scholarly journals Drug utilization pattern in orthopaedic outpatient department of a tertiary care hospital in Kerala: a geriatric perspective

Author(s):  
Sini K. ◽  
Mohammed Basheer ◽  
Shaikh Ubedulla Shaikh Iqbal Daud ◽  
Divya G. Krishnan

Background: Geriatric population due to the age related changes in pharmacokinetics and pharmacodynamics and the presence of comorbidities is vulnerable to drug interactions, adverse effects and high cost of therapy. This necessitates a periodic review of DU pattern in the geriatric population to ensure safe and effective treatment for them. The present study was undertaken to evaluate the DU pattern for medical conditions among the geriatric population in the Orthopaedic outpatient department (OPD) of a tertiary care hospital in Kerala.Methods: In this cross sectional observational study conducted in the Orthopaedics OPD of a tertiary care hospital, prescriptions were collected from patients attending the Orthopaedics OPD randomly over a period of 6 months. Out of these, prescriptions of male and female patients of age more than 60 years were sorted and analysed using World Health Organization drug prescribing indicators as well as additional parameters and the data was presented in the form of frequency and percentages using tables and charts.Results: A total of 800 prescriptions were collected and studied of which 76 (9.5%) belonged to patients from the geriatric population. Majority of the patients were in the age group of 61-70years (52.63%). Spondylosis (42.10%) was the most common indication for patients attending Orthopaedics OPD. Average number of drugs per prescription was 3.05 with a range between 1 and 5. Only 5.17% drugs were prescribed using generic name. Utilization from the essential drug list was 39.65%. The percentage of encounters in which an antibiotic and injection prescribed was 0% and 10.34% respectively. Of the total drugs prescribed 35% were FDCs. The most routinely prescribed drugs among the various classes were NSAIDs 34% followed by gastroprotectives (25%). The assessment of prescriptions with regard to completion and legibility was satisfactory.Conclusions: Current study pointed out deficiencies like polypharmacy, low prescribing of drugs by generic names, low prescribing of drugs from the essential drug list and higher use of FDCs. Use of antibiotics and injections was satisfactory and acceptable. Legibility and completion of prescription format was largely satisfactory. Proper strategies to rectify these deficiencies can ensure safe and effective treatment for geriatric patients.

Author(s):  
Shobha P. ◽  
Messaline Sunitha

Background: ICU patients are exposed to more number of life saving drugs and face drug related problems like therapeutic failure, drug interactions and frequent adverse drug reactions. The cost of ICU hospitalisation and money spent on medicines is also a huge burden on these patients. A study of prescribing pattern in an ICU set up will serve as a medical audit to monitor and evaluate the prescribing practices to make it more rational and cost effective.Methods: A prospective observational study was carried out in a medical ICU of a tertiary care hospital. All the inpatients admitted in the medical ICU during the study period of 2 months were included in the study. The data obtained from the case sheets were used to assess the prescribing pattern and rationality of drug use.Results: A total of 101 patients were admitted in 2 months. The most common illness for which the patients (22) were admitted was respiratory problems. Average number of drugs per prescription was 6.9. Cardiovascular system (23.9%) drugs were the most frequently prescribed. Pantoprazole (77) was the single most commonly prescribed drug. 40% of the drugs were prescribed from the essential drug list. The average cost of medicines incurred per person in our study was 5126.33 in INR.Conclusions: Polypharmacy and unwanted prescription of proton pump inhibitors can be avoided by prescribing more generics and drugs from essential drug list.


