Therapeutic adherence: A prospective drug utilization study of oral hypoglycemic in patients with type 2 diabetes mellitus

Objective: The objective of this study is to evaluate prescribing pattern, analyze drug-related problems, identify co-morbidities and complications in Type 2 Diabetes Mellitus patients and also to perform cost analysis of Biguanides, Sulfonylureas, Dipeptidyl Peptidase Inhibitors Methods: A Prospective observational study was done in General Medicine and Endocrinology Departments of PSG Hospitals. A total of 200 study subjects, including both inpatients and outpatients, above 18 y of age, prescribed with OHAs (Biguanides, Sulfonylureas and DPP4 inhibitors) were included in the study. Results: Diabetes was more prevalent among males. OHAs were most prescribed in the age group of 51-60 y. Hypertension (71%) was the most common comorbidity and Diabetic neuropathy (23%) was the most common complication found in the patients. Multidrug therapy (72.5%) was most prescribed in diabetic patients, followed by Biguanides. Hypoglycemia was the most prevalent ADR. Cost analysis showed that T. Linagliptin was of high cost and T. Glimepiride being the low cost. Using WHO core indicators prescribing patterns were assessed. Feedback was collected and results were reported to the physicians which showed rational utilization of drugs. Conclusion: The study on drug utilization conducted in a tertiary care hospital helped us to find out that prescribing trends seems to be progressing towards combination therapy, predominantly two-drug therapy

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The observational, cross-sectional study of drug utilization 90% and use of dipeptidyl peptidase-4 inhibitor in the patients with type 2 diabetes mellitus

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20194771 ◽

2019 ◽

Vol 8 (11) ◽

pp. 2376

Author(s):

Prashant P. Shivgunde ◽

Shantanu R. Joshi ◽

Archana D. Kodilkar

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Drug Utilization ◽

Dipeptidyl Peptidase ◽

Cross Sectional ◽

Dipeptidyl Peptidase 4 ◽

Type 2 Dm ◽

Multiple Drugs

Background: Diabetes is a chronic metabolic disease which affects the quality of life. It leads to multiple complications due to metabolic involvement. Out of multiple drugs used to treat diabetes, dipeptidyl peptidase 4 (DPP-4) inhibitors are comparatively new drugs used for type-2-diabetes mellitus (DM) treatment. This study aimed to find out the drug utilization (DU) 90% and use of DPP-4 inhibitors in patients with type-2-DM.Methods: A prospective, cross-sectional, observational study was conducted at a private healthcare clinic of an endocrinologist in Nashik. Type-2-DM patients of both sexes were selected and a total of 199 patients were enrolled in the study. The consented patients were interviewed and prescription copies were collected. After studying them; statistical analysis was done and results and conclusions were drawn.Results: Out of total prescribed drugs, 58.77% of drugs were anti-diabetics. It was observed that the biguanides were most frequently (25.32%) prescribed while the least prescribed drugs were meglitinide analogues (0.08%). Most commonly utilized anti-diabetic found to be metformin. Vildagliptin 50 mg is the most commonly prescribed drug from DPP-4 inhibitors. Most of the drugs from the DPP-4 inhibitor group came under DU90%.Conclusions:DPP-4 inhibitors are showing wide acceptability by endocrinologists for type-2-DM management, according to this study. Performing repetitive drug utilization pattern study and circulation of standard treatment guidelines to practising physicians can be required. To emphasize the point on generic prescription, more awareness should be created. So that these can responses to further cost-effective and rational prescribing practices.

