scholarly journals Evaluation of prescribing pattern of antidiabetic drugs in medicine outpatient clinic of a tertiary care teaching hospital

Author(s):  
Vineet Kumar ◽  
Manmeet Topno ◽  
Manju Gari ◽  
Megha Bansal ◽  
Kishor Chakraborty ◽  
...  

Background: Diabetes is rapidly gaining the status of a potential epidemic in India with more than 62 million diabetics currently diagnosed with the disease. Drug utilization studies are of paramount importance for the optimization of drug therapy and promote rational drug use among health care providers. The aim of this study was to investigate the drug utilization pattern in type-2 diabetic patients. The objective of the study was to analyse the prescribing pattern of anti-diabetic drugs in a tertiary care hospital.Methods: A prospective, cross-sectional study was carried out in medicine outpatient clinic of tertiary care hospital, RIMS Ranchi for a period of 7 months. The data was analysed using WHO core indicators and Microsoft Excel 2013.Results: The total number of encounters surveyed was 94. Avg no of drugs per prescription was 3.04. Percentage of drugs prescribed by generic name was found to be 34.2%. Percentage of prescriptions was a) with antibiotics was 27.6%, b) with insulin was 14.89%, c) from essential drugs list 44.05%. Most common co morbid disease was found to be hypertension present in 27.6% cases.Most commonly use drug was found to be metformin followed by glimepiride.Conclusions: Implementation of WHO core prescribing indicators by the prescribers would help us to reduce the cost, to recognize and prevent potentially dangerous drug- drug interaction and antibiotic resistance.

2016 ◽  
Vol 44 (7) ◽  
Author(s):  
Samina Ismail ◽  
Shemila Abbasi ◽  
Sobia Khan ◽  
Abdul Monem ◽  
Gauhar Afshan

AbstractAims:The aim of this study was to evaluate the factors responsible for epidural analgesia (EA) refusal among parturient patients.Methods:In this prospective cross-sectional study of six months, we included all consenting postpartum patients having a non-operative delivery in the obstetric unit of our hospital. Data were collected on a predesigned questionnaire and included information such as parity, education, reasons for delivering with or without EA, source of information and patient satisfaction. Knowledge regarding EA was assessed from patients delivering without EA.Results:From 933 patients enrolled, 730 (78.2%) delivered without EA, and 203 (21.7%) with EA. Only 11 (1.5%) patients refused EA for the reason of having natural birth process. Otherwise common reasons were misconceptions (65.9%) and lack of awareness about EA (20.5%); 70.5% had no knowledge of common side effects of EA. Among patients delivering with EA, 92.6% were offered EA by health care providers and had obstetricians and anesthesiologists as their sources of information.Conclusions:Patients in developing countries are laboring without EA, even in centers where there is a provision for it. The main reasons for not availing themselves of EA are lack of awareness and knowledge and misconceptions, rather than the desire to have un-medicated natural birth.


2020 ◽  
Vol 11 (1) ◽  
pp. 93-108
Author(s):  
Madhavi Mannam ◽  
Lavanya Nalluri ◽  
Dhanalakshmi Pinnika ◽  
Mounika Pothuraju ◽  
Ravindrababu Pingili ◽  
...  

Diabetic nephropathy is the leading cause of the end-stage renal disease (ESRD) worldwide, and it is estimated that ~ 20% of type 2 diabetic patients reach ESRD during their lifetime. The objective of the present study was to assess the drug utilization pattern, risk factors, and prevalence of diabetic nephropathy in patients with type 2 diabetes mellitus in a south Indian tertiary care hospital. A cross-sectional observational study was conducted on 613 subjects (254 with and 359 without diabetic nephropathy). Prevalence of diabetic nephropathy was measured, and risk factors for the development of diabetic nephropathy were determined by calculating odds ratios using graph-pad prism statistical software, and drug utilization pattern was assessed. Nephropathy was significantly higher in subjects who are married (98.8%, OR, 3.903; 95% CI, 1.125-13.54, P=0.0211),  poorly educated (61%, OR, 0.3670;95%CI, 0.2635-0.5112, P<0.0001), house wives (44.4%, OR, 0.5492; 95% CI, 0.3432 - 0.8789, P=0.0120), rural residents (51.2%, OR, 0.3943; 95% CI, 0.2820-0.5513, P<0.0001) and risk factors were hypertension (37.44%, OR, 4.131; 95% CI, 2.687-6.350, P<0.0001), other diseases (36.51%, OR, 4.963; 95% CI, 3.202 -7.692, P<0.0001), Endocrine diseases (9.53%, OR, 2.460; 95% CI, 1.433- 4.224, P=0.0009), history of CVD (7.90%, OR, 17.20; 95% CI, 7.049- 41.95, P<0.0001), HbA1c (36.1%, OR, 3.380; 95% CI, 2.157- 5.295, P<0.0001), low HDL (23%, OR, 0.5961; 95% CI, 0.3572 - 0.9947 , P=0.0470), high FBS levels (29.3%, OR, 6.111; 95%CI, 1.283 -29.10, P=0.0113), high triglyceride levels (39.8%, OR, 0.6077; 95%CI, 0.3878 -0.9523, P=0.0293), high serum creatinine (28.3%, OR, 154.3; 95% CI, 37.92- 627.7, P<0.0001), duration of T2DM(5-10years 39.8%, OR, 2.653;95% CI, 1.778 - 3.958, & > 10 years 37%, OR, 3.606 ; 95% CI, 2.362-5.504, P<0.0001), physical inactivity(64.9%, OR, 0.5188;95% CI, 0.3727-0.7220 , P<0.0001), soft drinks occasionally (31.9%, OR, 2.253; 95% CI, 1.531-3.315, P<0.0001), habit of taking tea /coffee twice without sugar(42.3%, OR, 1.845; 95% CI, 1.094 to 3.112, P=0.0208) were significant risk factors for development of nephropathy. Metformin (47.05%), a combination of Glimepiride and Metformin (30.71%), a combination of insulin isophane and insulin regular (29.41%), teneligliptin (10.45%), insulin regular (9.80%) were the anti-diabetic medications mostly given to the T2DM patients with nephropathy. The present study revealed that the risk factors for the development of diabetic nephropathy were multiple.