Author(s):  
Nishandar Tb ◽  
Kale As ◽  
Pise Hn ◽  
Jambhrunkar Sd

Objective: Drug utilization research is an essential part of pharmacoepidemiology as it describes the extent, nature, and determinants of drug exposure. Indiscriminate use of topical antibiotics, steroids, and nonsteroidal anti-inflammatory drugs causes histological and structural changes in the conjunctiva. The present study was proposed to investigate prescription and drug utilization practices in ophthalmology outpatient department (OPD) in a government tertiary care hospital in Maharashtra.Methodology: An observational, cross-sectional study was conducted in a tertiary care teaching hospital of rural Maharashtra, India, from January 2015 to June 2016 after approval of the institutional ethics committee. Patients of all age group and of either gender attending ophthalmology OPD in a tertiary care hospital were included in the study. Patients not willing to consent as well as follow-up patients were excluded from the study. Data collection was done in a predesigned pro forma. Prescriptions were evaluated for demographic data, World Health Organization (WHO) core drug prescription indicators. Statistical analysis was performed using Microsoft Office Excel® 2007.Results: In a total of 600 patients, females outnumbered males. A bit less than a half of patients belonged to the age group of 19–45 years. An average number of drugs per encounter was (1080/600), i.e. 1.8. Of 1080 total drugs prescribed, 678 drugs (62.78%) were prescribed by their generic name. 1027/1080 (95.09%) drugs were prescribed from the National List of Essential Medicines and 671/1080 (62.13%) drugs prescribed were from the WHO- Essential medicines List. Total encounters having antibiotics and injectable formulations were 274 (45.66%) and 4 (0.66%), respectively.Discussion: Drug utilization studies (DUS) are a tool for assessing the prescribing, dispensing, and distribution of drugs. The main aim of DUS is to facilitate rational use of medicines. Overall findings of the study suggest that ophthalmologists’ drug prescribing habits were appropriate to a larger extent in the current setting.


Author(s):  
Rucha M. Shinde ◽  
Anand S. Kale ◽  
Mahadeo P. Sawant

Background: Drug utilization study is an important tool to study the clinical use of drugs and its impact on healthcare system. DUS in patients with HTN and DM is essential to observe the changing prescribing attitude of physicians with the aim to promote rational use of drugs and to minimize the adverse drug reactions.Methods: A cross sectional observational study was conducted on randomly selected patients attending medicine outpatient department in a tertiary care hospital. Drug prescription sheets of 600 patients were studied for 18 months from January 2016 to June 2017 and the prescribing pattern was analysed using the World Health Organization basic drug indicators.Results: Total 2029 drugs were prescribed to 600 patients that belonged to various classes. The average number of drugs prescribed per encounter was 3.4. Majority (61.5%) drugs were prescribed using generic names. Percentage encounters with the antibiotics and injections were 6.3 and 11.5 per cent respectively. 38% drugs were prescribed from the 20th edition of WHO Model List of Essential Medicines. PDD in the current study was found to be significantly less than WHO DDD in all drugs. All of the prescriptions in the present study conformed to WHO guidelines and majority of them with JNC VIII guidelines.Conclusions: The findings of this study are comparable to those of other studies. However, there is a scope of improvement in areas such as overdosing, prescribing more by generic names instead of brand names and from WHO Model List of Essential Medicines.


2019 ◽  
Vol 7 (7) ◽  
pp. 1203-1208 ◽  
Author(s):  
Asmatanzeem Bepari ◽  
Nayana Sakre ◽  
Ishrat Rahman ◽  
Shaik Kalimulla Niazi ◽  
Asmabi M. Dervesh

