Irrational Fixed Dose Combinations & Need for Intervention: Understanding of Dental Clinicians and Residents

CONTEXT: There is a growing concern about ever-burgeoning list of irrational fixed dose combinations (FDCs) which have flooded pharmaceutical market recently in India. Till date no structured study has evaluated the level of understanding among the dental clinicians and residents about these concepts. The present study is designed to fulfil that lacuna. OBJECTIVE: To evaluate the knowledge, attitude and practice, regarding the use of FDCs by the dental residents and dental clinicians in a tertiary care teaching dental hospital. MATERIALS AND METHODS: The present study was carried out among postgraduate students and dental clinicians working at Rajasthan Dental College, a tertiary care teaching dental hospital, in Jaipur, India. Sixty residents and 77 dental clinicians from the departments of Orthodontics, Prosthodontics, Oral Medicine, Periodontology, Conservative Dentistry & Endodontics, Oral & Maxillofacial Surgery, Pedodontics who gave their informed consent were enrolled. A prevalidated questionnaire regarding knowledge, attitude and prescribing practice of fixed dose combinations was filled up. Data was analysed with suitable statistical tests. RESULTS: Out of the 60 residents and 77 dental clinicians recruited for the study, none of them were aware about all of the advantages and disadvantages of FDCs. On an average, only 47% of residents and 61% dental clinicians were aware of FDC included in WHO Essential Medicines List (EML). Only 47% residents and 58% dental clinicians could recall a single banned FDC in India. Common sources of information about FDCs were Monthly Index of Medical Specialities (MIMS), medical representatives and internet. The most commonly prescribed irrational FDC was diclofenac + paracetamol combination, 42% residents and 41% dental clinicians and residents believed that regular Continuous Medical Education (CMEs) stressing upon rational use of medicine could reduce the magnitude of this problem. CONCLUSION: It is the need of the hour to reduce the magnitude of this problem by sensitizing dental residents and prescribers regarding the efficacy, safety, suitability, rationality and cost benefit of FDCs available for patient use.