Author(s):  
Usharani H. Patted ◽  
Hema N. G. ◽  
Anil Kumar Mysore Nagaraj

Background: Psychiatric disorders are one of the major causes of morbidity and the burden of illness is enormous and remains grossly under represented. Psychotropic drugs have had a remarkable impact in psychiatric practice. Currently a large number of atypical antipsychotics available in the market are endorsed as better options for treating schizophrenia than the typical antipsychotics. The main objective of the study was to find the commonly prescribed antipsychotics in schizophrenia patients in a tertiary care center.Methods: After Institutional Ethics Committee approval, a retrospective cross-sectional drug utilization study of 400 prescriptions was under taken from 1st July 2015 to 30th July 2016 in the outpatient department of psychiatry of a tertiary care hospital. The prescribing pattern of antipsychotics in schizophrenia patients (N=107) was measured.Results: Out of 400 cases in the outpatient department, schizophrenia cases were predominant (N=107 i.e. 27%) out of which 42.1% were females and 57.9% were males. This was followed by mood disorders and neurotic & somatoform disorders. The most common antipsychotic used was olanzapine followed by risperidone. Least commonly used antipsychotic was haloperidol. Most of the patients who received risperidone also received an anticholinergic trihexyphenidyl (91.8%).Conclusions: Olanzapine and risperidone are the most commonly used antipsychotics. Anticholinergics should be used only in selected patients on antipsychotics as tolerance develops to extrapyramidal side effects. Anticholinergics are unnecessary after 3-6 months in all except 10% of patients. Moreover, it has its own side effects and adversely interacts with antipsychotics.


2019 ◽  
Vol 8 (2) ◽  
pp. 59-65
Author(s):  
S. Subedi ◽  
K. Paudel ◽  
M. Koirala ◽  
P. Chhetri

Introduction: Anxiety is a vague, uneasy feeling, the source of which is often non-specific but known to cause abnormal hemodynamic changes as a consequence of sympathetic, parasympathetic and endocrine stimulation. Most patients awaiting elective surgery experience anxiety. The degree, to which patient develops anxiety depends on many factors like age, gender, type and extent of the proposed surgery, previous surgical experience, and personal susceptibility to stressful situations. This study was conducted to find out the prevalence of preoperative anxiety and factors contributing to it. Material and Method: This is a cross-sectional study done among 74 pre-operative patients admitted the day before elective surgery in Department Of Surgery Universal College Of Medical Sciences Teaching Hospital, Bhairahawa. Socio-demographic as well contributing factor questionnaire, semi structured pro forma by interview method and Beck Anxiety Inventory Scale (BAI) Nepali Version were used to collect the data. Results: The findings of the study revealed that 90.54%, had very low level of anxiety and 2.70% of patients had severe pre-operative anxiety. The bivariate logistic regression analysis showed statistically significant association between family income (p= 0.004, AOR=2.03, CI= 0.009-2.567), family support (p< 0.001, AOR= 2.34, CI= 0.003-3.368), expected duration of hospital stay (p= 0.049, AOR=8.889, CI= 78.051-78.051), clarity on given information by health care providers (p< 0.001, AOR= 53.33, CI=7.165-396.99), staffs friendliness (p< 0.001, AOR= 21.01, CI= 3.450-127.82), fear of nil per oral (p= 0.015, AOR= 2.32, CI= 0.26-3.67) and level of pre-operative anxiety. Conclusion: It is concluded that varying degree of pre-operative anxiety were found in patients undergoing surgery. Providing adequate information about Peri-Operative procedure can help in reducing these anxiety.