BACKGROUND: Cancer is a major burden and threat to global society. A wide range of chemotherapeutic agents is extensively used to treat cancer at different stages. Inappropriate drug use may also lead to the raised cost of medical care, adverse drug effects, and patient mortality. Hence, in recent years, drug utilisation studies have become a potential tool to be used in the evaluation of different health care systems including cancer. AIMS: The objectives of the study were to identify the various types of cancer, the commonly prescribed drugs, rational use of anticancer drugs, and analyse the prescribing indicators in a tertiary care government hospital of India. MATERIAL AND METHODS: Newly diagnosed cancer and/or known case of carcinoma of either sex which required treatment/on treatment with chemotherapy aged > 18 yrs admitted in Radiotherapy Department from April 2016 to September 2016 were included in the study and analysed for prescribing indicators. RESULTS: The head & neck cancers were the prevalent cancers observed with more preponderance among males. Most of the patients were prescribed with a single anticancer drug. Cisplatin was the most commonly used cytotoxic drug followed by carboplatin, and antimetabolites. The most commonly used adjuvant drugs in our study were anti-emetics and anti-peptic ulcer drugs. Over 82% of anticancer agents were taken from the essential drug list and were prescribed in generic names, indicating rational use. CONCLUSION: Over 82% of anticancer agents were taken from the essential drug list and were prescribed in generic names, indicating rational use.


Author(s):  
Manish B. Nandeshwar ◽  
Ashish D. Chakravorty

Background: Gynaecological diseases are common in India because of socioeconomic, hygienic and literacy problems. Gynaecological drugs are one of the strong selling drugs in pharmaceutical market. Drug utilization research facilitate appropriate use of drugs in patient, minimize the adverse event and lead to better patient outcome. So, the present study was carried out to examine the patterns of drug prescription.Methods: A retrospective, observational study was done by collecting the prescriptions of the patients who attended the Gynaecology out-patient department in our institute for the period of six months. Total 300 prescription were collected and analysed. Patient’s demographic data, total number and category of drugs prescribed, percentage of individual drug and their dosage forms, drugs prescribed by generic name, brand names and percentage of drugs prescribed from essential drug list were analysed.Results: The mean age of presentation was 36.6±10.98 years. Among infective group breast abscess were common and among non-infective cases dysmenorrhea was most common. Out of 754 drugs prescribed, minerals were most commonly prescribed (42.70%) followed by antimicrobials (24.53%). Tablet form were prescribed more commonly (96.02%) followed by capsules (2%) and injections (1.06%). The average no. of drugs per prescription was 2.51±1.26 SD. Percentage of drugs prescribed by generic name were 98.01% and drugs prescribed from essential drug list were 85.41%.Conclusions: The overall drug use pattern in our study correlates with various gynaecological diseases. Majority of the women from rural background depend on primary health services for gynaecological diseases in their areas so, strengthening of gynaecological health care services reduce the morbidity among the women from rural areas. 


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.


2013 ◽  
Vol 2 (2) ◽  
pp. 13-17
Author(s):  
Mohammad Afsan ◽  
Muhammad Mahbubul Alam ◽  
Nushrat Noor ◽  
AH Hamid Ahmed

A cross-sectional descriptive study was carried out among individuals attending the Out Patient Department (OPD) of Medicine, Paediatrics, Dermatology & Venerology, ENT, Orthopaedics and Gynaecology & Obstetrics from December 2011 to March 2012 in East-West Medical College Hospital, Dhaka, Bangladesh, to see the patterns of prescriptions using World Health Organization (WHO) core prescribing indicators and some additional indices. A total of 300 prescriptions were collected and analyzed by the 3rd year MBBS students in this study. The average number of drugs per encounter was 3.22 and 5.33% drugs were prescribed by generic name. Use of antibiotic (48.67% of encounters) was frequent, but injection use (6.67% of encounters) was within the recommendation of WHO. Only 26.09% drugs were prescribed from national essential drug list. Percentage of encounters with a NSAID, an anti-ulcerant, an antihistamine, a calcium preparation and a multivitamin & multimineral prescribed were 44.33%, 43.33%, 22.33%, 19.33% and 15.67% respectively. So, the findings from current study showed a trend towards inappropriate prescribing, particularly the over-prescribing of antibiotics and under-prescribing of generic drugs and also most of the drugs were prescribed out of national essential drug list. Hence, there would be needed for effective intervention program to encourage the physicians and healthcare providers in promoting more appropriate drug use. DOI: http://dx.doi.org/10.3329/updcj.v2i2.15483 Update Dent. Coll. j: 2012; 2 (2): 13-17


