Prescription behavior of doctors when prescribing drugs for
Iron Deficiency anemia

Research paper presented to
SPPSPTM, NMIMS

In partial fulfillment of the Requirement for the Degree
B.Pharm + MBA (MBA PharmaTech)

By
Dishali Shah
A073
Academic Year 2015 - 2016

Statement by candidate
This is to submit that this submission report is my report entitled “Prescription behavior of doctors when prescribing drugs for Iron Deficiency anemia” represents my ideas in my own words and where others’ ideas have been included, I have adequately cited and referenced the original sources. I also declare that I have followed all the principles of academic honesty and integrity and have not misrepresented or fabricated or falsified any idea/ data/ fact / source in my submission. I understand that any violation of the above will be a cause of strict disciplinary action by the School and can also evoke penal action from the sources, which have thus not been properly cited, or from whom proper permission has not been taken when needed.

P. Score________%

Signature of Student
Name of Student

SVKM’s NMIMS
Shobhaben Pratapbhai Patel
School of Pharmacy & Technology Management,
Vile Parle (W), Mumbai-400056.

SHOBHABEN PRATAPBHAI PATEL SCHOOL OF PHARMACY AND TECHNOLOGY MANAGEMENT, SVKM’s NMIMS

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Certificate
The work described in this report entitled “Prescription behavior of doctors when prescribing drugs for Iron Deficiency anemia” has been carried out by Ms. Dishali J. Shah under my supervision. I certify that, this is his bonafide work. The work described is original and has not been submitted for any degree to this or any other university.

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Designation:
______________________
Chairperson
_____________________
Dean

SVKM’s NMIMS
Shobhaben Pratapbhai Patel
School of Pharmacy & Technology Management,
Vile Parle (W), Mumbai-400056
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Prescription behavior of doctors when prescribing drugs for Iron Deficiency
Anemia

SHOBHABEN PRATAPBHAI PATEL SCHOOL OF PHARMACY AND TECHNOLOGY MANAGEMENT, SVKM’s NMIMS

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ABSTRACT
Iron deficiency is a profoundly pervasive type of under nutrition, influencing around one-fourth of the world's ladies and youngsters, and is one of the most basic reasons for paleness.
We led far reaching surveys of distributed writing connecting iron insufficiency to incapacity and demise for four potential results: youngster mortality, perinatal mortality, maternal mortality and mellow mental impediment. For these results, the best accessible information was imminent observational studies in which paleness or hemoglobin focus was the danger element. Information on youngster mortality was not sufficient for this undertaking, in spite of the fact that a genuine danger can't be blocked by the information. Synopsis relative dangers for perinatal mortality (10 considers), maternal mortality (six studies) and mental hindrance (five studies) were assessed utilizing irregular impacts models (both mortality results) or a settled impacts model (hindrance) and weighting individual appraisals by the converse of their inside of study change. For mortality results, the bivariate relations in the middle of hemoglobin and passing were utilized. In two investigations of perinatal mortality, unadjusted and multivariate balanced chances proportions were contrasted with evaluate the potential level of inclination in the unadjusted affiliations. For mental hindrance, distributed multivariate balanced relations in the middle of hemoglobin and IQ were utilized. Worldwide iron deficiency pervasiveness information were supplied by the World Health Organization (WHO), and changed over to mean hemoglobin fixations, expecting typical dissemination and watched standard deviations from a expansive number of studies. To assess the hemoglobin dissemination if iron lack were amended, we accepted half would decrease the predominance of paleness in ladies and kids. By and large, for the world, this would expand hemoglobin focus by around 0.45 g/dl (range: 0.0 g/dl to
1.28 g/dl).

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Table of Contents
Sr no.

1

2

3

4

5

6

Content
Chapter I:
INTRODUCTION
• Statement of the Problem
• Purpose of the Study
• Significance of study
Chapter II:
REVIEW OF LITERATURE
• Anemia
• Types of anemia
• Iron Deficeincy Anemia
• Drugs used by the doctors
Chapter III:
METHODOLOGY
• Procedure
• Participants
• Instrumentation
Chapter IV:
ANALYSIS OF SURVEY
DATA
• t – test
• Ranking Test
• Pie charts
Chapter V:
CONCLUSIONS AND
RECOMMENDATIONS
• Conclusion
• Recommendation
• Limitation

BIBLIOGRAPHY

Pg. No.

6
6
6

7
8
9
19

25
25
25

27
38
38

42
43
43

45

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Chapter I: INTRODUCTION
Statement of problem
Anemia is one of the most prevalent disease in india. The main reason for it being the malnurishment and lack in the intake of iron in the diet for many most of the population. The doctors have to consider many factors when prescribing the drugs to treat the disease. Knowing the right and frequent factors in the concern and this research is based on isolating and summarizing the important factors that affect the prescription pattern of the general physicians.
Purpose of Study/Research Objectives:
To study the basic understanding of Iron deficiency anemia.
To study the factors that affect the prescription behavior of the doctors

when prescribing the

drugs to treat Iron deficiency anemia.
To study the drugs most prescribed by the doctors.

Significance of Study
This research project has information on the various factors that are needed for any pharmaceutical company, in order to establish its anti-anemic formulations in the market. Along with the factors, the most potential populous for prescription of Anti anemic drugs has been also found and published in this research.

