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USC study: ORS under-prescribed in India, risking 500k children’s lives yearly

February 9, 2024

In developing nations, oral rehydration salts (ORS) are a known, cost-effective solution for diarrheal disease, a leading child mortality cause. However, a Science-published study reveals a substantial under-prescription of ORS due to a knowledge gap between healthcare providers’ assumptions and patients’ preferences. Dr. Neeraj Sood, Senior Author, emphasizes the challenge: “Even when children seek care for diarrhea, they often do not receive ORS, recommended by the World Health Organization for decades.”

The study, focusing on India, where childhood diarrhea is prevalent, debunks three hypotheses—taste perceptions, stockouts, and financial incentives—for the under-prescription. Dr. Sood and colleagues enrolled over 2,000 healthcare providers in Karnataka and Bihar, diverse states economically and demographically. Standardized patients, scripted to present a viral diarrhea case, made 2,000 unannounced visits to test preferences.

Provider perceptions, assuming patients dislike ORS, contribute to 42% of under-prescribing, overshadowing stockouts (6%) and financial incentives (5%). Patients expressing ORS preference significantly increased its prescription by 27 percentage points, surpassing stockout elimination (7%) or financial incentive removal (negligible impact). Dr. Manoj Mohanan, co-author, notes the study’s relevance in India’s persistent health challenge.

The study offers insights for global healthcare, emphasizing the urgency of interventions aligning healthcare practices with patient preferences. Dr. Zachary Wagner, the corresponding author, stresses the broader impact on antibiotic resistance, emphasizing the study’s role in addressing a major global health question. The study advocates for interventions encouraging ORS preferences and raising provider awareness to enhance life-saving treatments and combat antibiotic resistance.

Also read: The World: Malnutrition and obesity conundrum

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