COVID-19: Hydroxychloroquine prophylaxis is just a prophylaxis! Be careful and perceive it right.

Dear Editor,

Medical survey remains an important tool to assess thoughts, experience, or facts. The public perception survey determines the cognitive and interpretive processes of the participants for a defined concept or culture. Survey questionnaire tool for assessing perception provides entirely a different outcome perspective as compared to the survey for factual information.[1] The outcome of perception survey provides the researcher about the individual thought process for acquiring, interpreting, organizing, and its applicability for an ongoing process or advisory. This outcome helps to understand the impact of such perception on individual behavior and attitude for a particular practice.

We read with interest the survey study for the perception of Indian anesthesiologists for the hydroxychloroquine (HCQ) prophylaxis for coronavirus 2019 disease (COVID-19).[2] In the ongoing COVID-19 pandemic, search for a curative therapy for COVID-19 is being tirelessly researched. Various researches are being conducted to identify an appropriate drug for its action on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at its multiple sites of action in the human body.

In the present era of evidence-based medicine practice, the clinical judgment for use of a particular medical strategy is based on critical appraisal of the available literature including systematic reviews and meta-analysis of clinical trials.[3] Based on these, clinical recommendations are released for optimal patient care by team of experts with experience in the specific field. This understanding is well ingrained in most of the physicians. The question is when there is a lack of such scientific evidence then how does one react to or perceive recommendations for using a drug for prophylaxis? This article in question tries to answer this critical question posed to us by this unprecedented scenario. In a Spanish study, wherein the researchers evaluated the perception of physicians toward clinical guidelines, observed that the knowledge and usefulness of it (both pragmatic characteristics) were the main constructs for revealing their perception.[4] The published article very importantly, in its questionnaire, deals in both of these constructs.[2] The study also revealed that dissemination of the clinical guidelines and its clear format is the main determinant of acquiring knowledge and its usage.[4] The survey and advisories by government and professional bodies shall serve these purposes. These shall enhance utilization by creating confidence among physicians for its implications in daily practice.

Hence, perception-based survey for medical intervention but without a scientific standing should be taken with a pinch of salt.