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Chapter II: REVIEW OF LITERATURE
ANEMIA
Anemia is a condition in which the blood has lower than the required number of red blood cells.
Anemia additionally can happen if your red blood cells don't contain enough hemoglobin. Hemoglobin is an iron-rich protein that gives blood its red shading. This protein assists red with blooding cells convey oxygen from the lungs to whatever remains of the body.
In the event that you have weakness, your body doesn't get enough oxygen-rich blood. Therefore, you may feel drained or powerless. You additionally may have different manifestations, for example, shortness of breath, unsteadiness, or cerebral pains.
Extreme or enduring Anemia can harm your heart, cerebrum, and different organs in your body.
Exceptionally serious Anemia may even bring about death.
It can likewise be characterized as a brought capacity of the blood down to convey oxygen. At the point when frailty goes ahead gradually the indications are regularly dubious and may include: feeling tired, shortcoming, shortness of breath or a poor capacity to work out. Anemia that goes ahead immediately frequently has more noteworthy manifestations which may include: perplexity, feeling like one is going to go out, and expanded thirst. Pallor must be huge before a man turns out to be perceptibly pale. Extra side effects may happen contingent upon the hidden reason.
There are three principle sorts of frailty: that because of blood loss, because of diminished red platelet creation, and because of expanded red platelet breakdown. Reasons for blood misfortune incorporate injury and gastrointestinal seeping, among others. Reasons for diminished generation incorporate iron inadequacy, an absence of vitamin B12, thalassemia and various neoplasms of the bone marrow among others. Reasons for expanded breakdown incorporate various hereditary conditions, for example, sickle cell iron deficiency, contaminations like intestinal sickness and some immune system illnesses among others. It can likewise be characterized in view of the span of red platelets and measure of hemoglobin in every cell. In the event that the cells are little it is microcytic iron deficiency, on the off chance that they are substantial it is macrocytic frailty and in the event that they are typical measured it is normocytic sickliness. Determination in men depends on a hemoglobin of under 130 to 140 g/L (13 to
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14 g/dL), while in ladies it must be under 120 to 130 g/L (12 to 13 g/dL).[4][5] Further testing is then required to focus the reason.
Certain gatherings of people, for example, pregnant ladies, advantage from the utilization of iron pills for prevention. Dietary supplementation, without deciding the particular reason, is not suggested. The utilization of blood transfusions is ordinarily in view of a man's signs and indications. In those without side effects they are not suggested unless hemoglobin levels are under 60 to 80 g/L (6 to 8 g/dL).[4][7]
These proposals might likewise apply to a few individuals with intense bleeding.[4] Erythropoiesisanimating solutions are just prescribed in those with serious weakness.
Pallor is the most well-known issue of the blood with it influencing around a quarter of individuals globally.[4] Iron-inadequacy frailty influences almost 1 billion.[8] In 2013 paleness because of iron insufficiency brought about around 183,000 people to die – down from 213,000 people in 1990.[9] It is more basic in females than males,[8] among kids, amid pregnancy, and in the elderly.[4] Anemia expands expenses of restorative care and brings down a man's efficiency through a diminished capacity to work.[5] The name is gotten from Ancient Greek: ἀναιµία anaimia, signifying "absence of blood"
TYPES OF ANEMIA
Iron deficiency anemia: Iron lack pallor is brought about by a component's deficiency iron in your body. The bone marrow needs iron to synthesize hemoglobin. Without sufficient iron, your body can't sufficiently deliver hemoglobin for red platelets.
This sort of frailty is regularly brought about by blood misfortune, for example, from overwhelming menstrual dying, a ulcer, growth, a polyp some place in your digestive framework, and delayed utilization of ibuprofen or medications known as nonsteroidal mitigating medications (NSAIDs).
Vitamin insufficiency anemias. Notwithstanding iron, your body needs folate and vitamin B-12 to deliver adequate quantities of sound red platelets. An eating routine ailing in these and other key supplements can bring about diminished red platelet generation.
Also, a few individuals may eat enough B-12, however their bodies aren't ready to handle the vitamin.
This can prompt vitamin inadequacy weakness, otherwise called malevolent pallor.

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Pallor of ceaseless infection. Certain perpetual ailments —, for example, malignancy, HIV/AIDS, rheumatoid joint pain, Crohn's infection and other constant incendiary sicknesses — can meddle with the creation of red platelets, bringing about incessant frailty. Kidney disappointment likewise can bring about iron deficiency.
Aplastic iron deficiency. This extremely uncommon life-undermining frailty is created by a reduction in the bone marrow's capacity to deliver red platelets. Reasons for aplastic frailty incorporate contaminations, drugs and immune system sicknesses.
Anemias connected with bone marrow ailment. A mixed bag of infections, for example, leukemia, myelodysplasia or myelofibrosis, can affecting so as to bring about iron deficiency blood generation in your bone marrow. The impacts of these sorts of disease and tumor like clutters fluctuate from a mellow modification in blood creation to a complete life-undermining shutdown of the bloodproduction process.
Different malignancies of the blood or bone marrow —, for example, numerous myeloma, myeloproliferative issue and lymphoma — additionally can bring about paleness.
Hemolytic anemias. This gathering of anemias creates when red platelets are pulverized quicker than bone marrow can supplant them. Certain blood ailments can bring about expanded red platelet demolition. You can acquire a hemolytic sickliness, or you can create it sometime down the road.
Sickle cell iron deficiency. This acquired and once in a while genuine weakness is brought on by a flawed type of hemoglobin that strengths red platelets to accept an unusual bow (sickle) shape. These sporadic molded red platelets kick the bucket rashly, bringing about an incessant deficiency of red platelets. IRON DEFICIENCY ANEMIA
Iron-insufficiency sickliness, likewise spelled iron-inadequacy frailty, is characterized as a decline in the measure of red platelets (RBCs) or hemoglobin in the blood because of insufficient iron.When pallor goes ahead gradually the side effects are frequently obscure and may include: feeling tired, shortcoming, shortness of breath or a poor capacity to work out. Sickliness that goes ahead immediately frequently has more noteworthy manifestations which may include: disarray, feeling like

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one is going to go out, and expanded thirst. There should be noteworthy paleness before a man turns out to be detectably pale. There may be extra manifestations relying upon the basic reason.
It is brought on by lacking dietary admission and ingestion of iron, or iron misfortune from dying.
Draining can be from a scope of sources, for example, the intestinal, uterine or urinary tract. The most huge reason for iron-insufficiency weakness in creating world kids is parasitic worms.Worms cause intestinal dying, which is not generally detectable in dung, and is particularly harming to developing youngsters. Jungle fever, hookworms and vitamin An inadequacy add to sickliness amid pregnancy in most immature nations. In ladies more than 50 years of age, the most well-known reason for iron-lack sickliness is incessant gastrointestinal seeping from nonparasitic reasons, for example, gastric ulcers, duodenal ulcers or gastrointestinal malignancy.
Iron lack causes around half of all pallor cases around the world, and influences ladies more frequently than men. Iron-lack frailty influences almost 1 billion.
SYMPTOMS of IRON DEFICIENCY ANEMIA
Iron deficiency anemia is also mild that it goes unnoticed. As the body becomes more deficient of iron, anemia gets worst, and the signs and symptoms start to intensify.
Iron deficiency anemia symptoms may include:
•

Fatigue

•

Paleness in the skin

•

Extreme Weakness in the body

•

Shortness of breath

•

Severe chest pain

•

Consistent infections

•

Throbbing Headache

•

Dizziness

•

Freezing hands and feet

•

Soreness of your tongue

•

Very Brittle nails

•

Tachycardia

•

Unusual cravings for ice, dirt or starch

•

Poor appetite, especially in infants and children with iron deficiency anemia

•

restless legs syndrome

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CAUSES OF IRON DEFICIENCY ANEMIA
Iron deficiency anemia happens when your body doesn't have enough iron to create hemoglobin.
Hemoglobin is the piece of red platelets that gives blood its red shading and empowers the red platelets to convey oxygenated blood all through your body. In the event that you aren't sufficiently expending iron, or in case you're losing an excessive amount of iron, your body can't create enough hemoglobin, and iron insufficiency sickliness will in the end create.
Reasons for Iron deficiency anemia include:
Blood loss: Blood contains iron inside of red platelets. So on the off chance that you lose blood, you lose some iron. Ladies with substantial periods are at danger of iron lack paleness on the grounds that they lose blood amid monthly cycle. Moderate, endless blood misfortune inside of the body —, for example, from a peptic ulcer, a hiatal hernia, a colon polyp or colorectal disease — can bring about iron lack pallor. Gastrointestinal draining can come about because of standard utilization of some overthe-counter torment relievers, particularly headache medicine.
An absence of iron in your eating regimen: Your body consistently gets iron from the nourishments you eat. On the off chance that you expend too minimal iron, after some time your body can get to be press inadequate. Samples of iron-rich nourishments incorporate meat, eggs, verdant green vegetables and iron-strengthened sustenances. For legitimate development and improvement, newborn children and kids need iron from their eating regimen, as well.
A powerlessness to absorb iron: Iron from nourishment is ingested into your circulatory system in your small digestive tract. An intestinal issue, for example, celiac illness, which influences your digestive tract's capacity to retain supplements from processed sustenance, can prompt iron inadequacy weakness. On the off chance that a piece of your small digestive tract has been avoided or uprooted surgically, that may influence your capacity to ingest iron and different supplements.
Pregnancy: Without iron supplementation, iron insufficiency frailty happens in numerous pregnant ladies in light of the fact that their iron stores need to serve their own particular expanded blood volume and additionally be a wellspring of hemoglobin for the developing fetus.

