scholarly journals Prescribing pattern of proton pump inhibitors among patients visiting the outpatient general medicine clinic in a tertiary care teaching hospital in Nepal

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Bijaya Basyal ◽  
Nirmal Raj Marasine ◽  
Sabina Sankhi ◽  
Rajendra Lamichhane ◽  
Bipashwi Nath Uprety

PurposeThe purpose of this study is to evaluate the prescribing pattern of proton pump inhibitors (PPIs) in patients visiting the outpatient general medical clinic in a Tertiary Care Teaching Hospital.Design/methodology/approachA hospital-based cross-sectional study was conducted in 419 patients aged ≥18 years, visiting the outpatient general medicine clinic of a tertiary hospital and prescribed with at least one PPI, from July to September 2016 using a purposive sampling technique. Descriptive statistics were performed using IBM-SPSS 20.0 (IBM Corporation, Armonk, NY, USA).FindingsPatients were mostly less than 30 years (30.78%) and female (58.95%). Pantoprazole was the most frequently prescribed PPIs (57.04%). The majority of PPIs were prescribed for acid peptic disorder (APD) (33.65%), followed by non-steroidal anti-inflammatory drugs (NSAIDs) prophylaxis (30.79%). Most of the PPIs were prescribed for twice-daily administration (68.26%). Nearly one-fourth (21.72%) of the patients presented with at least one additional medical condition, and almost all (99%) patients were receiving at least one additional drug along with PPIs.Originality/valueThe study suggests that PPIs are frequently prescribed and their use has been extended to other conditions that in fact do not require acid anti-secretory therapy. Result has highlighted the need for an interdisciplinary collaboration between pharmacists and medical professionals for the rational use of PPIs and promotion of PPIs prescription from the National List of Essential Medicines.

Author(s):  
Abhishek Ghosh ◽  
Shankar Dey

Background: Proton pump inhibitors are one of the most commonly used drugs worldwide. Often they are used for inappropriate indications too, imposing economic burden to patients and governments. Many studies have showed equipotent efficacy of oral and intravenous proton pump inhibitor therapy. Despite that, most of the hospitalized patients receive intravenous proton pump inhibitor without appropriate indications. This study aimed to assess use of proton pump inhibitors in government hospital.Methods: It was an observational cross-sectional study done in the general medicine department of a tertiary care teaching hospital in Eastern India, including 800 noncritical patients. Objective was to assess the use of proton pump inhibitors (indications, route of administration, dosing frequency).Results: 100% patient received intravenous proton pump inhibitor irrespective of diagnosis. 80% of them received it twice daily and 18% received it once daily. Majority of the patients received intravenous proton pump inhibitor despite taking other drugs by oral route.Conclusions: Most of the PPI administration was done without appropriate indication. All patients received Intravenous proton pump inhibitors, which may impose economic burden on a government hospital. Majority of the patients received proton pump inhibitors twice daily. These approaches are not cost effective and need to be rectified.


Author(s):  
Kousalya Prabahar ◽  
G Arun ◽  
Shanthi Vijayaraghavan ◽  
H Sharma ◽  
Keerthi Chaitanya ◽  
...  

Author(s):  
TALHA JABEEN ◽  
MOHD ABDUL KHADER ◽  
A. V. KISHORE BABU ◽  
A. SRINIVASA RAO

Objective: To identify frequency, type, severity and predictors of potential drug-drug interactions(pDDIs), potential drug-food interactions(pDFIs), potential drug-alcohol interactions(pDAIs) and potential drug-tobacco interactions(pDTIs) and most frequently interacting drug combination pairs in hospitalized patients from departments(depts) of General Medicine(GM), Orthopedic(Ortho), Gynecology(OBG), Pulmonology(Pulmo), General Surgery (GS), Psychiatry (Psych), Otolaryngology(ENT) and Dermatology (Derm) of study population. Methods: A Prospective Observational Study was conducted in eight major dept's of a tertiary care teaching hospital for a period of 6 mo. A sample size of 650 prescriptions reflecting admission no's for each department were used. Results: A total of 650 patients were included in the study. Among them, 282(43.4%) were males and 368(56.6%) were females. The mean age of the study population was 39.67±15.23. A total of 487 pDDIs, 734 pDFIs, 586 pDAIs and 159 pDTIs were found out of 650 hospitalized episodes. OBG showed the highest pDDIs and pDAIs. Highest pDFIs and pDTIs were seen in Pulmo. The majority of DDIs were minor, DFIs and DAIs were moderate and DTIs were of major in severity. Pharmacokinetic types of interactions were seen in the majority of the depts. Logistic regression analysis showed that Polypharmacy was associated with the occurrence of DIs. Most of the DIs repeated several times in particular depts and a list of these combinations was prepared. Conclusion: With the high occurrence of overall DIs and characteristic patterns of DIs combination pairs among different departments of the hospital, the presence of clinical pharmacists in hospitals can play a great role, especially in developing nations like India where their role in hospitalized settings is always controversial.