Author(s):  
Kamaldeep Singh ◽  
Garima Bhutani ◽  
Seema Rani ◽  
Rahul Saini

Background: Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’s expertise. World Health Organization has defined certain parameters to promote rational drug use in all countries. This study was designed to assess the prescription writing practices in a government tertiary care hospital in Haryana by using WHO prescribing indicators.Methods: A total of 2155 prescriptions were evaluated. Each prescription was evaluated for average number of drugs prescribed per patient per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed and percentage of medicines from Essential drug list prescribed. These indicators help us to check polypharmacy, practice of prescribing drugs by brand names, antibiotic overuse, preference of injectables and non-adherence to Essential drug list.Results: The average number of drugs prescribed per patient per encounter was calculated to be 3.25±0.24. The percentage of medicines prescribed by generic names was 35.89%. Percentage of encounters with an antibiotic prescribed was 48.21 % and with an injection prescribed was 1.85%. The percentage of medicines form NLEM was 76.36%.Conclusions: The values of WHO prescribing indicators obtained from this study show that there are some areas where the prescribers need to improve their prescribing practices.


Author(s):  
DHIVYA K ◽  
SHIVA SHANKARI R ◽  
MOHAMMED ZULKARNANE A ◽  
GAUTAM R

Objective: The objective of conducting prescribing pattern study is to monitor, evaluate, and if necessary, recommend modifications in the prescribing behavior of medical practitioners. Hence, this study was conducted to analyze the drug utilization and prescribing pattern of drugs in orthopedic outpatient department (OPD). Methods: This prospective observational study was conducted in the orthopedic OPD of tertiary care hospital for a period of 3 months. Data were obtained from the prescriptions through one-to-one interviews and recorded in a separately designed case report form. Results: Out of the 260 patients enrolled in the study, 181 were female and 79 were male. The patients between the ages of 50 and 60 years constituted the higher number with a mean age of 52.2 years. The total number of drugs prescribed in the analyzed prescriptions was 1012 which includes orthopedic drugs as well as drugs prescribed to treat various comorbidities. The World Health organization drug prescribing indicators were used to assess the appropriate use of drugs. Conclusion: Our study concludes that drug utilization and prescribing quality should be improved by promoting medical education on current updates. The periodic audit should be conducted by a clinical pharmacist to reduce an error in the prescription as well as to check the compliance of prescription with standard treatment guidelines for rationalizing the therapy.


Author(s):  
SAGARANANDA GIRI ◽  
GULAM MUHAMMAD KHAN

Objective: The current study aims to evaluate prescribing pattern and potentially inappropriate medicine (PIM) among elderly patients in a tertiary care hospital of western Nepal. Methods: A prospective cross-sectional study was conducted in the outpatient department of Manipal Teaching Hospital of Western Nepal. The World Health Organization prescribing indicators and Beers’ 2015 updated criteria were assessed to analyze the result. Results: The mean±standard deviation of the age was 73.47±6.42 years and the majority of patients were in the age group 65–74 (58.81%). Male preponderance (male: female=1.20:1) was found. The value of prescribing indicator includes the average number of drug per prescription (4.91), percentage of generic name prescription (3.40%), percentage of antimicrobials prescribed (19.40%), percentage of injections prescribed (2.70%), and percentage of the drug from essential drug list of Nepal (42.22%). At least one PIM was prescribed to 87 (21.6%) patients. Non-cyclooxygenase-selective nonsteroidal anti-inflammatory drugs (44%) and anticholinergics (18%) were the most frequently prescribed PIMs. Conclusions: Polypharmacy, PIMs, and potential drug-drug interaction were prevalent in this study. It is recommended that all the doctors, pharmacists, other concerned health-care professionals, patients, policymakers, and all other stakeholders must be aware of these situations and a multidisciplinary approach must be developed for the promotion of rational use of drugs.


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