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Parasitosis
The main source of iron inadequacy worldwide is infestation with parasitic worms (helminths, for example, tapeworms, flukes, and roundworms).[citation needed] The World Health Organization assesses that "around two billion individuals are contaminated with soil-transmitted helminths around the world. Parasitic worms cause both aggravation and unending blood loss.
DIAGNOSIS of IRON DEFICIENCY ANEMIA
Anemia may be analyzed from side effects and signs, however when it is gentle, it may not be analyzed from mellow nonspecific manifestations.
Anemia is regularly first appeared by routine blood tests, which for the most part incorporate a complete blood tally (CBC) which is performed by an instrument which gives a yield as a progression of list numbers. An adequately low hemoglobin (Hb) by definition makes the determination of iron deficiency, and a low hematocrit quality is additionally normal for paleness. Further studies will be attempted to focus the iron deficiency's reason. In the event that the paleness is because of iron insufficiency, one of the first irregular qualities to be noted on a CBC, as the body's iron stores start to be exhausted, will be a high red platelet appropriation width (RDW), mirroring an expanded variability in the measure of red platelets (RBCs). Over the span of gradually exhausted iron status, an expanding
RDW ordinarily shows up even before paleness shows up.
A low mean corpuscular volume (MCV) frequently shows up next over the span of body iron consumption. It compares to a high number of unusually little red platelets. A low MCV, a low mean corpuscular hemoglobin or mean corpuscular hemoglobin fixation, and the presence of the RBCs on visual examination of a fringe blood smear contracts the issue to a microcytic pallor (truly, a "little red platelet" weakness). The numerical qualities for these measures are all figured by current research facility hardware.
The blood smear of a patient with iron insufficiency indicates numerous hypochromic (pale and generally dry) and rather little RBCs, and may likewise demonstrate poikilocytosis (variety fit as a fiddle) and anisocytosis (variety in size). With more serious iron-insufficiency pallor, the fringe blood smear may indicate hypochromic pencil-molded cells, and at times little quantities of nucleated red blood cells.[15] Very generally, the platelet check is somewhat over the high furthest reaches of typical in iron lack paleness (this is gentle thrombocytosis). This impact was traditionally hypothesized to be because of high erythropoietin levels in the body as a consequence of iron deficiency, cross-responding
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to enact thrombopoietin receptors in the forerunner cells that make platelets; in any case, this procedure has not been substantiated. Such marginally expanded platelet numbers introduce no threat, yet stay profitable as a marker regardless of the possibility that their starting point is not yet known.
The conclusion of iron-inadequacy weakness will be proposed by proper history (e.g. iron deficiency in a bleeding lady or a competitor occupied with long-separation running), the vicinity of mysterious blood (i.e. shrouded blood) in the stool, and regularly by other history.[16] For instance, known celiac ailment can bring about malabsorption of iron. A travel history to territories in which hookworms and whipworms are endemic may be useful in controlling certain stool tests for parasites or their eggs.
Body-store iron insufficiency is analyzed by indicative tests, for example, a low serum ferritin, a low serum iron level, a hoisted serum transferrin and a high aggregate iron tying limit. A low serum ferritin is the most touchy lab test for iron lack pallor. Be that as it may, serum ferritin can be raised by an interminable aggravation as it is not generally a solid test of iron status in the event that it is inside of typical points of confinement (i.e. this test is important if strangely low, however less significant if typical). DIAGNOSTIC TESTS
In the event that your blood work shows iron deficiency anemia, your specialist may arrange extra tests to distinguish a basic reason, for example,
Endoscopy. Specialists regularly check for seeping from a hiatal hernia, a ulcer or the stomach with the guide of endoscopy. In this technique, a flimsy, lit tube furnished with a camcorder is gone down your throat to your stomach. This permits your specialist to see your throat — the tube that keeps running from your mouth to your stomach — and your stomach to search for wellsprings of dying.
Colonoscopy. To discount lower intestinal wellsprings of dying, your specialist may suggest a strategy called colonoscopy. A slight, adaptable tube outfitted with a camcorder is embedded into the rectum and guided to your colon. You're generally calmed amid this test. A colonoscopy permits your specialist to view inside some or the greater part of your colon and rectum to search for interior dying.
Ultrasound. Ladies might likewise have a pelvic ultrasound to search for the reason for overabundance menstrual dying, for example, uterine fibroids

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PREVENTION OF IRON DEFICIENCY
ANEMIA
Your specialist may prescribe over-the-counter iron tablets to recharge the iron stores in your body.
Your specialist will tell you the right measurements for you. Iron is additionally accessible in fluid structure for babies and youngsters. To enhance the chances that your body will ingest the iron in the tablets, you may be told to:
Take iron tablets on a vacant stomach. On the off chance that conceivable, take your iron tablets when your stomach is void. Be that as it may, in light of the fact that iron tablets can irritate your stomach, you may need to bring your iron tablets with suppers.
Try not to bring iron with stomach settling agents. Prescriptions that instantly ease indigestion side effects can meddle with the retention of iron. Take iron two hours before or four hours after you take acid neutralizers.
Bring iron tablets with vitamin C. Vitamin C enhances the assimilation of iron. Your specialist may prescribe bringing your iron tablets with a glass of squeezed orange or with a vitamin C supplement.
Iron supplements can bring about stoppage, so your specialist might likewise suggest a stool conditioner. Iron may turn your stools dark, which is a safe symptom.
Iron inadequacy can't be remedied overnight. You may need to take iron supplements for a while or more to recharge your iron stores. For the most part, you'll begin to feel better following a week or somewhere in the vicinity of treatment. Ask your specialist when you have to come back to have your blood rechecked to quantify your iron levels. To make certain that your iron stores are recharged, you'll likely need to take iron supplements for a year or more.

