Assessment of rational prescribing practice among interns: a questionnaire based observational study

Rohini Gupta, Apoorva Malhotra, Pavan Malhotra


Background: Rational use of medicines (RUM) is recognized as an important factor in health policy. Prescribing appropriate drugs in right doses is an integral part by which a physician can influence the patient’s health and well‑being. Rational prescription writing is a skill which should be mastered at the earliest. Understanding the knowledge and perception of interns will help us to identify the problems in clinical pharmacology teaching, and the method to implement RUM. Objective was to assess the rational prescribing practice among interns in a tertiary care teaching hospital.

Methods: This cross-sectional, questionnaire-based study was carried out in 92 interns of Acharaya Shri Chander College of Medical Sciences and H, Sidhra, Jammu (J and K). Interns posted in different departments of the hospital in the year 2016 (n = 92) were approached and explained the purpose of the study. 88 gave consent to participate in the study. Out of 88 only, 82 duly filled questionnaires were used for final analysis. Those who were not willing to participate in the study and those whose questionnaires were not duly filled were excluded from the study. The completed questionnaires were then assessed for responses of the students on principles of good prescribing.

Results: Of the 92 interns, 88 gave consent to participate in the study while 82 of them returned the duly completed questionnaires (response rate was 89.1%). The mean age of the respondents was 24.1 years. Out of 82 interns, 95.1% respondents were aware about the term RUM, only 8.5% had National List of Essential Medicines of India (NLEMI) available at their work place. Though 41.5% interns were aware of the term P-drug, only 3.7% were aware about STEP criteria. Majority of interns 62.1% relied on information from standard text books whereas 24.3% rely on Medical representatives (MR) for obtaining information about various drugs and regimens.

Conclusions: In conclusion, it is encouraging finding that higher percentages of interns were aware about essential medicines (EM) and also prescribe it. However, level of understanding related to personal drug (P-drug) concept and existence of Essential medicine list (EML) are much below par. Furthermore, prescribing by trade name and dependency on MR for drug information is the matter of concern. Hence, there is a need to strengthen the mechanism for continuing professional development of interns to update their knowledge and skills to prescribe rationally.


Essential drugs, Interns, P-drug, Rational use of medicines

Full Text:



Banerjee I, Bhadury T. Prescribing pattern of interns in a primary health center in India. J Basic Clin Pharma. 2014;5:40-3.

World Health Organization. The Pursuit of Responsible Use of medicines: Sharing and Learning from Country Experiences. Available on WHO_EMP_MAR_2012.3_eng.pdf.

World Health Organization. The Selection of Essential Medicines-Perspectives WHO policies. 2002;1-6.

CDSCO. National list of essential medicines of India 2011. Available from:

Manikandan S, Gitanjali B. National list of essential medicines of India: The way forward. J Postgr Med. 2012;58(1):68-72.

Parmar DM, Jadhav S. The concept of personal drugs in the undergraduate pharmacology practical curriculum. Indian J Pharmacol. 2007;39(3):165-7.

Vries T De. Guide to good prescribing. Geneva World. 1994. Available from: Cited 2017 June 1.

Banerjee I, Bhadury T. Prescribing pattern of interns in a primary health center in India. J Basic Clin Pharma. 2014;5:40-3.

Aronson JK. A prescription for better prescribing. Br J Clin Pharmacol. 2006;61(5):487-91.

Ferner R. Should medical students be taught rational prescribing?. Student BMJ. 2003 Apr 1;11:89-90.

Krishnaiah V, Ramaiah V, Ramakrishna R. Comparison of rational pharmacotherapy approach by medical students with and without Guide to Good prescribing guidelines. Natl J Physiol Pharm Pharmacol. 2013;3:53-6.

Mahajan R, Singh NR, Singh J, Dixit A, Jain A, Gupta A. Current scenario of attitude and knowledge of physicians about rational prescription: A novel cross‑sectional study. J Pharm Bioallied Sci. 2010;2:132‑6.

Kar SS, Pradhan HS, Mohanta GP. Concept of essential medicines and rational use in public health. Indian J Community Med. 2010;35:10‑3.

Cameron A, Mantel-Teeuwisse AK, Leufkens HGM, Laing RO. Switching from originator brand medicines to generic equivalents in selected developing countries: how much could be saved? Value Health. 2012;15(5):664-73.

Upadhyaya P, Seth V, Sharma M, Ahmed M, Moghe VV, Khan ZY, et al. Prescribing knowledge in the light of undergraduate clinical pharmacology and therapeutics teaching in India: Views of firstyear postgraduate students. Adv Med Edu Pract. 2012;3:47-53.

Oshikoya KA , Bello JA, Ayorinde EO. Prescribing knowledge and skills of final year medical students in Nigeria. Indian J Pharmacol. 2008;40:2551-5.

Ross S, Loke YK. Do educational interventions improve prescribing by medical students and junior doctors? A systematic review. British J Clinical Pharmacol. 2009 Jun 1;67(6):662-70.

Norris P, Herxheimer A, Lexchin J, Mansfield P, World Health Organization. Drug promotion: what we know, what we have yet to learn: reviews of materials in the WHO/HAI database on drug promotion. Geneva: World Health Organization; 2005.

Patrício KP, Alves NA, Arenales NG, Queluz TT. Teaching the Rational Use of Medicines to medical students: a qualitative research. BMC medical education. 2012 Dec;12(1):56.

World Health Organization. Factsheet: WHO Policy Perspectives on Medicines‑Promoting rational use of medicines: Core components Geneva: WHO; 2002. Available from: htpp:// Cited on 2017 November 7.

Maxwell S, Walley T, Ferner RE. Using drugs safely. BMJ. 2002;324:930‑1.