scholarly journals Prescribing pattern of ophthalmological medication in geriatric inpatients of a tertiary care hospital

2019 ◽  
Vol 8 (5) ◽  
pp. 940
Author(s):  
Sudhindra Prathap A. ◽  
Radhika M. S. ◽  
Reethesh Kumar Rai
Keyword(s):  
Tertiary Care ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Essential Drug List ◽  
Topical Analgesics ◽  
Male Patients ◽  
Health Organization

Background: Older people are potentially at greater risk of medication error. Gaining insight into the prescribing pattern especially in eye diseases as they are a common problem in elderly, in order to identify prescribing related problems is the fundamental step in improving the quality of prescription and patient care.Methods: Prescriptions fulfilling inclusion criteria were collected from hospital Medical record department (MRD) and analyzed using the World Health Organization (WHO) core prescribing indicators for rationality of prescriptions.Results: Among 811 prescriptions analysed, 52.7% (428) were of male patients, those aged 60-70 years were 77.2% (626) and patients with only cataract constituted 77% (625). Prescriptions with oral antibiotics were 57.1% (334); topical antibiotics were 35.8% (429) and topical analgesics 46.2% (553). Out of 1182 FDCs noted, 59% (479) were found to be rational and 34.6% (281) were from Essential Medicines List 2014. Only 2% (61) drugs were prescribed using generic name while 64.06% (1606) of drugs were from the WHO Model List of Essential Medicines (April 2015). Average number of drugs per encounter was 3.7. Percentage of encounters with antibiotics was found to be 43.8% and no prescriptions with injections were noted.Conclusions: Although usage of antibiotics and topical drugs was conforming to WHO recommended standards, there is a need to improve prescription pattern by using generic names and drugs from Essential Drug List.

scholarly journals Study of drug prescription pattern and adverse drug reaction monitoring in patients with hypertension and diabetes visiting outpatient department in a government tertiary care hospital in Maharashtra, India

2019 ◽  
Vol 8 (6) ◽  
pp. 1430
Author(s):  
Rucha M. Shinde ◽  
Anand S. Kale ◽  
Mahadeo P. Sawant
Keyword(s):  
Tertiary Care Hospital ◽  
Drug Prescription ◽  
Tertiary Care ◽  
Brand Names ◽  
Outpatient Department ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Cross Sectional

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.

scholarly journals The prescribing pattern for the management of dengue fever in pediatric patients of a tertiary care hospital: an observational study

2018 ◽  
Vol 7 (12) ◽  
pp. 2384
Author(s):  
Shruthi Rammohan ◽  
Basavaraj Bhandare ◽  
Adarsh E. ◽  
Satyanarayana V.
Keyword(s):  
Observational Study ◽  
Dengue Fever ◽  
Health Hazard ◽  
Tertiary Care ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Rational Use ◽  
Regulatory Bodies

Background: Dengue fever is a mosquito borne viral infection which has become a global health hazard, especially in tropical and subtropical areas. Children have higher risk of developing severe forms of dengue fever, however, studies show that paediatric complications/fatalities from dengue fever are potentially avoidable by proper management. Data about drug usage patterns for dengue are particularly lacking, especially in the paediatric age group, therefore this study will help facilitate the rational use of drugs and aid in establishing a more specific management for dengue fever. The objective of the present study was to identify the prescribing pattern of dengue fever in paediatric inpatients admitted to RajaRajeswari Medical College and Hospital and assess according to the WHO core prescribing indicatorsMethods: This prospective observational study took place from March 2017 to September 2017 in the paediatric general wards. Data was collected from case files of NS1 positive patients of both genders between 1-18years. Data was analysed using descriptive statistics and expressed as percentages, means and standard deviations. The prescription pattern was analysed using the prescribing indicators mentioned in the World Health Organization core drug use indicators.Results: Total of 300 drugs were prescribed for 110 prescriptions that were analysed excluding IV fluids and blood products. Mean number of drugs prescribed was 2.7±0.8. Drugs prescribed by a generic name was 7.33%. Patients prescribed an antibiotic was 12.73%. Patients prescribed with an injection was 62.72% Majority of drugs prescribed in this study come from essential medicines list created by regulatory bodies. Intravenous fluids were administered to all patients with majority receiving normal saline (60.9%).Conclusions: Mainstay of treatment of dengue fever for paediatric patients is symptomatic along with focus on fluid management. Majority of drugs prescribed are from essential medicines lists formed by regulatory bodies. With dengue infections being a worldwide health hazard, more studies are needed to facilitate rational use of drugs in this disease.

scholarly journals Medication use pattern and quality assessment of psychiatry outpatient department prescriptions of a tertiary care hospital

2019 ◽  
Vol 8 (2) ◽  
pp. 211
Author(s):  
Ayan K. Pati ◽  
Siddhartha Ghosh
Keyword(s):  
Psychotropic Drugs ◽  
Tertiary Care ◽  
Treatment Guideline ◽  
Essential Medicine ◽  
World Health ◽  
Fixed Dose ◽  
Family Welfare ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Health Organization