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Treating underlying cause for iron deficiency
On the off chance that iron supplements don't build your blood-iron levels, it's conceivable the frailty is because of a wellspring of draining or an iron-assimilation issue that your specialist should examine and treat. Contingent upon the reason, iron lack sickliness treatment may include:
Medicines, for example, oral contraceptives to help overwhelming menstrual stream
Anti-microbial and different medicines to treat peptic ulcers
Surgery to uproot a draining polyp, a tumor or a fibroid
In the event that iron lack pallor is extreme, you may need iron given intravenously or you may need blood transfusions to assist supplant with pressing and hemoglobin rapidly.
Foods rich in iron include:
•

Red meat

•

Pork

•

Poultry

•

Seafood

•

Beans

•

Dark green leafy vegetables, such as spinach

•

Dried fruit, such as raisins and apricots

•

Iron-fortified cereals, breads and pastas

•

Peas

Body can enhance absorption of iron by drinking citrus juice or eating other foods that are rich in vitamin C and also by eating food rich in iron. Vitamin C in citrus juices helps better absorption of dietary irons.
Vitamin C is also found in:
•

Broccoli

•

Grapefruit

•

Kiwi

•

Leafy greens

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•

Melons

•

Oranges

•

Peppers

•

Strawberries

•

Tangerines

•

Tomatoes

SIDE EFFECTS AND SAFETY WHEN USING IRON
Iron is LIKELY SAFE for the vast majority when it is taken by mouth in suitable sums. In any case, it can bring about reactions including stomach surprise and agony, clogging or loose bowels, sickness, and heaving. Bringing iron supplements with nourishment appears to lessen some of these symptoms.
Be that as it may, sustenance can likewise diminish how well the body consumed iron. Iron ought to be tackled a vacant stomach if conceivable. On the off chance that it causes an excess of reactions, it can be brought with nourishment. Attempt to abstain from bringing it with nourishments containing dairy items, espresso, tea, or oats.
There are numerous types of iron items, for example, ferrous sulfate, ferrous gluconate, ferrous fumarate, and others. A few items, for example, those containing polysaccharide-iron complex
(Niferex-150, and so forth), claim to bring about less symptoms than others. Be that as it may, there is no dependable confirmation to bolster this case.
Some enteric covered or controlled discharge iron items may decrease queasiness for a few individuals; be that as it may, these items additionally have less assimilation by the body.
Fluid iron supplements may darken teeth.
High measurements of iron are LIKELY UNSAFE, particularly for kids. Iron is the most widely recognized reason for harming passings in youngsters. Measurements as low as 60 mg/kg can be lethal.
Iron harming can bring about numerous significant issues including stomach and intestinal trouble, liver disappointment, hazardously low pulse, and demise. In the event that you think a grown-up or tyke has taken more than the suggested measure of iron, call your human services proficient or the closest toxic substance control focus quickly.

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There is some worry that high admission of iron may expand the possibility of creating coronary illness. A few studies demonstrate that individuals with high admission of iron, particularly from nourishment sources, for example, red meat, will probably have coronary illness. This may be particularly valid for individuals with sort 2 diabetes. Be that as it may, this is disputable. Different studies don't demonstrate that iron expands the shot of coronary illness. It is too early to tell without a doubt if iron expands the shot of coronary illness.
Precautions & Warnings:
Pregnancy and bosom nourishing: Iron is LIKELY SAFE for pregnant and bosom bolstering ladies who have enough iron put away in their bodies when utilized as a part of measurements beneath the bearable upper admission level (UL) of 45 mg for every day of natural iron. The UL is the most abnormal amount of admission at which no destructive reactions are normal. Be that as it may, iron is
LIKELY UNSAFE when taken by mouth in high measurements. In the event that you don't have iron inadequacy, don't take more than 45 mg for every day of basic iron every day. Higher measurements much of the time reason stomach and intestinal reactions, for example, sickness and heaving. Abnormal amounts of hemoglobin at the season of conveyance are connected with awful pregnancy results.
Hemoglobin is the atom in red platelets that contains iron.
Diabetes: There is worry that an eating routine that is high in iron may build the danger of coronary illness in ladies with sort 2 diabetes, despite the fact that this has not been demonstrated. On the off chance that you have diabetes, talk about your iron admission with your social insurance supplier.
Stomach or intestinal ulcers: Iron may bring about aggravation and exacerbate these conditions.
Utilization iron with consideration.
Intestinal aggravation, for example, ulcerative colitis or Crohn's illness: Iron may bring about bothering and exacerbate these conditions. Utilization iron with consideration.
Hemoglobin ailment, for example, thalassemia: Taking iron may bring about iron over-burden in individuals with these conditions. In the event that you have a hemoglobin infection, don't take iron unless coordinated to do as such by your human services supplier.

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Untimely newborn children: Giving iron to untimely babies with low blood levels of vitamin E can bring about major issues. The vitamin E inadequacy ought to be rectified before giving iron. Converse with your social insurance supplier before offering iron to an untimely newborn child.
.

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Drugs used by the doctors:
According to the survey, following are the most prescribed anti-anemic drugs by the general physicians: No of times the doctors prescribing the drug

2% 2% 2%

5%

8% 3%

3%

Tab. Vetcofol

5%

12%

Tab. Hepss Tab. Fersol Tab. Orofer Xt

5%

Tab. Raricap Tab. Livogen

3%

7%

Tab. Ferrous Sulphate Sryp. Dexa Orange

5%

Tab. Avarin Tab. Hemofer folic

7%

Tab. Fecontin z

18%

3% 5%

5%

Tab. Abitol Tab. PP 26 Tab. Ferium xt Tab. Forsolate Tab. Imax xt Tab. Ferrlecit Cap. Heam

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DRUGS

No of times the doctors prescribing the drug

Tab. Vetcofol

5

Tab. Hepss

2

Tab. Fersol

7

Tab. Orofer Xt

4

Tab. Raricap

11

Tab. Livogen

3

Tab. Ferrous Sulphate

3

Sryp. Dexa Orange

2

Tab. Avarin

4

Tab. Hemofer folic

3

Tab. Fecontin z

2

Tab. Abitol

3

Tab. PP 26

3

Tab. Ferium xt

2

Tab. Forsolate

1

Tab. Imax xt

1

Tab. Ferrlecit

1

Cap. Heam

3

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LITERATURE REVIEW
1) Management of Iron Deficiency Anemia-Recent Challenges, Volume : 4 | Issue : 2 | Feb 2015,
Dr.R.Perhar, Dr.R.Shukla, Dr.N.Mishra
In this research the author explains how iron insufficiency is a typical reason for weakness around the world. Iron insufficiency is more than a hematological issue and influences different other body organs.
Absence of screening in vast populace, attendant folic corrosive and B, inadequacy, need to recognize from different reasons for microcytic sickliness are difficulties connected with finding of iron insufficiency weakness. Albeit oral iron is commonest treatment methodology utilized, it is connected with a few inconveniences, for example, requirement for long haul treatment, gastrointestinal antagonistic impacts, and poor patient consistence. Parenteral iron can conquer the deficiencies of oral iron also, can recharge iron stores speedier and to finish degree as against oral iron. More established parenteral irons, for example, iron dextran are connected with the danger of hypersensitivity. Picking the right iron readiness, time limitation in weakness remedy particularly amid pregnancy.lack of open mindfulness, remedy of connected with hookworm infestations are a few other challenges in aversion and administration of iron insufficiency paleness.

