Assessment of Rational Prescribing Awareness and Influencing Factors among Clinicians in North-West Maharashtra: A Cross-Sectional Study

Abstract

Background: Rational prescribing is essential for safe and cost-effective healthcare; however, pharmaceutical marketing and institutional factors may influence prescribing behavior. Data from tertiary care settings in North-West Maharashtra remain limited.

Methods: A cross-sectional, non-interventional survey was conducted among clinicians practicing in tertiary care outpatient departments in North-West Maharashtra. A pre-validated digital questionnaire assessed awareness of rational prescribing, influencing factors, exposure to pharmaceutical promotion, and institutional support mechanisms. The calculated minimum sample size was 103; 122 complete responses were analyzed. Associations were assessed using the Chi-square test, and multivariate logistic regression identified independent predictors of moderate-to-high perceived commercial influence. A p-value <0.05 was considered statistically significant.

Results: Most clinicians demonstrated moderate-to-high awareness of rational prescribing principles. Clinical efficacy, safety, and cost were the most commonly reported determinants of prescribing decisions, although a substantial proportion acknowledged pharmaceutical marketing influence. Fewer years of clinical experience and exposure to pharma-sponsored educational activities were independently associated with higher perceived commercial influence (p <0.05), while availability of prescription audits showed a protective effect.

Conclusion: Despite adequate awareness, commercial exposure and limited institutional oversight significantly influenced prescribing behavior. Strengthening audit systems and promoting independent continuing medical education may enhance rational prescribing practices.