all over the state. This was undertaken in seventeen workshops spread over a year. The last workshop was held on November 14-15, 2010.  
    Promoting awareness amongst school children on rational use of medicines – World Health Organization  
    The World Health Organization (WHO) had awarded DSPRUD a contract on ‘Promoting awareness amongst school children on Rational Use of Medicines’. The project was aimed at sensitizing and training adolescent school children in the proper use of medicines thus making the school children ambassadors for spreading the message of Rational Use of Medicines.

The project was proposed to be carried out in two phases – phase I and phase II, the former essentially being the preparatory work and the latter being the execution of the awareness programme.

The broad findings of the Survey are as follows:
  • A large percentage of students responded to having consulted doctors/other health professionals for their ailments. A small number resorted to self medication.
  • Information by the doctors to the patients is lacking. Doctors may inform about the disease but at the same time about the appropriate use of medicines – dose, frequency and duration of the treatment - and other related aspects are not imparted to the patients unless such information was specifically sought for.
  • Students were also not aware as to what they are supposed to inform to the doctors at the time of consultation viz. the medication they are taking; allergy to any medicine and seek information from the doctor about the appropriate use of medicine.
  • At the time of purchasing the medicines, a very small percentage carry the prescription with them and cross checks the name of the medicine with the prescription or verify the date of expiry.
  • Majority do not ask for the bill of purchase of medicines.
  • A minimum percentage only admitted to having received the instructions with the medicines before using them.
  • The knowledge of students about the storage of medicines at home was inadequate. The knowledge of carrying the medicines to school was inappropriate.
  • There is a tendency to use the left over medicines by the students on their own at their discretion.
  • Lack of knowledge of students about the antibiotics is alarming. Students are not aware as to what antibiotics are and for what they are used, leave alone their appropriate usage.
DSPRUD plans to address these issues in Phase II of this project while creating awareness amongst the students.

    Training of Pharmacists of ART Centres – National AIDS Control Organization (NACO, Government of India  
    NACO has entrusted DSPRUD the responsibility to train the pharmacists working at the ART Centres on ARV drugs and treatment etc. as these drugs are not part of the routine training of pharmacists. DSPRUD is to (i) prepare a training manual. (ii) conduct the training programmes for pharmacists working at ART Centres in Delhi; and (iii) conduct training programmes for pharmacists working at ART Centres in Mumbai, Kolkata, Chennai, Bangalore and Hyderabad. The first training programme for pharmacists in Delhi was conducted on June 11 & 12, 2010, in which the draft training manual was tested. The draft manual is being revised to take into account the few suggestions received from the first batch of trainees and other resource persons. Once the manual is finalized, training will commnence at Delhi and other centres – Mumbai (Maharashtra), Kolkata (Eastern & NE states), Chennai (Tamil Nadu, Kerala and Pondicherry), Bangalore (Karnataka and Goa) and Hyderarbad (Andhra Pradesh).

Dr. (Mrs.) Sampada P. Patvardhan (Mumbai); Dr. (Mrs.) P.K. Lakshmi, (Hyderabad & Bangalore); Dr. G.P. Mohanta (Chennai); and Dr. Santanu K. Tripathi (Kolkata) have been appointed as Coordinators to coordinate the work on behalf of DSPRUD for training at centres other than Delhi.

    Visit of the Executive Vice President to Abu Dhabi  
    Dr. Usha Gupta, Executive Vice President, was invited by the Health Authority Abu Dhabi, in the first week of January 2009, to deliver lectures and provide consultation on important issues related to Rational Use of Drugs activities using the different methods of analysis for drug use, prescription audit and prescribing behaviour.
    Meeting of the Anti-Microbial Use and Resistance Project (AMR) Advisory Committee and the Principal Investigators  
    Under the aegis of the World Health Organization a multi-centric study was initiated in 2003 of antimicrobial resistance (AMR) for
  1. coordinated monitoring of antimicrobial resistance and antimicrobial use in communities as well as hospitals; and
  2. develop appropriate intervention to improve antimicrobial use and therefore contain the development of antimicrobial resistance.
The study was to be carried at three centres in India, namely, Delhi (Sir Ganga Ram Hospital & Vallabhbhai Patel Chest Institute), Mumbai (BYL Nair Hospital) and Vellore (Christian Medical College).

The mechanism set up to monitor the products of the project was a multi-disciplinary Advisory Committee which was serviced by the Delhi Society for Promotion of Rational Use of Drugs (DSPRUD).

A meeting of the AMR Advisory Committee with the Principal Investigators from the three centres (Delhi, Mumbai and Vellore) was held at the Bharatiya Vidya Bhavan, New Delhi, on December 15, 2008, in which progress of the project was reviewed and it was noted that

  1. all the three centres had completed Phase I (to set up a surveillance system)
  2. two of the three centres had completed Phase II (to refine the surveillance system and undertake qualitative investigation)
  3. the third centre had just completed data collection for Phase II.
The very useful role played by DSPRUD since the beginning of the project and the excellent support given by DSPRUD to the Advisory Committee was appreciated.

Among the major suggestions that emanated in this meeting were:

  1. There was unanimity about the urgent need to reduce inappropriate use of anti microbial agents.
  2. An effective intervention would need to be evolved bringing in all the major stakeholders of whom the prescribers and the community (patients) were the most important.
  3. A two-pronged approach involving the delivery of targeted messages to consumers (via different groups in the community) through their local prescribers and dispensers (involving them as co-investigators) was discussed. Vellore had developed a proposal along these lines.
  4. It was felt to be the only way of truly involving all concerned stakeholders, since the qualitative investigation had revealed a lack of interest on the part of private practitioners and pharmacy shop owners to participate in continuing medical education.
  5. It was suggested that a proposal should be made to the Government of India to alert them on the dangers of inappropriate use of anti microbial resistance duly substantiated by the evidence that had been gathered on inappropriate use of antibiotics in actual surveys in the pilot project.
    Visit of President and Executive Vice President to Srinagar  
    Mr. R. Parameswar, President and Dr. Usha Gupta, Executive Vice President made a visit to Srinagar in the third week of June 08, on the invitation of Jammu & Kashmir (J&K) Government, to help the state to formulate a Drug Policy. After a round of meetings with principals of medical colleges, leading clinicians, specialists and the Principal Secretary to the Government of J&K – Department of Health, they gave a draft of a State Drug Policy. A second round of discussion was convened by the Principal Secretary to discuss the draft policy. The draft Drug Policy is now to be taken to the J&K Council of Ministers.

During discussion, the Principal Secretary indicated that he would be looking forward to DSPRUD to provide technical support for implementing some aspects of the Drug Policy after it is approved by the Government.
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