An evaluation of prevalence and prescribing patterns of rational and irrational fixed dose combinations (FDCs): a hospital based study

Background: Fixed-dose combinations (FDCs) are combinations of two or more active drugs produced in a single dosage form and are used in the treatment of a wide range of ailments. Objective: The objective was to find out prevalence, prescribing pattern, and rationality of FDC amongst patients attending out-patients department of medicine in a tertiary care teaching hospital. Materials and Methods: A hospital based prospective cross sectional observational study based on a convenience sample of 620 prescriptions carried out in between May 2015 and July. A seven point tool was developed based on the WHO guideline to evaluate the rationality FDCs. The format for the collection of data were to include patients demographic information such as name, age, sex, social history, family history, as well as medication information, diagnosis, and current treatment regimen given by prescriber. Collected prescriptions were screened for fixed dose combinations and analysed for prevalence, prescribing pattern, and rationality. Result: Prevalence of FDCs in the prescription was 81.31%. Brand names were used in 82.78% of the prescriptions. FDCs containing nutritional supplements containing vitamins and minerals are prescribed for maximum numbers (20.48%). About 70% of FDCs were irrational, where 17.71% were either controversial or banned and 15.83% were rational. Conclusion: The prevalence of irrational prescribing of FDC is high. To minimize the pattern, educating the prescribers about rational prescribing is essential. A relook and rationalization may be required in the use of combination product.