Author(s):  
Rajesh Venkataraman ◽  
Madan Rayamajhi ◽  
Shahinur Islam ◽  
Nanjunda N

 Objectives: The objectives of the study were to study the prescribing pattern on psychotropic agents at psychiatric department at rural tertiary care teaching hospital, B.G. Nagara.Methods: A prospective and observational study was conducted among psychiatric department (either sex) after considering inclusion and exclusion criteria for the period of 6 months and a total of 300 prescriptions were analyzed.Results: A total of 300 psychiatric patients were enrolled, male 170 (56.67%) patients predominated over females 130 (43.33%) patients. Majority of participants were under age group of 31–40 years (28.6%), illiterate (75%), unemployed (52%), and married (84%). Prevalence of mood disorder 109 (36.33%) was high followed by substance used and addictive disorder 53 (17.67%), schizophrenia 46 (15.33%), and psychosomatic medicine 22 (7.33%). Antidepressant (28.59%) was the commonly prescribed group followed by benzodiazepines (14.81%), anticholinergic (7.18%), and anticonvulsants (7.18%). Tricyclic antidepressants drugs amitriptyline (53.44%) was most frequently prescribed an antidepressant. An average number of drugs per prescription was 2.32 out of which 16.91% of drugs were prescribed by their generic name.Conclusion: Selective serotonin reuptake inhibitors (SSRIs) were the most common group, and escitalopram was the most common medication used among the SSRIs. Majority of the drugs were prescribed from essential drug list. This study advocated an overall rational utilization of psychotropic drugs with fewer deviations due to the socioeconomic status of patients and prescription practices of healthcare providers and need to improve prescribing habits to ensure rational use.


Author(s):  
Mohammed Sarfaraz ◽  
A. S. Archana ◽  
Bhavana Kalwa ◽  
Monish Abraham Mathew ◽  
Shilpa Anna Kuriakose ◽  
...  

Background: Anemia is a major public health problem in India affecting people in all age groups with major consequences for human health as well as economic development. Hence the study aims to assess prescribing pattern of physicians in anemia and to create awareness among in-patients in a tertiary care teaching hospital.Methods: A prospective and observational study was carried out in 180 in-patients admitted to General Medicine department in a tertiary care teaching hospital diagnosed with anemia for 6 months. Data was collected from case sheets of patients and assessed for prescribing pattern and direct interview was conducted with patients using standardized KAP questionnaire on anemia.Results: Among 180 in-patients, 126 patients (70%) were females and 54 patients (30%) were males. As part of the therapy, folic acid with vitamin combinations (37 prescriptions) followed by elemental iron with folic acid combinations (32 prescriptions) were most prescribed drugs. KAP questions were scored appropriately and compared with hemoglobin levels. Knowledge level of patients was not significantly correlated (i.e., p=0.254) with their haemoglobin levels. There was a highly significant positive correlation (i.e., p=0.006) between attitude scores of patients and haemoglobin levels. A significant positive correlation (i.e., p=0.001) was found between practice scores of patients and hemoglobin levels.Conclusions: This study clearly showed that prescribing pattern of drugs in anemia patients’ needs to be continuously evaluated. To address the issue of anemia, the patient’s awareness should be enhanced.


Author(s):  
ANCY SEBASTIAN ◽  
ANEESHA PK ◽  
JOSHWA AREECKAL ◽  
SONIYA DAVIS

Objective: The aim of this study is to evaluate the pattern of prescription and utilization of antidepressants (ADs) for various non-psychiatric indications in department of general medicine, cardiology, surgery, gynecology, and orthopaedic of a tertiary care teaching hospital. Methods: A prospective cross-sectional unicentric drug utilization study of inpatients was carried out in a 450 bedded tertiary care hospital. The study included 200 subjects admitted for both psychiatric and non-psychiatric illness. Pediatric patients and those with a length of stay <48 h were excluded from the study. Results: Prescriptions of 200 patients were studied in which 55% were males and 45% were females. The most widely prescribed drug is alprazolam comprising 50% of the total drug consumption and is followed by clonazepam (19.5%), amitriptyline (13.5%), diazepam (9.5%), escitalopram (3.5%), lorazepam (3%), and zolpidem (0.5%). About 36% of the drugs were prescribed in the general medicine department, and 27.5% of the prescriptions were from the cardiology department. Prescriptions from surgery, orthopedics, and gynecology were 16%, 11.5%, and 9% of the total, respectively. Conclusion: ADs were found to be potentially useful for non-psychiatric indications such as peripheral and diabetic neuropathy, gastroenterological conditions, and urological conditions. No benefit was observed in insomnia and musculoskeletal conditions except for fibromyalgia. ADs were also found to improve the treatment outcome and quality of life of patients having comorbid psychiatric conditions being treated for non-psychiatric disorders.


Background: Drug use is a tricky task comprises of prescriber, dispenser and the patient. It is influenced by factors such as prescribing experience, drug cost, availability, dispenser knowledge and patient cultural belief. Objective: Current study aim is to assess the drug prescribing pattern in the inpatient ward of the surgery department at tertiary care teaching hospital using WHO prescribing indicators. Material and Methods: A prospective observational study was carried out after the approval from the institutional ethical committee for a period of six months from February 2019 to July 2019. Data were collected, evaluated and represented using descriptive statics and graph wherever applicable. Result: Total of 190 prescriptions were collected and analyzed using WHO prescribing indicators. An average number of the drug was 5.23%. The percentage of the drug from essential medicine list, generic name and Injectables prescribed was 46.93%, 17.68% and 53.16% respectively. Conclusion: Labelling status of prescribing was not according to standards of WHO prescribing indicators and needs special attention. Such study plays a crucial role in the institution level and helps in preparation of evidence-based modules for rational use of drugs.


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