scholarly journals Drug prescribing patterns in elderly patients in a tertiary level hospital

2017 ◽  
Vol 6 (4) ◽  
pp. 759
Author(s):  
Nachiket Bhaveshaikh ◽  
Sangita Sukumaran ◽  
Upal Vyas
Keyword(s):  
Elderly Patients ◽  
Tertiary Care ◽  
Prescribing Patterns ◽  
P Value ◽  
Pulmonary Medicine ◽  
Potentially Inappropriate Medications ◽  
Care Hospital ◽  
Prescribing Practices ◽  
Inappropriate Drugs ◽  
Utilization Patterns

Background: Elderly people have multiple co morbidities and are often prescribed potentially inappropriate medications (PIMs). As there is paucity of information about the prescribing practices in elderly this study was undertaken to assess drug utilization patterns in elderly patients.Methods: A prospective observational study was conducted in a tertiary care hospital. A total of 576 prescriptions of elderly patients were included in the study. Prescribing patterns among elderly patients attending OPD and admitted to wards of departments of Medicine, Psychiatry, Dermatology, Pulmonary Medicine, General Surgery, E.N.T., Ophthalmology, Orthopaedics, Obstetrics and Gynaecology were analysed using the prescribing indicators (WHO criteria). The PIMs were identified as per the Beers 2012 criteria.Results: The average number of drugs per patient was 3.91±1.93 for O.P.D and 7.37 ±2.22 for I.P.D. patients. 37.76% patients in I.P.D. and 26.87% patients in O.P.D. received a medication which was potentially inappropriate as per Beers 2012 criteria. 7.58% (234/3088) of total medications prescribed to patients in the study were potentially inappropriate. There was a significant increase in the number of PIMs (p value ˂0.05) as the total number of drugs prescribed increased.Conclusions: Educational programmes are needed to reinforce rational prescribing by physicians and precautions should be taken while prescribing potentially inappropriate drugs to elderly patients.

scholarly journals The study on prevalence of polypharmacy in elderly patients presenting for first time to the geriatric clinic of a tertiary care hospital in Kerala

2018 ◽  
Vol 5 (2) ◽  
pp. 3542-3544 ◽  
Author(s):  
Dr Aswin Rajeev ◽  
Dr George Paul ◽  
Dr Sobha George ◽  
Dr Priya Vijayakumar
Keyword(s):  
Elderly Patients ◽  
Tertiary Care Hospital ◽  
Inappropriate Medication ◽  
Tertiary Care ◽  
Potentially Inappropriate Medications ◽  
Care Hospital ◽  
Inappropriate Drugs ◽  
Geriatric Clinic ◽  
First Time ◽  
Inappropriate Medications

Introduction : Elderly patients are the most common group who use heath care facilities. This study assesses the prevalence of polypharmacy and use of potentially inappropriate medications in elderly patients presenting to the geriatric clinic of a tertiary care hospital in Kerala for first time. Materials and methods : The study was a hospital based retrospective study. The data from patients presenting to Geriatrics clinic from period of 1 st January 2016 to 31 st December 2016 were retrieved from the medical records and assessed for polypharmacy (taking >5 medications at a time) and potentially inappropriate drugs in accord with modified 2012 Beer’s criteria. Results : A total of 275 patients were included in the study of which 110 (40%) were males and 165 (60%) were females. The prevalence of polypharmacy found to be 22.9%. 63 out of total 275 patients took more than 5 medications at a time. 81 (29.5%) out of 275 patients had at least one potentially inappropriate medication. Conclusion : The prescription of potentially inappropriate medications is a serious problem which can affect overall quality of health care. Hence regular medication review and  reconciliation practices should be implemented to prevent this to an extent.

