Greenhalgh T
Soc Sci Med. 1987;25(3):307-18. doi: 10.1016/0277-9536(87)90233-4.
This paper reports a study of the prescribing and dispensing of drugs in India. The drugs supplied to 2400 patients by the public and private medical sectors and by private pharmacies (over the counter dispensing) were recorded, and were analysed with respect to the patient's presenting complaint and diagnosis. The main findings discussed in this paper are: 1. Large numbers of drugs are prescribed by doctors in the private sector. Combination preparations containing 'hidden' classes of drug are often given. Anti-infectives are widely and often inappropriately used. 2. Potentially dangerous drugs are sold over the counter and prescribed for trivial or bizzare indications. Drugs which have been withdrawn as dangerous in the West remain popular first line drugs in India. 3. Food supplements and tonics of dubious nutritional and pharmacological value make up a high proportion of the total drugs bill. It is concluded that a rational drugs policy and/or an essential drugs list will be useless unless accompanied by intensive efforts to improve the education and updating of doctors and pharmacists and to reduce the commercial pressures on doctors to prescribe unnecessary drugs.
本文报道了一项关于印度药品处方与配药情况的研究。记录了公共和私营医疗部门以及私人药店（非处方配药）向2400名患者提供的药品，并就患者的就诊主诉和诊断对这些药品进行了分析。本文讨论的主要研究结果如下：1. 私营部门的医生开出大量药品。常开出含有“隐性”药物类别的复方制剂。抗感染药物被广泛使用且常常使用不当。2. 有潜在危险的药物在柜台销售，并被用于轻微或奇怪的适应症。在西方已因危险而退市的药物在印度仍是常用的一线药物。3. 营养和药理价值存疑的食品补充剂和滋补品在药品总费用中占比很高。得出的结论是，除非大力努力提高医生和药剂师的教育水平并使其知识更新，以及减少促使医生开具不必要药物的商业压力，否则合理用药政策和/或基本药物清单将毫无用处。