2) Iron deficiency anaemia, Rebecca J. Stoltzfus, Luke Mullany and Robert E. Black
We led exhaustive audits of distributed writing connecting iron lack to incapacity and passing for four potential results: kid mortality, perinatal mortality, maternal mortality and gentle mental impediment.
For these results, the best accessible information were planned observational studies in which paleness or hemoglobin fixation was the danger variable. Information on youngster mortality were not satisfactory for this undertaking, despite the fact that a genuine danger can't be blocked by the information. Rundown relative dangers for perinatal mortality (10 considers), maternal mortality (six studies) and mental impediment (five studies) were evaluated utilizing arbitrary impacts models (both mortality results) or a altered impacts model (impediment) and weighting individual assessments by the backwards of their inside of study change. For mortality results, the bivariate relations in the middle of hemoglobin and demise were utilized. In two investigations of perinatal mortality, unadjusted and multivariate balanced chances proportions were contrasted with survey the potential level of inclination in the unadjusted affiliations. For mental impediment, distributed multivariate balanced relations in the middle of hemoglobin and IQ were utilized. Worldwide pallor commonness information were supplied by the World Health Organization (WHO), and changed over to mean hemoglobin focuses, accepting ordinary dissemination and watched standard deviations from a huge number of studies.
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3) Iron Deficiency Anaemia Assessment, Prevention, and Control,A guide for programme managers
WHO/NHD/01.3,Distribution: General in this article the author bargains fundamentally with pointers for checking intercessions to battle iron insufficiency, including iron insufficiency pallor, however it additionally audits the present systems for surveying and averting iron lack in the light of late huge exploratory advances. Criteria for characterizing IDA, and the open seriousness of weakness in light of pervasiveness evaluations, are given. Ways to deal with getting dietary data, and direction in planning national iron insufficiency aversion projects, are exhibited. Procedures for averting iron lack through nourishment based methodologies, i.e. dietary change or alteration what's more, stronghold, and a timetable for utilizing iron supplements to control iron insufficiency and to treat gentle to-direct iron insufficiency paleness, are talked about. For every procedure, alluring activities are illustrated and criteria are recommended for appraisal of the mediation. Consideration is given to micronutrient complementarities in system usage, e.g., the especially close connection between the change of iron status and that of vitamin A.
At long last, this record suggests activity situated exploration on the control of iron inadequacy, giving direction in undertaking achievability concentrates on on iron fortress in many nations.
4) Iron Metabolism Diagnosis and Therapy of Anemias, Third edition,M. Wick,W. Pinggera, P.
Lehmann
in this research article the author gives a detailed understanding of the physiology of iron absorption, distribution, metabolism, diagnosis and disgnostic strategies, therapeutic approach of anemia. We have tried to portray obviously the significance of the foremost analytes of iron digestion system to right on time acknowledgment, analysis, what's more, the checking of treatment, and also to give valuable bedside support for the specialist. Diagnostics, and specifically the systems for clinical science, have propelled such a great amount as of late that it appears to be beneficial likewise amplifying the scope of routine diagnostics. The writers have chosen to overhaul the book. In view of papers for the
"Agreement Conferences Frankfurt in J annuary 1996 [171] and Oxford in March 1996" [188] another part "restorative methodologies in anemias" was built up. The creators are appreciative to Cheryl Byers and Doris Raab of Boehringer Mannheim and to Michael Katzenberger of SpringerVerlag for their conferred collaboration and their master backing in the production of this book.

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5) Iron Deficiency Anemia: Evaluation and Management
MATTHEW W. SHORT, LTC, MC, USA, and JASON E. DOMAGALSKI, MAJ, MC, USAMadigan
Healthcare System, Tacoma, Washington
Iron lack is the most well-known nutritious issue overall and records for around one-portion of frailty cases. The analysis of iron lack paleness is affirmed by the discoveries of low iron stores and a hemoglobin level two standard deviations beneath ordinary. Ladies ought to be screened amid pregnancy, and youngsters screened at one year of age. Supplemental iron may be given at first, trailed by further workup if the patient is not receptive to treatment. Men and postmenopausal ladies ought not be screened, but rather ought to be assessed with gastrointestinal endoscopy if determined to have iron insufficiency weakness. The basic reason ought to be dealt with, and oral iron treatment can be started to renew iron stores. Parenteral treatment may be utilized as a part of patients who can't endure or retain oral arrangements. (Am Fam Physician. 2013;87(2):98-104. Copyright © 2013 American
Academy of Family Physicians.

6) Control of iron deficiency anemia in low- and middle-income countries,Sant-Rayn Pasricha1,Hal
Drakesmith3,James Black1, David Hipgrave2, and Beverley-Ann Biggs
Regardless of overall monetary and exploratory improvement, more than a world's quarter populace stays weak, and about portion of this weight is a consequence of iron inadequacy weakness (IDA). IDA is most pervasive among preschool youngsters and ladies. Among ladies, iron supplementation enhances physical and intellectual execution, work profitability, and prosperity, and iron amid pregnancy enhances maternal, neonatal, newborn child, and even long haul kid results. Among kids, iron may enhance psychological, psychomotor, and physical improvement, however the confirmation for this is more restricted. Techniques to control IDA incorporate every day and discontinuous iron supplementation, home stronghold with micronutrient powders, fortress of staple nourishments and fixings, and exercises to enhance sustenance security and dietary differing qualities. The security of routine iron supplementation in settings where irresistible ailments, especially intestinal sickness, are endemic stays questionable. The World Health Organization is overhauling worldwide rules for controlling IDA. Execution of iron deficiency control programs in creating nations requires watchful benchmark epidemiologic assessment, determination of proper intercessions that suit the populace, and progressing checking to guarantee wellbeing and viability. This audit gives a review and a methodology for the execution of general wellbeing intercessions for controlling IDA in low-and center salary nations, with an accentuation on current confirmation based proposals.

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7) Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia Rebecca J.
Stoltzfus Michele L. Dreyfuss International Nutritional Anemia Consultative Group (INACG)
Iron inadequacy paleness is the most widely recognized micronutrient insufficiency on the planet today. It affects the lives of a great many ladies and youngsters adding to poor subjective improvement, expanded maternal mortality and diminished work limit. Yet with fitting general wellbeing activity, this type of micronutrient lack of healthy sustenance can be brought under control. These rules are offered as a vital part of iron lack pallor control programs. The International Nutritional Anemia
Consultative Group (INACG) has a long standing duty to give deductively stable suggestions to open wellbeing organizers and supervisors about approaches to control iron lack pallor. This distribution is another in a progression of productions went for giving such direction. While the primary center of these rules is on iron supplementation programs also, parasite control, these rules recognize the advantageous part nourishment stronghold also, dietary enhancement can have in controlling iron lack pallor. Additional data on these methodologies can be found in other INACG records and those of different associations. It is trusted that these rules, which mirror our present condition of information, will be helpful to those accused of arranging and executing iron supplementation programs. Kindly don't hesitate to send your remarks with respect to these rules, so that they may be enhanced at a future date. SHOBHABEN PRATAPBHAI PATEL SCHOOL OF PHARMACY AND TECHNOLOGY MANAGEMENT, SVKM’s NMIMS

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Chapter III:

METHODOLOGY

ü Procedure:
A Questionnaire about various factors affecting the research topic was prepared and a Survey.
Survey was carried out for a period of 10 -15 days, where I personally met the Participants in their clinics, designated hospitals and centres.
A total of 25 participants were asked to fill out the questionnaire from areas such as Vile
Parle(w), Vile Parle(e), Andheri(w), Andheri(e). Visiting cards and business cards were collected from most of the participants.

ü Participants:
The participants for the Survey were qualified General physicians, from various Age groups and different Genders.

ü Instrumentation:
Survey was conducted with the help of a questionnaires printed on white A4 sheets.

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Chapter IV: ANALYSIS OF THE SURVEY
DATA
Various tests that have been performed on the data collected by the survey: ü T-Test for Significance of various parameters was done ü Ranking test to rank the dosage forms preferred by the doctors. ü Pie charts to summarize frequencies of various parameters

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A. T- Test Research Objectives:
To identify significant and non-significant parameters from the parameters under consideration.