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Drug utilization study and adverse drug reactions of oral anti diabetics among type 2 diabetes mellitus patients in tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191103 ◽

2019 ◽

Vol 8 (4) ◽

pp. 700

Author(s):

Sahana M. Mogali ◽

Aruna Bhushan ◽

Jagadishchandra S. Ratnakar

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Drug Utilization ◽

Adverse Drug Reactions ◽

Antidiabetic Drugs ◽

Drug Reactions ◽

Oral Antidiabetic Drugs ◽

Oral Antidiabetic

Background: The aim was to evaluate the drug utilization pattern of oral antidiabetic drugs in type 2 diabetes mellitus outpatients and monitor adverse drug reactions (ADRs) associated with oral antidiabetic drugs.Methods: A retrospective observational study was carried out by collecting the data of type 2 diabetes mellitus patients visiting outpatient department of noncommunicable disease clinic of a tertiary care hospital for a period of one year. The data of demographic, drug utilization pattern and adverse drug reactions of patients on oral antidiabetic drugs was collected and entered in a proforma.Results: Total number of patients in this study were 39 out of which 21 (53.85%) patients were females and 18 (46.15%) patients were males. Majority of patients were in the age group 51-70 years (66.6%). Metformin was the most commonly prescribed drug 76.9% followed by Glibenclamide 17.9%. About 7.7% of patients who were taking oral antidiabetic drugs later switched over to insulin as their blood glucose levels were not controlled. Out of 18 (46.15%) patients, hypertension (38.5%) was the most common comorbid condition and a concomitant drug was prescribed was amlodipine 25.6%. Among all the adverse drug reactions observed, diarrhoea was the most common adverse drug reaction reported 76.9%.Conclusions: Metformin was the most commonly used oral antidiabetic drug. Diarrhoea was the common adverse drug reaction reported.

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Improving Therapeutic Adherence of Oral Antidiabetics in Insulin-Dependent Patients with Type 2 Diabetes Mellitus: the Combination of a Fixed-Dose

Austin Journal of Pharmacology and Therapeutics ◽

10.26420/austinjpharmacolther.2021.1141 ◽

2021 ◽

Vol 9 (4) ◽

Author(s):

Márquez-Rivero S ◽

◽

Márquez-Contreras E ◽

López-García-Ramos L ◽

Castaño-Durán C ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Fixed Dose ◽

Control Group ◽

Effective Strategy ◽

Therapeutic Adherence ◽

Insulin Dependent ◽

Prospective Longitudinal

Objective: To assess whether the combination of fixed-dose Oral Antidiabetic drugs (OA) in a single tablet compared to OA separated into 2 or more tablets is an effective strategy to improve adherence in insulin-dependent patients with Type 2 Diabetes Mellitus (DM2). Methods: This was a prospective, longitudinal, multi-center study, carried out in 3 primary care centers in Spain. One hundred and twenty patients treated with OA and insulin prescribed for insulin-dependent DM2 were included. A cluster randomization was performed based on two groups: (1) Control Group (CG): Sixty patients treated with two OA prescribed separately in different tablets, and (2) an Intervention Group (IG): Sixty patients treated with OA were with 2 drugs in combination at a fixed dose, in a single tablet. Three visits took place. AO Adherence was measured by using electronic monitors (MEMS). Average adherence percentage (%; Average AP) and daily compliance (%; Daily AP) was calculated. A patient was considered adherent when AP was 80–100%. Insulin adherence was measured by counting. Results: One hundred and ten patients completed the study (79 in the IG and 31 in the CG). Global adherence was 92,59% and 79,62% in IG and 82,85% and 48,21% in CG at 6 and 12 months, respectively (p<0.05 by groups). Daily adherence was 79,62% and 62,96% in IG and 17,85% and 10,71% in CG at 6 and 12 months, respectively (p<0.05). Global adherence with insulin by count was 77,78% and 70,37% in IG and 57,14% and 60,71% in CG at 6 and 12 months, respectively with significant differences. In the non-adherent group, the number of concomitant medications and glucemia and haemoglobin A glycosylate levels at 6 and 12 months, were significantly higher than in the adherent population. The NNT was 4,42 patients to prevent one non-adherence. Conclusions: The combination of fixed-dose OA in a single tablet compared to OA separated into 2 or more tablets is an effective strategy to improve AO therapeutic adherence in patients with insulin-dependent DM2.

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