Causes of Epilepsy in Elderly Patients Presenting in a Tertiary Care Hospital of Karachi

2020 ◽  
Keyword(s):  
Elderly Patients ◽  
Cerebrovascular Disease ◽  
Neurodegenerative Disorder ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Traumatic Head Injury ◽  
Keywords Epilepsy ◽  
College Hospital ◽  
Cross Sectional

Background: Epilepsy is fairly a frequent occurrence in the elderly. It is commonly diagnosed after the episode of two or more unprovoked seizures. Unprovoked seizures in elderly are recurrent rather than younger individuals. This study was designed to estimate the concrete burden of frequent causes of epilepsy. Methods: A descriptive cross-sectional study with a total of 153 patients diagnosed case of epilepsy were included in this study at Jinnah Medical College Hospital from February 2018-August 2018. Mean was calculated for age, duration of disease of the patients. Causes of epilepsy, gender, and education was calculated and presented as percentages. Electrolyte readings were taken i.e., Sodium, Calcium and Magnesium levels and imaging was planned to rule out stroke, primary neurodegenerative disorders and tumors. Post stratification Chi square test was applied and p-value less than or equal to 0.05 was considered significant. Results: The mean age of the patients was 63.91±5.68 years and mean duration of the disease was 4.61± 1.07 months. The common causes of epilepsy were found to be cerebrovascular disease 56.9%, cryptogenic 54.2%, neurodegenerative disorder 20.3%, traumatic head injury 11.8%, metabolic abnormalities or electrolyte disturbances 10.5% and brain tumor 7.8%. Conclusion: Elderly patients with first seizure should present to a facility designed in a way that neurologist, cardiologist, rehabilitation and geriatrics work together to identify and treat the condition in a better way. Keywords: Epilepsy; Seizures; Cerebrovascular Disease; Neurodegenerative Disorder.

COMPARATIVE EVALUATION OF SPIROMETRY PARAMETERS IN HEALTHY YOUNG AND ELDERLY ADULTS POPULATION IN PUNJAB, INDIA

2021 ◽  
pp. 1-3
Author(s):  
Ajay Pal Singh ◽  
Kailash Meena ◽  
Surinder Pal Singh ◽  
Avnish Kumar ◽  
Ashish Shukla ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Tertiary Care ◽  
P Value ◽  
Pulmonary Medicine ◽  
Care Hospital ◽  
Age Group ◽  
Elderly Adults ◽  
Elderly Age ◽  
Cross Sectional ◽  
Age Related

INTRODUCTION: Spirometry is a vital tool for the assessment of pulmonary function status. Spirometry can be used to demonstrate the age-related decline in pulmonary function. The spirometry values can be used as reference values for a particular age group. The aims of our study was to compare spirometry values between the young and elderly groups and evaluate age-related changes in both groups. MATERIAL AND METHODS: A cross-sectional study was conducted on 600 adults, which divided into two healthy groups: one was of young adults (18-35 years), and other was of elderly adults (>60 years) of 300 persons, each taken over a period of one year, in the Department of pulmonary medicine, a tertiary care hospital, Punjab. We conducted spirometry in both age group. Spirometry values were measured FVC, FEV1, FVC/FEV1, PEFR, and FEF25- 75 % of each groups.The subjects were selected based on random sampling RESULT: Spirometry values compared between young and elderly adults. Mean BMI in young and elderly groups was 25.09±2.87 and 25.82±2.45, respectively. Spirometry values in FVC , FEV1, FEV1/FVC , PEFR and FEF25-75% in young was 4.31± 0.18 , 3.84,± 0.88± 0.02, 9.87± 0.38 and 3.75 ±0.26 and elderly age group 3.01±, 2.60 ±0.85± 0.02, 7.70± 0.30 and 2.82 ± 0.26. On statistical analysis, p value <0.001 in all spirometry parameters. CONCLUSION: The study shows that there was a decline in spirometry parameters of healthy adults with the increase in age. This decline was signicant in all spirometric parameters (FVC, FEV1, FEV1/FVC, PEFR, FEF25–75%) measured in the present study

scholarly journals Assessment of Potentially Inappropriate Medications and Prescription Appropriateness in Geriatics at Teritiary Care Hospital

