#DoseOptimizationAndIndianDoctors
1. In India, dose optimization is still not institutionally accepted as a formal, accountable clinical responsibility, even though it is scientifically essential and routinely practiced in advanced healthcare systems.
2. Prescribing often remains experience-based and generalized, rather than individualized.
3. The same standard dose is given irrespective of patient-specific variables such as age, renal function, liver status, body weight, pharmacogenetic variability, or interacting medicines.
4. This approach ignores the fundamental principle that the right drug is only safe and effective when given in the right dose for the right patient.
5. The deeper issue is structural, not intellectual.
6. India’s healthcare system recognizes diagnosis and prescribing authority, but does not formally recognize dose optimization as a defined professional service with legal backing, documentation standards, or accountability frameworks.
7. Clinical pharmacists, who are trained to optimize dosing through pharmacokinetic and pharmacodynamic assessment, therapeutic drug monitoring, and evidence-based adjustment, are neither empowered nor integrated into routine care.
8. As a result, dose optimization remains incidental rather than systematic.
9. This gap has consequences. It contributes to adverse drug reactions, therapeutic failure, antimicrobial resistance, prolonged hospital stays, and increased healthcare costs.
10. Yet these outcomes are rarely traced back to dose appropriateness because dose optimization itself is not formally audited or regulated.
11. Until India formally recognizes dose optimization as a clinical responsibility—supported by law, institutional protocols, and designated professionals such as PharmDs—medication use will remain prescription-centric rather than patient-centric.
12. True rational drug therapy begins not with selecting the drug alone, but with scientifically optimizing its dose for the individual patient.
#MoHFW GoI
#AIPDA
#IMA
#APTI
#PharmD
POV: Bhagwan PS
