Rational Injection Practice
Slide 2
Rational Therapy is an essential element for achieving quality medical care. It is defined as therapy which is appropriate for the clinical diagnosis, in the appropriate formulation and dosage for the amount of time which is deemed to be necessary, at the minimal possible cost. The benefits of the therapy should be such that morbidity is restricted only to the time the patient is under treatment.
It Includes both Rational Drug and Injection Therapy
Slide 3
A study done by Ansari et al in Allahabad in which a medical audit of prescriptions was undertaken showed Eighty five percent of them were without the age of the patient, which includes 30% of the pediatric prescriptions. In these 200 prescriptions drugs were inappropriately administered in more than half (52 %).Forty percent (40%) of the prescriptions showed over prescribing. In 10% of the prescriptions interacting drugs were used.
Slide 4 to Slide 9
These slides show different studies which show the injection load in the community and also the morbidity and mortality caused by them, most of the diseases for which these injections are given are those which can easily be treated with oral drug therapy
Inappropriate prescriptions can increase the morbidity and the mortality along with the cost of treatment. It is a waste of precious resources and leads to development of resistance and an increased risk of untoward reactions. A good example of this irrational use of drugs is development of multi drug resistant tuberculosis and also emergence of resistant strains of staphylococcus aureus.
Slide 10
The reasons for injection overuse have more to do with the beliefs of the heath care providers and the population along with the economic considerations.
Most of the common illnesses do not require any specific treatment it can be said that a pill / shot for every ill is a wrong notion.
Slide 11
Irrational Injections increase the morbidity and mortality due to transmission of infections like Hep B, C and HIV. They also contribute to waste of precious resources as injectable cost more than oral drugs. The risk of untoward reactions is more with injectables.
Slide 12
Injections are recommended only for immunizations and acute disease care settings like OT, Emergency wards or if the patient’s condition warrants so.
Slide 13
  • To ensure rational prescription patient should receive medications
  • appropriate  as  per  indication  and  recommendation for the specific disease condition
  • in  correct  dosage
  • for  defined  duration
  • in  rational  formulation
  • with  possible  minimal  cost
  • with  prior  proper  information  to  the  patient
  • under  supervision  and  close  monitoring
Slide 14
IAP recommends that there is need to promote rational drug/injection therapy among all prescribers. This can be achieved through:
  • Promote  rational  drug  therapy
  • Define  effective  and  safe  treatment  protocols
  • Prescription  audit
  • CME  for  health  workers
  • Increase Community  awareness  for  harmful  effects  of  injections
  • Use of only Auto-disable / Reuse prevention syringes and needle stick injury prevention devices