IMA-FOMA DELHI RESOLUTIONS

IMA-FOMA DELHI RESOLUTIONS From the desk of Dr KK Aggarwal, National Presidemt, IMA and Dr R N Tandon, HSG, IMA An emergency Action group meeting of IMA followed by an emergency meeting of Indian Medical Association - Federation of Medical Associations of India were held in IMA Headquarters Delhi from 11 am to 2 pm on Wednesday 26/04/2017 to discuss the emergent situation on generic drugs. (IMA- Federation of Medical Associations of India) Prescription of Generic Name of the Drugs by Medical Professionals IMA-FOMA appreciates Hon’ble Prime Minister, Shri Narendra Modi’s concern about the availability, accessibility and affordability of quality economical drugs to the society. 1. The judgement to choose a rational drug and its format vests only with the Registered Medical Practitioners. This right of the medical profession is sacrosanct. 2. IMA - FOMA also wants the Government to strengthen Quality control mechanisms to ensure adherence to Good Manufacturing Practices (GMP) for patient safety. 3. For a rational prescription, doctors should choose drugs generic-generic or generic - brand based on quality, efficacy and economy and write legibly and preferably in capital letters. 4. IMA-FOMA recommends that Government should ban differential pricing of a drug under different brand names (generic-generic, generic- trade or generic- brand) by one company. (one chemical drug, one company, one prise) 5. IMA FOMA will be meeting the President of MCI, Union Health Minister and Prime Minister of India about the views of the medical fraternity on this issue. All the constituent members of IMA-FOMA shall communicate these IMA-FOMA Delhi Resolutions to its members. Reference MCI Ethics Regulations Clause No. 1.5 states " All physicians SHOULD prescribe medicines with generic names, legibly and preferably in capital letters and he or she SHALL ensure rational prescription and use of drugs" List of Associations which attended the FOMA meeting Indian Medical Association, All India Ophthalmological Society, Urological Society of India, Geriatric Society of India, Indian Radiology & Imaging Association, Indian Academy of Echocardiography, Heart Care Foundation of India, Cardiological Society of India, Association of Surgeons of India, Indian Psychiatric Society, Delhi Psychiatrist Society, Indian Orthopaedic Association, The Federation of Obstetric & Gynaecological Societies of India, Indian Association of Dermatologists, Venereologists and Leprologists, Association of Physicians of India, Indian Academy of Echocardiography, FFPAIA,

Write drug names in capital letters to avoid prescription errors

Write drug names in capital letters to avoid prescription errors Doctors are known to have poor handwriting and they also use abbreviations in their prescriptions. As a result, quite often, prescriptions may be unreadable and it is often said that only chemists could decipher a doctor’s prescription. This is an area that needs to be addressed by doctors as illegible prescriptions may be misread and wrongly dispensed, often with disastrous consequences. A report ‘Preventing Medication Errors’ from the Institute of Medicine (IOM) published in 2006 said, “In hospitals, errors are common during every step of the medication process—procuring the drug, prescribing it, dispensing it, administering it, and monitoring its impact—but they occur most frequently during the prescribing and administering stages.” Beneficence and nonmaleficence along with patient autonomy and justice constitute the four guiding tenets of medical ethics. Patients come to us when they are sick and as clinicians, we are trained to use our skills and knowledge to diagnose and treat them. This is the principle of beneficence ‘do good’ complemented by that of 'non-maleficence' i.e. to do no harm. The fiduciary nature of the doctor-patient relationship places an ethical obligation on the doctor to always put the interests of the patient first. To reduce prescription errors, the Medical Council of India (MCI) has issued guidelines that require doctors to write in capital letters to that the writing is legible. In September 2016, MCI revised its code of ethics notified as Indian Medical Council (Professional Conduct, Etiquette and Ethics) (Amendment) Regulations, 2016 – Part – I. this revision required doctors to write the generic names of drugs and in capital letters so that the drugs prescribed could be easily read and dispensed. The notification read as follows: In Chapter 1-B-Duties and responsibilities of the Physician in general, Clause – 1.5 under the heading – Use of Generic names of drugs, the following shall be substituted: “Every physician should prescribe drugs with generic names legibly and preferably in capital letters and he/she shall ensure that there is a rational prescription and use of drugs.” IMA welcomes the new MCI gazette notification asking doctors to prescribe generic medicine in capital letters but clarifies it further. “Every physician should prescribe drugs with generic names legibly and preferably in capital letters and he/she shall ensure that there is a rational prescription and use of drugs”. Here are some examples of common prescription errors and how to avoid them. • Always spell the drug: Always spell the drug if you are giving telephonic instructions. Sound-alike drugs can cause confusion. o E.g. the patient received Isoprin IV in place of Isoptin and nearly died. o E.g. Amlopress AT/80mg; a hypertensive called up his family physician who asked him to take amlopress AT but the patient took amlopress 80 mg. After sometime he developed dizziness, flushing, palpitation, nausea, abdominal pain. • Never write ‘U’ to abbreviate the word ‘units’: Do not write ‘U’ for units when writing prescription. Always write the complete word ‘units’. It may be mistaken as zero. E.g. never write 4U insulin. The patient may be given 40 units of insulin when the doctor meant 4 U (4 units). • Never write the numeric after a decimal point: The use of a trailing zero after a decimal point when writing prescription may lead to medication errors. E.g. do not write 3.0 mg. There are chances that the patient may get 50 mg; 5.0 mistaken as 50 mg if the decimal point is not seen. • Always write the numeric 0 before the decimal point: Always add a leading zero when writing dose of a drug, which is less than one. Lack of a leading zero may lead to a decimal point being missed. For example, never write .25 mg; instead write 0.25 mg. Otherwise there are chances the patient may take 25 mg in the first instance itself. • 8-2-8 mistake: The time interval should be written more clearly as 8am 2pm 8pm. Or, the patient may consider it to be the number of tablets to be taken 8 in the morning, 2 in the afternoon and again 8 at night