Study parameters and the scale used:
I.

Gender of the patient is considered as a factor when selecting the treatment method II.

Age of the patient is considered when selecting the treatment method

III.

Treatment method/ drug selection depends on the severity of the anemic disease

IV.

Preference of dosage form of the patient is considered when selecting a treatment

V.
VI.
VII.
VIII.
IX.

Monthly periods is a cause of patients suffering with Iron deficiency anemia
Pregnancy is a cause of patients suffering with Iron deficiency anemia
NSAIDS is a cause of patients suffering with Iron deficiency anemia
Stomach Ulcer is a cause of patients suffering with Iron deficiency anemia
GI cancer is a cause of patients suffering with Iron deficiency anemia

X.

Angiodysplasia is a cause of patients suffering with Iron deficiency anemia

XI.

Kidney disease is a cause of patients suffering with Iron deficiency anemia

XII.

Malnutrition is a cause of patients suffering with Iron deficiency anemia

XIII.

Lack of iron is a cause of patients suffering with Iron deficiency anemia

XIV.

Financial condition of the patient is considered when decieding the treatment method for anemia

XV.

Efficacy of the drug is a factor considered when prescribing drugs for treatment of Iron Deficiency anemia

XVI.

Side effects of the drug is a factor considered when prescribing drugs for treatment of Iron Deficiency anemia

XVII.

Cost of the drug is a factor considered when prescribing drugs for treatment of
Iron Deficiency anemia

XVIII.

Brand name of the drug is a factor considered when prescribing drugs for treatment of Iron Deficiency anemia

XIX.

Company manufacturing the drug is a factor considered when prescribing drugs for treatment of Iron Deficiency anemia

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Scale used:
a. Strongly Disagree- 1
b. Disagree- 2
c. Neutral- 3
d. Agree- 4
e. Strongly Agree- 4
Research Hypotheses:
Following are the six hypotheses which we would be testing using 5% significance level,
1) Parameter – Gender of the patient is considered as a factor when selecting the treatment method
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
2) Parameter – Age of the patient is considered when selecting the treatment method
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
3) Parameter – Treatment method/ drug selection depends on the severity of the anemic disease
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
4) Parameter – Preference of dosage form of the patient is considered when selecting a treatment
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
5) Parameter – Monthly periods is a cause of patients suffering with Iron deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
6) Parameter – Pregnancy is a cause of patients suffering with Iron deficiency anemia.
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
7) Parameter – NSAIDS is a cause of patients suffering with Iron deficiency anemia.
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
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H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
8) Parameter – Stomach Ulcer is a cause of patients suffering with Iron deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
9) Parameter – GI cancer is a cause of patients suffering with Iron deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter
10) Parameter – Angiodysplasia is a cause of patients suffering with Iron deficiency anemia.
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
11) Parameter – Kidney disease is a cause of patients suffering with Iron deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
12) Parameter – Malnutrition is a cause of patients suffering with Iron deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
13) Parameter – Lack of iron is a cause of patients suffering with Iron deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
14) Parameter – Financial condition of the patient is considered when decieding the treatment method for anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
15) Parameter – Efficacy of the drug is a factor considered when prescribing drugs for treatment of Iron
Deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
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16) Parameter – Side effects of the drug is a factor considered when prescribing drugs for treatment of
Iron Deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
17) Parameter – Cost of the drug is a factor considered when prescribing drugs for treatment of Iron
Deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.

18) Parameter – Brand name of the drug is a factor considered when prescribing drugs for treatment of
Iron Deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.
19) Parameter – Company manufacturing the drug is a factor considered when prescribing drugs for treatment of Iron Deficiency anemia
Ho: µ = 3 i.e. there exists a neutral perception w.r.t. the parameter.
H1: µ ≠ 3 i.e. there exists a non-neutral perception w.r.t. the parameter.

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One-Sample Statistics
N
consideration of

Mean

Std. Deviation

Std. Error Mean

30

3.3667

1.21721

.22223

30

3.1333

.86037

.15708

30

3.8000

.61026

.11142

30

3.7667

.72793

.13290

30

4.4667

.81931

.14958

preganancy as cause

30

4.6000

.49827

.09097

NSAIDS as cause

30

4.1667

.37905

.06920

30

4.0667

.52083

.09509

30

4.1000

.40258

.07350

30

3.9333

.63968

.11679

30

4.2333

.67891

.12395

malnutrition as cause

30

4.8000

.40684

.07428

lack of iron as cause

30

4.9333

.25371

.04632

30

3.5667

.77385

.14129

30

4.7333

.44978

.08212

30

4.7333

.44978

.08212

cost of drug

30

3.4667

1.07425

.19613

brand name

30

2.2000

1.06350

.19417

30

2.1000

1.06188

.19387

patients gender consideration of age of the patient consideration of severity of disease preference of dosage form monthly periods as cause stomach ulcer as cause GI cancer as cause
Angiodysplasia as cause kidney disease as cause consideration of financial condition efficacy of drug side effects of the drug company manufacturing SHOBHABEN PRATAPBHAI PATEL SCHOOL OF PHARMACY AND TECHNOLOGY MANAGEMENT, SVKM’s NMIMS

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One-Sample Test
Test Value = 3
95% Confidence Interval of
Sig. (2t consideration of patients gender consideration of age of the patient consideration of severity of disease preference of dosage form monthly periods as cause preganancy as cause NSAIDS as cause stomach ulcer as cause GI cancer as cause
Angiodysplasia as cause kidney disease as cause malnutrition as cause lack of iron as cause tailed)

df

Mean
Difference

the Difference
Lower

Upper

1.650

29

.110

.36667

-.0878

.8212

.849

29

.403

.13333

-.1879

.4546

7.180

29

.000

.80000

.5721

1.0279

5.769

29

.000

.76667

.4949

1.0385

9.805

29

.000

1.46667

1.1607

1.7726

17.588

29

.000

1.60000

1.4139

1.7861

16.858

29

.000

1.16667

1.0251

1.3082

11.217

29

.000

1.06667

.8722

1.2611

14.966

29

.000

1.10000

.9497

1.2503

7.992

29

.000

.93333

.6945

1.1722

9.950

29

.000

1.23333

.9798

1.4868

24.233

29

.000

1.80000

1.6481

1.9519

41.738

29

.000

1.93333

1.8386

2.0281

4.011

29

.000

.56667

.2777

.8556

21.108

29

.000

1.73333

1.5654

1.9013

consideration of financial condition efficacy of drug

SHOBHABEN PRATAPBHAI PATEL SCHOOL OF PHARMACY AND TECHNOLOGY MANAGEMENT, SVKM’s NMIMS

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side effects of the

21.108

29

.000

1.73333

1.5654

1.9013

cost of drug

2.379

29

.024

.46667

.0655

.8678

brand name

-4.120

29

.000

-.80000

-1.1971

-.4029

-4.642

29

.000

-.90000

-1.2965

-.5035

drug

company manufacturing Hypothesis testing Results with Inferences :
Parameters

Hypothesis

‘p’ value

Decision & Inference at
95% confidence level

Gender of the patient is

Ho: µ = 3

considered as a factor when

0.110

H1: µ ≠ 3

Reject Ho, Non-neutral

greater

selecting the treatment method

P is

perception

than α i.e.
0.05

Age of the patient is

Ho: µ = 3

considered when selecting the

0.403

H1: µ ≠ 3

Reject Ho, Non-neutral

greater

treatment method

P is

perception

than α i.e.
0.05

Treatment method/ drug

Ho: µ = 3

selection depends on the

0.000

H1: µ ≠ 3

perception

0.05

Preference of dosage form of

H1: µ ≠ 3

the patient is considered when

H1: µ ≠ 3

0.000

P is less

Accept Ho, Neutral

than α i.e.