Author(s):  
Arun Patil ◽  
Darshana Dighe ◽  
Shrikrishna Kolte ◽  
Pradeep R. Jadhav ◽  
Y. A. Deshmukh

Background: Skin diseases are common and cause a huge disease burden globally. Different class of drugs and combinational products are available in dermatology for treatment. Periodic prescription analysis in the form of drug utilization study can improve the quality of prescription and curb the menace of irrational prescribing. Aim and objective of the study were to study the prescribing pattern and drug utilization trends in Dermatology outpatient department at a tertiary care hospital in Navi Mumbai.Methods: A cross-sectional, observational study was conducted over a period of three months in dermatology department of a tertiary care teaching hospital, Navi-Mumbai. A total of 102 adult patients visiting dermatology OPD were included and their prescriptions were analyzed with WHO prescribing indicators and additional indices.Results: Analysis showed that the average number of drugs per prescription was 3.27. Percentage of drugs prescribed by generic name was 31.1%. Percentage of drugs prescribed from National Essential drug list (NEDL) was 44.2%. The commonest prescribed drugs were antihistaminics followed by antifungals. Oral tablets were the commonest prescribed dosage form.Conclusions: Antihistaminics and antifungals dominated the prescribing pattern in this study with restraint on polypharmacy, but showed ample scope for improvement to prescribe generic and selection of essential drugs.


Author(s):  
Nitin D. Pise ◽  
Swapnil B. Kaikade

Background: Antimicrobial agents are most commonly prescribed drug and share major cost of the treatment. Excessive and inappropriate use of antimicrobial has become a global problem, resulting not only in substantial economic burden on healthcare system but also in contributing to the selective pressure favoring the emergence of antibiotic-resistant microorganisms. Antimicrobial agents which one uses for prophylactic, empiric and therapeutic purposes, depends upon the local epidemiology of infectious diseases, microbiology and resistance pattern as well as local clinical experience. Rational use of antibiotics is one of the most important way of preventing development of resistant strains to these drugs. However, for this, the health care providers should be aware of the available antibiotic prescription guidelines and should strictly adhere to it. Also, they should be updated of emerging resistant strains. Though the strict guidelines are available for the use of antibiotics, there are differences in level of knowledge and approach to antibiotic prescription among professional health care providers.Methods: The present cross sectional study was carried out in A.V.B.R. Teaching Hospital by collecting data from admitted patient’s case paper, tabulated in seven groups of diseases and different groups of antimicrobial agents prescribed.Results: Penicillin and quinolone group of antimicrobials show maximum use whereas sensitivity found more in cephalosporins and quinolone group of antimicrobials.Conclusions: It was found that Cephalosporins (3rd Gen.) are the most commonly prescribed antimicrobial agents followed by aminoglycosides (Gentamicin) and Fluroquinolones (Ciprofloxacin).


Author(s):  
Karavadi Sri Sai Vidusha ◽  
Margaret Menzil

Background: Healthcare providers (HCPs) have been identified as the most common vehicle for transmission of hospital acquired infections (HAIs) from patient to patient and within the healthcare environment. Hand hygiene has been identified as the single most important, simplest and least expensive means of preventing HAIs. This study was conducted to assess the knowledge of hand hygiene among healthcare providers in a tertiary care hospital in Bengaluru.Methods: A cross sectional descriptive study was conducted among all the health care providers who have been working in the hospital for more than one year. Total 122 health care providers were included in the study. A semi-structured, self-administered questionnaire was developed and used to obtain information on respondent’s socio-demographic characteristics, and knowledge of hand hygiene. For collecting data in this study, the World Health Organization (WHO) "Hand Hygiene Knowledge Questionnaire "revised 2009 edition was used. Descriptive statistics was used as necessary.Results: A total of 122 health care providers participated in the study. Among them 78 (63.9%) have received formal training in hand washing. The mean age of the study participants was 29.11±8.6 years. Majority opined that hand rubbing is required before palpation of the abdomen (86.9%) knowledge about hand hygiene was found to be moderate in majority of the study subjects (144 out of 200, 74%).Conclusions: In the present study the knowledge on hand hygiene among health care providers is moderate it highlights the importance of improving the current training programs targeting hand hygiene practices among health care providers.


Author(s):  
Rami Mosleh ◽  
Mohammed Hawash ◽  
Yazun Jarrar

Background: Diabetes prevalence at Palestine was 10%, with a rising fund crisis, and diabetes healthcare problems. There was a limited research concerning diabetes healthcare dimensions including organizational factors and their predictors. Objectives: This study described patient characteristics and organizational factors, and assessed relationships among organizational factors of type 2 diabetes health care in Palestine. Methods: This study is retrospective cross sectional, recruited by convenience sampling method in 330 participants from a type 2 diabetes patients list. It was carried out at Ramallah, Palestine. The Statistical Package for Social Sciences (SPSS v 19) was used to analyze data on patient characteristics and organizational factors collected from personal interview and medical records review. Results: The results showed that 51.2% were males, and 88.5% had additional chronic diseases. Preventive healthcare and patient–healthcare professionals’ relationship were the most prominent organizational factors in statistically significant relationships among organizational factors. Conclusion: This study reflected the need for reviewing prescription mode, and educational programs that emphasize the diabetes self–care management and the health care providers’ role that would be of great benefit in health outcomes further.


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