2020 ◽  
Vol 10 (6) ◽  
pp. 42-48
Author(s):  
Wahiba Mohammed Wazir ◽  
Saba Afreen ◽  
FARIA IFFATH ◽  
Amtul Muqeet Rafia ◽  
Mohammed Ateeq Ur Rahman
Keyword(s):  
Tertiary Care ◽  
Research Work ◽  
General Medicine ◽  
Future Research ◽  
P Value ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Care Hospital ◽  
Prescribing Indicators ◽  
Inappropriate Medications

Background: Elder people are a diversified group commonly presenting with multiple comorbid illnesses resulting into multiple prescriptions which in turn increases adverse effects and polypharmacy. Potentially inappropriate medications (PIM) further contribute to this risk. Therefore, the aim of this study was to assess the prescription appropriateness and (PIM) in geriatrics as per WHO core prescribing indicators and Beer’s Criteria, 2015 respectively. Methods: A prospective observational study was conducted in Osmania General Hospital, a Tertiary Care Teaching Hospital from December 2018 to May 2019. A total of 100 case records of inpatients greater than or equal to 60 years of age, in general medicine wards were reviewed. Relevant information was recorded in a structured proforma and data was evaluated. Results: Out of 100 patients, 70 patients were male and 30 patients were female. Majority of them were from the age group of 65-70 years. There were 34% patients prescribed at least one PIM. Polypharmacy was observed in all patients. Average no. of drugs per prescription was 10.5%.Percentage of drugs prescribed from EDL (Essential drug list) were 84%.The p value of WHO core prescribing indicators was assessed using chi square test and was found to be significant. Conclusion: Our study found WHO core prescribing indicators to be deviated from the optimum values set by WHO and high prevalence of Potentially Inappropriate Medications as per Beers criteria 2015. This highlights the need of future research work, strategies and regulatory measures focusing on geriatric patients and also encouraging prescribers to use the WHO core prescribing indicators and Beers criteria while prescribing elderly for providing optimum healthcare. Keywords: Beer’s criteria, Geriatrics, WHO prescribing indicators, Polypharmacy. Ageing, Potentially Inappropriate Medications.

scholarly journals The study of incidence of post operative delirium in geriatric patients who needed prolonged ICU stay after undergoing a major cardiac surgery in a tertiary care hospital

2018 ◽  
Vol 5 (2) ◽  
pp. 3504-3506
Author(s):  
Dr Aswin Rajeev ◽  
Dr George Paul ◽  
Dr Sunil K S ◽  
Dr Priya Vijayakumar
Keyword(s):  
Cardiac Surgery ◽  
Elderly Patients ◽  
Artery Bypass ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Icu Stay ◽  
Care Givers ◽  
Hospitalized Elderly ◽  
Prolonged Icu Stay

INTRODUCTION: Delirium, defined as an acute disorder of attention and global cognitive function  is a common, serious and potentially preventable source of morbidity and mortality in  hospitalized elderly patients.  Different studies have shown that prolonged post operative ICU stay contributes to occurrence of delirium OBJECTIVE: To assess the incidence of post operative delirium in elderly patients who needed prolonged ICU stay after  undergoing a major cardiac surgery (coronary artery bypass grafting). MATERIALS AND METHODS: Prospective cohort study, Study Period: 1 ½ years. Using a prepared questionnaire after obtaining fully informed written consent. 3 visits for each patient: 1) before surgery, 2) in the ICU: 48 hours after surgery and 3) In ward after shifting out from ICU. Prolonged ICU stay was defined as admission more than 3 days in ICU. The details from nursing staff and care givers were taken. RESULTS: Out of total 250 patients included in the study, 43 (17.2%) patients developed post operative delirium. 32 (26%) out of 19 patients who needed prolonged ICU stay developed post operative delirium compared to 11 (8.7%) out of 116 patients who spent less than 3 days in ICU in post operative period. (p Value: <0.001). Prolonged ICU stay contributes to post operative delirium and measures have to be instituted to shift out the patient from ICU at the earliest after stabilization.

scholarly journals Drug prescribing pattern in surgical wards of a tertiary care hospital in Western part of India

