EVIDENCE-based medicine has propelled the medical field towards a more safe and effective way of treat the patients. Using extensive research to support proven treatments, it has enabled us to stop the use of treatments and procedures which have been shown not to work, or whose risk factors outweigh benefits.
Unfortunately, this form of safe practice still evades most medical practitioners in Pakistan.
When you have a patient population which believes so strongly in consuming medications in all forms as the only way of treatment, they seek out doctors who prescribe the medicine asked for. The reason is the doctors themselves understand that if they want to earn a living they must keep their patients happy. There is also the other way around, for the physicians themselves insist that the only way of treatment is to use a defunct, old medication. The fear of illness keeps the patients coming back to them. It’s a catch-22, you’re dammed if you do and you perish if you don’t.
Some physicians try to ease their conscience by prescribing what they consider ‘harmless’ placebos when patients insist on a prescription.
We know a cough can take anywhere between two to four weeks to settle, and a snotty nose up to 10 days. It is normal for children under six years of age, especially those under four, to have seven to eight viral episodes per season. The US Food and Drug Administration, the American Academy of Pediatrics and the NICE in UK, no longer recommend cough syrups for children under six, as research has shown that they do not work.
Medicated inhalers via spacers is the preferred treatment over nebulisers in children with reversible airway disease, or asthma like reaction to a cold, and is not a cough remedy for the common cold!
And yet medications are prescribed with abandon. Then you have patients who self-prescribe, knowing that this is what the doctor gave them last time.
Public health education is the way to move forward to help change the way we think and empower patients by helping them understand disease and treatment.
Dr Anookhi Khanum
Karachi
Published in Dawn, July 6th, 2019
