Abstract
BackgroundPrescription of medicines by non-doctors is an issue with serious global implications. To our knowledge prescription of drugs by medical and non-medical students has not been studied before. We aimed to determine the practice and attitudes of drug prescription by medical students and: a) how non-medical students respond to this practice, b) How this compares with the attitudes and practices of non-medical students.MethodsA cross-sectional study was conducted on a sample of 600 students randomly selected from 2 medical and 2 non-medical universities. Ethical requirements were ensured and data was collected using self administered questionnaires. The Chi square tests and logistic univariate regression analyses were performed using SPSS v 14 to identify associations and differences.ResultsA total of 572 forms were completed and the sample consisted of 295 medical students and 277 non-medical students with no significant difference in their demographic profile. Of the 295 medical students 163 (55.3%) had prescribed a medicine independently and most (48.5%) said that they did this 2–3 times a year. The commonest reasons for this were 'previous experience' (68.7%), 'problem too trivial' (34.4%) and 'we knew everything about the condition' (31.3%). One-third (33.6%) of the undergraduate medical students thought that it was alright to independently diagnose an illness while a vast majority (78.3%) thought that it was alright for them to prescribe medicines to others. Common prescriptions were pain-killers, antipyretics, antiallergics and antibiotics. Medical students who prescribed medicines were of lesser age (CI = 1.366–1.887) and more likely to belong to the 1st (CI = 3.588–21.731), 2nd (CI = 2.059– 10.869) or 3rd (CI = 4.331–26.374) year of medical college. One-third (33.9%) of the non-medical students reported that a medical student had prescribed medicines to them and 21.3% said that they trusted medical students and would follow their advice blindly. Many students thought it alright for medical students to diagnose and treat illnesses. A similar proportion of non-medical students (58.5%) reported prescribing medicines to others.ConclusionPrescription of medicines by non-doctors is rampant and urgent corrective measures are warranted. We have highlighted areas for future research and intervention and have given a few recommendations.
Highlights
Prescription of medicines by non-doctors is an issue with serious global implications
We conducted a cross-sectional study on a population of 600 students from four universities in Karachi, which is the largest city of Pakistan with a population of over 13 million
It has been observed that medical students in our part of the world start prescribing medicines to each other and to other people much before they graduate from medical college
Summary
Prescription of medicines by non-doctors is an issue with serious global implications. Medicines are complex chemicals with many actions, many of which are besides the desired ones They can interact with other drugs, interfere with normal bodily functions, enhance or suppress various enzymes and can have a multitude of adverse effects [1]. In some countries especially developing countries where resources are limited, health workers other than doctors have been given the power to prescribe drugs and other health care services to others [3]. These people have been trained appropriately and are licensed to do so. Every other person who prescribes a drug/s is acting outside the law and doing something very perilous which can result in devastating effects for the individual but the society as a whole
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