Evaluation of prescription pattern of fixed-dose combinations in a tertiary care hospital in India - A cross-sectional study

Background: Inappropriate and indiscriminate use of fixed-dose drug combinations (FDCs) may lead to increased cost, unnecessary exposure to drugs, and adverse drug reactions. Government of India had issued a ban notification on manufacturing and sale of few FDCs which involved human risk and no therapeutic justification for their use. Despite the stringent steps from the health-care authorities, such FDCs are available in the market and are being prescribed extensively without considering the appropriate alternative in the form of a single drug formulation. Aims and Objective: This study was planned to find out the number FDCs prescribed by clinicians and find out the rationality with respect to the indication. Materials and Methods: Prescriptions of patients attending hospital pharmacy and indoor papers of patients admitted in the wards were screened for the presence of FDCs for a period of 6 months. A total of 3500 prescriptions were screened, and collected data were analyzed using descriptive statistics. Results: Out of 3500 prescriptions screened, 1000 (28.5%) had FDCs prescribed in it. Out of 1000 FDCs, 151 (15.1%) were prescribed by generic names and 849 (84.9%) were prescribed by brand names. A total of 596 (59.6%) FDCs were prescribed for infectious diseases followed by 195 (19.5%) FDCs prescribed for pain and inflammatory disorders and 169 (16.9%) FDCs were prescribed for diseases affecting the respiratory system. Out of 1000 FDCs, 818 (81.8%) were rational and 182 (18.2%) were irrational. Conclusion: The study revealed that the majority of prescriptions had rational FDCs prescribed by the treating doctors reflecting rational use of FDCs in our patients.