2018 ◽  
Vol 7 (8) ◽  
pp. 1587
Author(s):  
Khyati M. Patel ◽  
Shilpa D. Jadav ◽  
Shailesh P. Parmar ◽  
Hiren Trivedi
Keyword(s):  
Tertiary Care ◽  
Essential Medicine ◽  
Pharmaceutical Products ◽  
Prescribing Patterns ◽  
Care Hospital ◽  
Drug Prescribing ◽  
Prescribing Practices ◽  
Antimicrobial Drugs ◽  
Prescribing Pattern ◽  
Injectable Drug

Background: In surgical wards, drugs are required to manage pain, nausea, vomiting, infections, etc. A growing number of pharmaceutical products are available in present era. Irrational prescribing of drugs is prevalent worldwide. Drug utilization study can be used to assess prescribing patterns. Authors undertook this study to determine current practice of prescribing in surgical wards of the hospital.Methods: Authors conducted observational, noninterventional, descriptive study among patients admitted in surgical wards for one year. Authors have analysed collected data of 604 patients using descriptive statistics to determine utilization pattern of drugs and drug use indicators.Results: Appendicitis (14.9%) followed by hernia (10.6%) were leading diseases for admission. Mean duration of stay was 7.44. Average number of drugs in a prescription was 8.94. Antibiotics (32.07 %), analgesics (17.11 %) and antacids (16.09 %) were leading drug groups prescribed. Amikacin (5.81 %) followed by metronidazole (5.30 %) and ciprofloxacin (5.19 %) were commonly prescribed antimicrobial drugs. Tramadol (5.31 %) and pantoprazole (7.17 %) were leading drugs prescribed from analgesics and antacids respectively. All prescriptions had at least one injectable drug. At least one antibiotic was present in 92.05 % prescriptions. Majority of drugs (87.27 %) were prescribed by generic names. Proportion of drugs prescribed from essential medicine list was 84.22 %.Conclusions: Polypharmacy and injectable drug prescribing were common in practice. There is a scope for improving such prescribing practices among practitioners. Use of multiple antibiotics should be avoided whenever possible and usage should be evidence based.

scholarly journals A STUDY OF DRUG UTILIZATION PATTERN OF THE GERIATRIC PATIENTS IN THE DEPARTMENT OF GERIATRIC MEDICINE IN A TERTIARY CARE HOSPITAL IN ASSAM, INDIA

2017 ◽  
Vol 10 (2) ◽  
pp. 122 ◽  
Author(s):  
Lakhimi Borah ◽  
Diptimayee Devi ◽  
Prasanjit Kumar Debnath ◽  
Dibyajyoti Deka
Keyword(s):  
Elderly Patients ◽  
Drug Utilization ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Care Hospital ◽  
Age Group ◽  
Utilization Pattern ◽  
Inappropriate Medications

Objective: To investigate the drug utilization pattern and the prevalence of potentially inappropriate medications (PIMs) using updated AGS Beers criteria 2012 among the elderly patients who attended the geriatric outpatient departments as well as admitted  indoor patients ina tertiary care Hospital at Guwahati, Assam, India.Method: A hospital based prospective, observational and cross sectional study, involving patients aged 65 years and above was planned and conducted over a period of 6 months from January 2016 to June 2016. Patients were visited daily, interviewed and case records were collected. Data were analyzed using Microsoft Office Excel Sheets.Results: A total of 150 patients aged 65 years and above were analyzed. 97 patients (65%) were males and 53 (35%) were females. Majority of the patients (61 numbers, 41%) belonged to the age group of 65-70 years, and least were in the age group of 86-90 years (13 numbers, 9%). Prescription of five or more medications (polypharmacy) was observed in 117 (78%) patients. Majority of the patients presented with diseases of cardiovascular system (25.7%). Using WHO drug use indicators, the average number of drugs per prescription was found to be 5.6. The percentage of drugs prescribed by generic name was 86%. The percentage of encounters in which antibiotics were prescribed was  61%. Injection was prescribed was 65% cases and the percentage of drugs prescribed from the NLEM (National List of Essential Medicines of India) was 96%.  43 patients received PIMs from Beers list; majority were belonging to category 1. Spironolactone was most commonly prescribed PIM.Conclusion:  Irrational prescribing practices and polypharmacy were detected in our study.Prescribers should be educated about rational use of drugs and Beers criteria for elderly. Keywords: Beers criteria, WHO prescribing indicators, Potentially inappropriate medications, Elderly patients, Polypharmacy