A Heart Healthy Prescription

A Heart Healthy Prescription Cardiovascular disease (CVD) is one of the leading Global causes of morbidity and premature mortality contributing to over 17.5 million deaths every year New Delhi, 25 September 2016: The increasing incidence of cardiac diseases is causing serious concern amongst the medical fraternity of India. The primary reasons for this include the lifestyle irregularities of the 21st century Indian. In addition to this, early signs of heart disease are often ignored or not taken seriously causing grave problems in the future. According to Padma Shri Awardee, Dr. KK Aggarwal, President HCFI & President Elect IMA, “The number of heart patients in India can be drastically reduced if every individual lives a healthy and balanced lifestyle and immediately makes necessary lifestyle modifications whenever heart disease symptoms are reported. People often get fooled by misconceptions about heart diseases and hence, it becomes really important to understand the facts associated with your heart. For instance women often continue to believe that they can never suffer from heart disease. However, this is a myth. Similarly, it is often believed that heart disease only happens in those above the age of 55. The reality is that in the present day and age, heart disease is increasingly common in people in the age group of 30-40 years.” “Heart disease prevention and education must from the very onset because the seeds of heart disease are sown in teenagers and young adults. Over the years, the plaque in the wall of the arteries continues to clog them causing heart attacks and episodes of sudden cardiac arrest. Hypertension, diabetes, and obesity must be kept under check since they all can lead to heart attacks", he added. According to reports, more women have died from heart attacks than men in past 30 years. Doctors recommend that everyone regardless of their gender get regular cholesterol level and blood pressure checked as in the case of women, they rarely experience conventional symptoms such as heartache or pain in the chest. Lifestyle modifications are key for the reversal of CAD. If you have to consume alcohol, drink in moderation. Drinking excessive amounts of alcohol causes raised blood pressure, which is one of the most important risk factors for having a heart attack or a stroke. Increases in your blood pressure can also be caused by weight gain from excessive drinking. Obesity too leads to cardiovascular ailments. Additionally, the difference between good and bad cholesterol must be understood. While some fat is good for the body, consuming a high-trans-fat diet can cause plaque deposit over the long run A healthy and balanced diet is key for a healthy heart. An over-dependence on junk food, consumption of saturated and trans fats, food containing high salt and sugar levels cause obesity, high cholesterol, hypertension and diabetes, all key risk factors for heart disease. A healthy diet must consist of items, which have low levels of saturated fats, fresh fruits and vegetables. You should immediately break away from the thinking that ‘exercising is too risky if you have a heart disease’ as doctors recommend regular exercises to people with heart issues. Also, Regular exercise is important to strengthen one's, heart, lower blood pressure, keep obesity under control, burn off stress, boost your self-esteem and help you sleep better. By regularly exercising for at least 30 minutes three to four times a week, one can keep their heart healthy. Aerobic exercise particularly is beneficial for patients with a tendency to get heart disease. Heart’s care continues for as long as you live. In addition to this, heart disease can develop again after you have got yourself treated. Many individuals suffer heart attacks twice or thrice in their lives. But the best remedy to totally undo all the damage is by start following a healthy regime that will make you less prone to all the heart casualties. Formula of 80 to live a healthy life till the age of 80 years 1. Keep your abdominal circumference less than 80cm 2. High blood pressure and its risks, keep the lower reading at 80 3. Keep your blood sugar below 80mg 4. Bad cholesterol levels should be lesser than 80mg 5. Keep the pulse lower than 80 beats per minute 6. Eat a balanced diet and avoid cereals for 80 days in a year 7. Get at least 80 minutes of exercise in a week 8. Consume alcohol in moderation, not more than 80 grams in a week for men and two weeks for women