smartcybers786@gmail.com 
#prescription #crisis #Political #Economy
Those patients’ relationships and health literacy are closely connected. A well -informed doctor can equip his patients with evidence -based information that promotes understanding of patients’ conditions and how to manage it effectively. Pharmaceutical management is an important part of the physician’s consultation. This includes both the appropriate prescription and a prescription.
Some terms require short -term drugs, for example, antimicrobials; Others need long -term use, for example, hypertension, diabetes, heart failure, etc. The appropriate prescription includes the choice of the right medicines for the patient’s preference (joint decision -making), its previous use, side effects or interaction with its regular medicines. Such a prescription is usually achieved by the presence of therapeutic awareness, therapeutic skills of therapeutic, the presence of co -marked conditions, such as therapeutic communication skills, liver or kidney problems, and the ability to achieve the appropriate date from the patient. The correct dose, frequency, delivery method (such as oral, parent, etc.) and the duration of medicines are also the main ingredients for the prescription. De -prescriptions include reducing dose or stopping medicines. Improved treatment results and patients for medication, dedicated sessions for medicine management need to be included in the health care curriculum.
Pakistan’s health care system currently lacks a strong primary care system. Prescription, especially antimicrobials, especially in availability issues may be a challenge to practice physicians for a number of reasons. This issue is further increased through hospital policies that ban the marketing of internal pharmacies and aggressive pharmaceutical company. Physicians sometimes face a confusion where they are forced to choose between administrative rules and proper care of patients. Are they damaging medical ethics and promoting the country’s growing antimicrobial resistance problem?
When properly implemented, the hospital’s formulary system has a full history of success. In the 1950s, the United States Veterans Administration Hospitals were advanced, which spread internationally in the next decades. In the 1970s, Sri Lanka’s major national pharmaceutical policy proved that state -owned agencies affiliated with national formulas could dramatically reduce drug costs while maintaining standards. After that, Sri Lanka’s model became a template of developing countries around the world.
Today, mostly developed health care systems use some forms of formulary management. France has successfully implemented its social security system as well as hospital formulas. The UK, Sweden and Australia have established national or regional formulas that balance the cost with clinical effectiveness. Research has permanently shown that well -managed formulars can carefully review the quality of care by taking care of the medicines carefully for properness, safety and cost effectiveness.
In Pakistan, there has been a disturbing contradiction between these proven benefits and the care of patients. Doctors report that they are just pressing to suggest medicines available in hospital pharmacies, even when medical treatment is available elsewhere. When the hospital’s pharmacy is closed, the problem becomes more clear. The main problem is in chronic under -funding – Pakistan’s government hospitals are only available for 22 % of their budgets, which is at least recommended. It transforms potentially beneficial policies into obstacles to maximum medical care.
In the proposed decisions, manipulation in the pharmaceutical industry has worsened the situation. This year, a major research published in the BMJ exposed the shocking limit of corruption. Researchers found that more than 40 % of Pakistani doctors easily agreed to write specific medicines in exchange for cash payments, medical equipment and sponsor travel.
The most disturbing detection of this study was that even aimed at the moral prescription, the targeted education failed to change the behavior. More than 30 % of doctors who received special training on prescription ethics still accepted pharmaceutical incentives. This shows the extent to which these corrupt methods have been deepened in the medical culture of Pakistan.
The results are visible in Pakistan’s prescription patterns. The country has an average of 4.4 drugs per prescription in the country. 70 % of patients receive antibiotics, whether they need them or not. Common medicines are almost never suggested – only 4.3 % of the prescriptions are mentioned.
These failures are disastrous for patients and healthcare. Recent research suggests that a prolonged stay in the hospital costs $ 34 per patient to treat drug abstinence. For families already struggling with health care costs, it represents a crushing financial burden.
The quality of the prescription has become dangerously poor. Studies show that more than a quarter prescriptions are invalid and important information is missing as usual. Only 35 % include a proper diagnosis and medical history of only 25 % documents. This sloppy practice ends the safety of patients and makes it impossible to proper medical care.
Children face the worst threats. Punjab research has found that 97 % of children admitted to the hospital receive antibiotics, while in developed countries only 36 %. These prescriptions are for almost half -powerful spacious spectrum antibiotics that should be specified for serious resistant infections.
These prescription procedures are directly creating Pakistan’s anti -microbial resistance crisis. Hospital studies have found that more than 70 % of patients receive inappropriate antibiotics, including powerful medicines such as sefluspicin, in which 67 % are incorrectly recommended.
The extensive process of proposing antibiotics without proper testing further worsens this problem. In a major study, only four out of sixteen hospitals had the test facilities to see which antibiotics would actually work against the infection of patients. Without this test, doctors resort to powerful spectrum drugs, which accelerate the development of resistance.
Pakistan needs immediate reforms in the prescription policy, which achieve both administrative performance and clinical entrepreneurship. The solution is not to fully abandon the management of institutional pharmaceuticals, but to implement it properly with proper funding and clinical surveillance.
The hospital’s formulary policies can be effective if they include comprehensive pharmaceutical options for all normal circumstances, maintaining proper stock levels through proper financing and a clear process of clear exception for special medical needs. The key is ensuring that these systems provide medical results rather than just administrative facilities.
First, hospitals need enough budget to maintain a comprehensive pharmacy stock, moving beyond 22 % of the current 22 % of the operational funds allocated. When formulas are properly financed and medically appropriate, they can earn cost savings while maintaining care standards.
Second, the government will have to remove strict sanctions that prevent doctors from suggesting more and more treatment externally when internal stock is inadequate or inappropriate. The clear protocol should allow therapists to write a prescription outside the formulary instead of simply justifying the hospital system, rather than stopping such decisions.
Third, the influence of the pharmaceutical company must be resolved through strict rules and regulations, which ban marketing privileges, including real penalties for disclosures and violations. Patients’ selection must be restored through a general recommended mandate, which gives the family cheaper options instead of forcing expensive branded purchases.
Finally, prescription quality standards require immediate implementation through viable requirements and full documents, while antibiotic selection guidance requires strengthening with proper laboratory testing in antibiotic stewardship programs.
Pakistan’s prescription crisis reflects a health care system that has lost its way. Existing policies force doctors to give prescriptions from a limited hospital stock, while pharmaceutical companies make medical decisions through financial privileges. This violates medical ethics, the rights of patients are overwhelmed, and the drug resistance is accelerated.
The evidence is high that basic correction is needed. Clinical decisions must be returned to eligible physicians rather than adminator or pharmaceutical sales representatives. Just before taking medical ethics, patients’ welfare and evidence -based medicine, Pakistan can fix its broken prescription system and can deal with the increasing risk of drug abuse infections.
There is a lot to ignore non -practical costs. The patient deserves the health care system that leads to their interests.
Dr. Hina is an associate professor at Javed Health Services Academy, Family Medicine in Islamabad.
Dr. Testaib Zulfifer is a research fellow at Australian National University, Canberra.