Seroprevalence of anti-SARS-CoV-2 IgG antibodies in hospitalized patients at a tertiary referral center in North India (Preprint)

2020 ◽  
Author(s):  
Dr. Animesh Ray ◽  
Dr. Komal Singh ◽  
Souvick Chattopadhyay ◽  
Farha Mehdi ◽  
Dr. Gaurav Batra ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Age Groups ◽  
Hospitalized Patients ◽  
North India ◽  
P Value ◽  
Care Hospital ◽  
Igg Antibodies ◽  
Igg Antibody ◽  
Increased Risk ◽  
Significant Difference

BACKGROUND Seroprevalence of IgG antibodies against SARS-CoV-2 is an important tool to estimate the true extent of infection in a population. However, seroprevalence studies have been scarce in South East Asia including India, which, as of now, carries the third largest burden of confirmed cases in the world. The present study aimed to estimate the seroprevalence of anti-SARS-CoV-2 IgG antibody among hospitalized patients at one of the largest government hospital in India OBJECTIVE The primary objective of this study is to estimate the seroprevalence of SARS-CoV-2 antibody among patients admitted to the Medicine ward and ICU METHODS This cross-sectional study, conducted at a tertiary care hospital in North India, recruited consecutive patients who were negative for SARS-CoV-2 by RT-PCR or CB-NAAT. Anti-SARS-CoV-2 IgG antibody levels targeting recombinant spike receptor-binding domain (RBD) protein of SARS CoV-2 were estimated in serum sample by the ELISA method RESULTS A total of 212 hospitalized patients were recruited in the study with mean age (±SD) of 41.2 (±15.4) years and 55% male population. Positive serology against SARS CoV-2 was detected in 19.8%patients(95% CI 14.7-25.8). Residency in Delhi conferred a higher frequency of seropositivity 26.5% (95% CI 19.3-34.7) as compared to that of other states 8% (95% CI 3.0-16.4) with p-value 0.001. No particular age groups or socio-economic strata showed a higher proportion of seropositivity CONCLUSIONS Around, one-fifth of hospitalized patients, who were not diagnosed with COVID-19 before, demonstrated seropositivity against SARS-CoV-2. While there was no significant difference in the different age groups and socio-economic classes; residence in Delhi was associated with increased risk (relative risk of 3.62, 95% CI 1.59-8.21)

scholarly journals Clinical characteristics and factors related to antibiotic-associated diarrhea in elderly patients with pneumonia: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yoko Takedani ◽  
Tsukasa Nakamura ◽  
Noriko Fukiwake ◽  
Toshihiro Imada ◽  
Junji Mashino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Elderly Patients ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Tertiary Care ◽  
Multivariate Logistic Regression Model ◽  
Care Hospital ◽  
Antibiotic Associated Diarrhea ◽  
Elderly Inpatients