selecting a treatment

perception

0.05

Monthly periods is a cause of

Ho: µ = 3

patients suffering with Iron

H1: µ ≠ 3

0.000

P is less

Accept Ho, Neutral

than α i.e.

deficiency anemia

perception

0.05

Pregnancy is a cause of

H1: µ ≠ 3

patients suffering with Iron

H1: µ ≠ 3

deficiency anemia

Accept Ho, Neutral

than α i.e.

severity of the anemic disease

P is less

0.000

P is less

Accept Ho, Neutral

than α i.e.

perception

0.05

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NSAIDS is a cause of patients

H1: µ ≠ 3

suffering with Iron deficiency

0.000

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

anemia.

P is less

perception

0.05

Stomach Ulcer is a cause of

H1: µ ≠ 3

patients suffering with Iron

0.000

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

deficiency anemia

P is less

perception

0.05

GI cancer is a cause of

H1: µ ≠ 3

patients suffering with Iron

0.000

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

deficiency anemia

P is less

perception

0.05

Angiodysplasia is a cause of

Ho: µ = 3

patients suffering with Iron

0.000

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

deficiency anemia.

P is less

perception

0.05

Kidney disease is a cause of

Ho: µ = 3

patients suffering with Iron

0.000

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

deficiency anemia

P is less

perception

0.05

Malnutrition is a cause of

Ho: µ = 3

patients suffering with Iron

0.000

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

deficiency anemia

P is less

perception

0.05

Lack of iron is a cause of

H1: µ ≠ 3

patients suffering with Iron

0.000

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

deficiency anemia

P is less

perception

0.05

Financial condition of the

Ho: µ = 3

patient is considered when

0.000

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

deciding the treatment method

P is less

perception

0.05

for anemia
Efficacy of the drug is a factor

H1: µ ≠ 3

considered when prescribing

H1: µ ≠ 3

drugs for treatment of Iron

0.000

P is less

Accept Ho, Neutral

than α i.e.

perception

0.05

Deficiency anemia

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Side effects of the drug is a

H1: µ ≠ 3

factor considered when

0.000

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

prescribing drugs for treatment

P is less

perception

0.05

of Iron Deficiency anemia
Cost of the drug is a factor

H1: µ ≠ 3

considered when prescribing

0.024

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

drugs for treatment of Iron

P is less

perception

0.05

Deficiency anemia
Brand name of the drug is a

H1: µ ≠ 3

factor considered when

0.000

H1: µ ≠ 3

Accept Ho, Neutral

than α i.e.

prescribing drugs for treatment

P is less

perception

0.05

of Iron Deficiency anemia

Parameters

Hypothesis

‘p’ value

Decision & Inference at
95% confidence level

Company manufacturing the

Ho: µ = 3

drug is a factor considered

H1: µ ≠ 3

when prescribing drugs for

0.000

P is less

Accept Ho, Neutral

than α i.e.

perception

0.05

treatment of Iron Deficiency anemia SHOBHABEN PRATAPBHAI PATEL SCHOOL OF PHARMACY AND TECHNOLOGY MANAGEMENT, SVKM’s NMIMS

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One-Sample Statistics – Further analysis & findings
Parameters
Treatment method/ drug

Mean

Remarks
3.8000

The method/ drug selecting

selection depends on the

depend on the severity of the

severity of the anemic disease

disease to a large extent.

Monthly periods is a cause of

4.4667

Monthly cause is agreed upon

patients suffering with Iron

as a cause of Iron deficiency

deficiency anemia

anemia

Pregnancy is a cause of patients

4.6000

Pregnancy is almost strongly

suffering with Iron deficiency

agreed upon as a cause for Iron

anemia

deficiency anemia

NSAIDS is a cause of patients

4.1667

NSAIDS is more agreed upon

suffering with Iron deficiency

as cause for iron deficiency

anemia

anemia

Stomach Ulcer is a cause of

4.0667

Stomach ulcer is agreed upon as

patients suffering with Iron

a cause for iron deficiency

deficiency anemia

anemia

GI cancer is a cause of patients

4.1000

GI cancer is agreed upon as a

suffering with Iron deficiency

cause for iron deficiency

anemia

anemia

Angiodysplasia is a cause of

3.9333

Angiodysplasia is almost agreed

patients suffering with Iron

upon as a cause for Iron

deficiency anemia

deficiency anemia

Kidney disease is a cause of

4.2333

Kidney disease is almost agreed

patients suffering with Iron

upon as a cause for Iron

deficiency anemia

deficiency anemia

Malnutrition is a cause of patients suffering with Iron

4.8000

Malnutrition is strongly agreed to cause iron deficiency anemia

deficiency anemia

SHOBHABEN PRATAPBHAI PATEL SCHOOL OF PHARMACY AND TECHNOLOGY MANAGEMENT, SVKM’s NMIMS

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Lack of iron is a cause of

4.9333

patients suffering with Iron

Malnutrition is strongly agreed to cause iron deficiency anemia

deficiency anemia
Financial condition of the

3.5667

Financial condition of the

patient is considered when

patient is a more agreed as

deciding the treatment method

factor when prescribing drugs

for anemia

for iron deficiency anemia

Efficacy of the drug is a factor

4.7333

Efficacy of the drug is almost

considered when prescribing

strongly considered when

drugs for treatment of Iron

prescribing drugs for iron

Deficiency anemia

deficiency anemia

Side effects of the drug is a

4.7333

Side effects of the drug is

factor considered when

almost strongly considered

prescribing drugs for treatment

when prescribing drugs for iron

of Iron Deficiency anemia

deficiency anemia

Cost of the drug is a factor

3.4667

Cost of drug is a almost

considered when prescribing

neutrally and nearly agreed as a

drugs for treatment of Iron

factor when prescribing drugs

Deficiency anemia

for iron deficiency anemia

Brand name of the drug is a

2.2000

Brand name of the drug is

factor considered when

almost disagreed as a factor

prescribing drugs for treatment

when prescribing drugs for iron

of Iron Deficiency anemia

deficiency anemia

Company manufacturing of the

2.1000

Manufacturing company of the

drug is a factor considered when

drug is almost disagreed as a

prescribing drugs for treatment

factor when prescribing drugs

of Iron Deficiency anemia

for iron deficiency anemia

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B) Ranking Test
1

2

3

4

5

Tablets

0

0

1

0

29

148

1

Capsules

0

0

1

4

24

139

2

Solution

0

3

7

16

4

111

3

Powders

2

7

11

9

1

90

4

16

9

2

0.0

3

55

5

Injectable

Sum product Rank

Recommendations
It is recommended that the companies should focus more on manufacturing tables, capsules and solutions as a dosage form as the doctors’ rank them as the most prescribed dosage form across all the age groups of patients.
Injectable and powders are ranked least as compared to tablets, capsules and solutions. Thus injectable, should not be the preferred dosage form that the companies should manufacture.
C) Pie charts