Abstract Background Antibiotic-associated diarrhea (AAD) is a common problem among elderly inpatients because many elderly patients are admitted for pneumonia or other conditions that necessitate antibiotic treatment. In the super aging population, more patients are suffering from pneumonia than before, but the incidence or risk factors for AAD among many elderly patients have not been well scrutinized. Methods We conducted a retrospective cohort study of elderly patients diagnosed with pneumonia from April 2014 to March 2019 who were admitted to the Department of General Medicine of a Tertiary Care Hospital in Japan. Patients (≥ 65 years of age) who were diagnosed with bacterial pneumonia or aspiration pneumonia and treated with antibiotics were included. We defined AAD by diarrhea with more than three loose or watery stools per day and included patients who had these symptoms for either one day or two or more consecutive days. We also assessed the length of hospital stay and in-hospital mortality. The potential risk factors for AAD included age, sex, body weight, body mass index, smoking, alcohol, activities of daily living (ADL),　comorbidities, vital signs, laboratories, the severity of pneumonia, antibiotic and other medication use. Results There were 1,067 patients, the mean age was 83 years, and men accounted for 59 %. β-Lactamase inhibitors were frequently prescribed antibiotics in 703 patients (66 %), and proton pump inhibitors (PPIs) were also commonly administered (48 %). AAD developed in 322 patients (30 %). The multivariate logistic regression model showed that β-lactamase inhibitors (OR 1.43, 95 % CI 1.05–1.95) and PPIs (OR 1.37, 95 % CI 1.03–1.83) were associated with AAD as well as age (OR 1.03 per year, 95 % CI 1.01–1.05). Conclusions AAD was common among elderly inpatients with pneumonia, and β-lactamase inhibitors and PPIs were associated with AAD. Strict use of such medication should be considered to decrease the risk of AAD.

scholarly journals Post-Operative Outcomes of Intravenous Lidocaine Infusion on Major Abdominal Surgery in Pediatric Patients: A Randomized Control Trial in a Tertiary Care Hospital

2018 ◽  
Vol 10 (1) ◽  
pp. 23-27
Author(s):  
Nirupama Saha ◽  
Nadiuzzaman Khan ◽  
Mirza Kamrul Zahid ◽  
Shah Alam Talukder ◽  
ASM Meftahuzzaman
Keyword(s):  
Abdominal Surgery ◽  
Tertiary Care ◽  
Major Abdominal Surgery ◽  
P Value ◽  
Care Hospital ◽  
Intravenous Lidocaine ◽  
Operative Outcomes ◽  
Group A ◽  
Randomized Control ◽  
Group B

Background: Post-operative outcomes of a major abdominal surgery depend on careful & effective post-operative management. But it is a critical job especially in children. Obtaining adequate analgesia after major surgery is a problematic issue and postoperative pain still imposes a major burden of suffering in surgical patients.Objectives: The principle objectives of the study is to evaluate the effects of intravenous lidocaine infusion in pain management of pediatric population undergone in major abdominal surgery; to reduce post-operative morbidity & enhance better surgical outcome in children.Methodology: This is a randomized control trial carried out from January 2015-June2015,in a tertiary care hospital among 60 cases of 4 to 14 years children with major abdominal surgery without having any pulmonary, cardiac, hepatic or renal insufficiency. Grouping of patients that is lidocaine infusion group (Group A) and control group (Group B) was made among admitted cases for elective abdominal surgery by simple random technique by means of lottery. For assessment of postoperative pain FLACC Scale was used in both groups. Clinical examination findings & specifically designed data collection sheet with a set questionnaire were used as research instruments. Formulated data was analyzed by SPSS version 17, taking p value <0.05 as significant.Results: It is noted that, after 24 hours of operation most of the patients 56.7% of group A had mild pain whereas 90% patients of group B had moderate pain (p<0.001)& during that time there was no patient with severe pain in group A whereas in group B 10% patients were with severe pain. At 48 hours, pain was absent in 13.3% children of group A and 6.7% in group B. In group A most of the children 76.7%had mild pain compared to moderate pain 18 (60%) in group B children at that hours (P<0.001). Again, regarding required amount of analgesics, patients received I/V lidocaine required less amount of analgesics than its counterpart. In present study, complications was noted only 3.3% patien in group A, where as in the opposite group it was found in 23.3% & p was <0.05. In group A, in 50% patients post operative bowel sound was returned within 72 hours, compared to 73.3% patients in group B. The p value was 0.001. About post-operative hospital stay, 83.3% children of the group A were released from hospital after 5th P.O.D whereas, in group B, only 50% children were released after 7th P.O.D of operation. The P value was 0.03 that is also significant.Conclusion: Intravenous lidocaine could improve immediate and late post-operative pain with early recovery after major abdominal surgery in children & it can contribute to rapid postoperative rehabilitation programs.J Shaheed Suhrawardy Med Coll, June 2018, Vol.10(1); 23-27

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