60 % of the doctors strongly agree that monthly period is a cause for Iron deficiency anemia
33.33 % of the doctors disagree that monthly period is a cause for Iron deficiency anemia

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60 % of the doctors agree that monthly period is a cause for Iron deficiency anemia

60 % of the doctors strongly agree that pregnancy is a cause for Iron deficiency anemia
40 % of the doctors agree that pregnancy is a cause for Iron deficiency anemia

60 % of the doctors agree that kidney disease is a cause for Iron deficiency anemia
33.33 % of the doctors strongly agree that kidney disease is a cause for Iron deficiency anemia
3.33 % of the doctors are neutral that kidney disease is a cause for Iron deficiency anemia
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3.33 % of the doctors disagree that kidney disease is a cause for Iron deficiency anemia

80 % of the doctors are neutral that Malnutrition is a cause for Iron deficiency anemia
20 % of the doctors are neutral that Malnutrition is a cause for Iron deficiency anemia

93.3 % of the doctors are neutral that Lack of iron in diet is a cause for Iron deficiency anemia
6.67 % of the doctors are neutral that Lack of iron in diet is a cause for Iron deficiency anemia
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Chapter V: CONCLUSIONS AND
RECOMMENDATIONS
•

Conclusions

•

Recommendations

•

Limitations

•

Bibliography

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Conclusions
Regardless of overall financial and investigative advancement, more than a world's quarter populace stays sickly, and about portion of this weight is a consequence of iron inadequacy weakness (IDA).
IDA is most predominant among preschool youngsters and ladies. Among ladies, iron supplementation enhances physical and intellectual execution, work efficiency, and prosperity, and iron amid pregnancy enhances maternal, neonatal, baby, and even long haul youngster results Methodologies to control IDA incorporate day by day and discontinuous iron supplementation, home fortress with micronutrient powders, stronghold of staple sustenance and toppings, and exercises to enhance nourishment security and dietary assorted qualities.

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LIMITATIONS
Every research has its own limitations. It is not possible that the research is accomplished without having bounding and limitations. There are always some short comings, which hinder the accomplishment of a particular research study. This result of this study has been interpreted taking into account a few limitations, which are as follows

•

Time is the main constraint, which is not sufficient in case of the research

•

The respondent do not always respond accurately due to their schedule.

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Recommendation
From the research conducted, I would like to recommend that the companies should focus ofn manufacturiign drugs with more efficacy and less side effects as the doctirs see it as a very important factor when prescribing the drugs. Also the cost shouldn’t be kept very inadequate, as the financial condition of the patients are also condiered by the doctors.
The dosage from should be kept as oral, more speficiing to tablets and capsules, as they are the most prefered dosage from by the patients and thus the doctors.
The companies can also manufature drugs according to the causes of Iron Deficiency Anemia, and give the mechanism of action of the drug accordingly.

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BIBLIOGRAPHY
1) Management of Iron Deficiency Anemia-Recent Challenges, Volume : 4 | Issue : 2 | Feb 2015,
Dr.R.Perhar, Dr.R.Shukla, Dr.N.Mishra
2) Iron deficiency anaemia, Rebecca J. Stoltzfus, Luke Mullany and Robert E. Black
We led exhaustive audits of distributed writing connecting iron lack to incapacity and passing for four potential results: kid mortality, perinatal mortality, maternal mortality and gentle mental impediment.
3) Iron Deficiency Anaemia Assessment, Prevention, and Control,A guide for programme managers
WHO/NHD/01.3,Distribution: General
4) ) Iron Metabolism Diagnosis and Therapy of Anemias, Third edition,M. Wick,W. Pinggera, P.
Lehmann
5) Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia Rebecca J.
Stoltzfus Michele L. Dreyfuss International Nutritional Anemia Consultative Group (INACG)
6) Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia Rebecca J.
Stoltzfus Michele L. Dreyfuss International Nutritional Anemia Consultative Group (INACG)
7) Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia Rebecca J.
Stoltzfus Michele L. Dreyfuss International Nutritional Anemia Consultative Group (INACG)
8) www.healthline.com/health/iron-deficiency-anemia
9) www.nlm.nih.gov/medlineplus/ency/article/000584.htm
10) http://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/basics/definition/con20019327
11) http://www.hematology.org/Patients/Anemia/Iron-Deficiency.aspx
12) http://www.nhs.uk/conditions/Anaemia-iron-deficiency-/Pages/Introduction.aspx
13) http://www.webmd.com/a-to-z-guides/iron-deficiency-anemia-topic-overview
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14) http://www.epi.umn.edu/let/pubs/img/adol_ch9.pdf
15) Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia Rebecca
J. Stoltzfus Michele L. Dreyfuss
16) https://www.nhlbi.nih.gov/files/docs/public/blood/anemia-yg.pdf

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QUESTIONNARE
Prescription behavior of the doctor when selecting treatment method for
IRON DEFICIENCY ANEMIA (IDA)

PATIENT
1. GENDER of the patient is considered as a factor when selecting the treatment method.

Stongly disgree

Disagree

Neutral

Agree

Strongly Agree

2. Which Gender is prescribed more often?
Male

Female

3. AGE of a patient is considered when selecting the treatment method.

Stongly disgree

Disagree

Neutral

Agree

Strongly Agree

4. Which Age groups are diagnosed most often? o 0-7 years

o

8-15 years

o

16-30 years

o

30-45 years

o

45-60 years

5. Treatment method / Drug selection depends on the SEVERITY of anemic disease.

Stongly disgree

Disagree

Neutral

Agree

Strongly Agree

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6. Preference of DOSAGE FORM of the patients is considered WHEN SELECTING a treatment method. Stongly disgree

Disagree

Neutral

Agree

Strongly Agree

7. Causes of patients suffering with IDA.
Causes

Strongly disagree Disagree

Neutral

Agree

Strongly agree Monthly periods
Pregnancy
Gastrointestinal blood loss:Ø NSAIDS
Ø STOMACH ULCER
Ø GASTROINTESTINAL
CANCER
Ø ANGIODYSPLASIA
Kidney diseases
Malnutrition
Lack of iron in diet

8. What is the most preferred dosage form?
Rank them according to, 1 - least preferred, 5- most preferred
1

2

3

4

5

Tablet
Capsule
Solution
Powders
Injectable

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9. Financial condition of the patient is considered when deciding a treatment method for anemia.

Stongly disgree

Disagree

Neutral

Agree

Strongly Agree

DRUG
10. How are the following factors related to the drug considered, when prescribing drugs for treatment for IDA?
Strongly
disagree

Disagree

Neutral

Agree

Strongly
Agree

Efficacy of the drug Side effects of the drug
Cost of the drug
Brand name
Company
manufacturing

11. What are the top 5 brands prescribed for the treatment of anemia? ü --------------------------ü --------------------------ü --------------------------ü --------------------------ü ---------------------------

Name-

Gender- M / F

Age-

Specialization-

Date-

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