Background: Psychiatric illness is a major but often underreported health burden. The field of psychopharmacotherapy is continuously evolving therefore needs monitoring to prevent irrationality. In this setting, authors analyzed the prescribing pattern of psychotropic drugs while simultaneously monitoring prescription quality in a tertiary care teaching private hospital.Methods: A 6 month-prospective observational study was conducted in psychiatry out-patient department. Prescription pattern was analyzed using World Health Organization (WHO) drug use indicators. The quality of the prescriptions was assessed as per prescription writing guidelines issued by The Department of Health and Family Welfare, Government of West Bengal.Results: Of the 745 prescriptions analyzed, depression and psychosis constituted the bulk of diagnosed cases irrespective of any gender predominance. The average number of psychotropic drugs per prescription was 2.85±1.48. Antidepressants, sedative-hypnotic and anxiolytics are most commonly prescribed drugs. 37.58% of psychotropic drugs were given as fixed dose combination, most common being risperidone with trihexyphenidyl. Only 2.91% of the drugs were prescribed in generic name whereas 53.99% were enlisted in national essential medicine list 2015. Polypharmacy and therapeutic duplication were noted in 41% and 26.84 % of prescriptions and dose, duration and frequency were not mentioned in 2.68%, 53.02% and 19.00% of the prescription respectively.Conclusions: Use of psychotropic drugs follows closely with different treatment guideline, though routine uses of central anticholinergics with atypical antipsychotics are not recommended. Despite high utilization of NLEM, more generic prescribing, correct prescription dosing schedule, avoidance of polypharmacy and non-Judicious use of multivitamin FDCs may significantly improve treatment outcome.

scholarly journals Analysis of Essential Medicines Used for Emergency Care in Pakistan

2020 ◽  
Vol 1 (1) ◽  
pp. 75-77
Author(s):  
Talha Khalid ◽  
Amna Khokhar ◽  
Naseem Jehan ◽  
Umar Sultan ◽  
Arooj Fatima
Keyword(s):  
Health Care ◽  
Health Care Systems ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Care Needs ◽  
Cross Sectional ◽  
Health Organization

Introduction: According to the World Health Organization (WHO), essential medicines (EM) have the ability to meet the health care needs of maximum individuals. High accessibility to essential medicines (EM) was proposed under the Millennium Development Goal. The access to high quality, suitable, and inexpensive essential medicines is an essential constituent of health care systems. Methodology: This retrospective cross-sectional observational study was performed at Jinnah Hospital Lahore from February 2018 to November 2018, for analysis of essential medicine usage in a public sector tertiary care hospital of Pakistan. The data were collected from records of patients admitted in the emergency department. Results: Drugs prescribed per encounter were estimated to be 3. Most patients got a single antibiotic, and cephalosporin was the most commonly prescribed antibiotic. Conclusion: The concept of essential drugs has gained high acceptance, but the EMs should be prescribed logically, appropriately and should be in line with WHO guidelines.

scholarly journals PRESCRIBING PATTERN AND APPROPRIATENESS OF PRESCRIPTION AMONG ELDERLY PATIENTS IN A TERTIARY CARE HOSPITAL OF WESTERN NEPAL – A PROSPECTIVE CROSSSECTIONAL STUDY

2020 ◽  
pp. 126-131
Author(s):  
SAGARANANDA GIRI ◽  
GULAM MUHAMMAD KHAN
Keyword(s):  
Elderly Patients ◽  
Health Care Professionals ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
World Health ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Essential Drug List

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.

scholarly journals DRUG UTILIZATION STUDY IN POST-OPERATIVE PATIENTS IN THE SURGERY WARD OF A TERTIARY CARE TEACHING HOSPITAL IN SOUTH INDIA

2018 ◽  
Vol 11 (12) ◽  
pp. 124
Author(s):  
Mohammad Arshad ◽  
Raghunandan M ◽  
Vasant R Chavan ◽  
Mohd Fayazuddin
Keyword(s):  
Drug Utilization ◽  
Teaching Hospital ◽  
General Pattern ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Case Record ◽  
Health Organization

Objectives: Pharmacotherapy with multiple agents before, during, and after surgery is marked in the present day indoor hospital setting. The main objective of our research is to evaluate the prescribing and drug utilization patterns using the World Health Organization (WHO) indicators in post-operative patients in the surgery ward of Raichur Institute of Medical Sciences (RIMS) teaching hospital - Raichur, which will help us to use the medicines rationally and decrease the adverse effects in surgical patients.Methods: A retrospective study was done on post-operative patients of surgery ward in RIMS teaching hospital - Raichur. A total of 574 patients prescriptions/case record forms were collected over a period of 15 months from January 2015 to March 2016 from the medical record section of the hospital for analysis and rationalization. We analyzed the data using the various drug use indicators given by the WHO.Results: The average number of drugs per encounter was 7.04. Ranitidine, analgesics, antibiotics, and intravenous fluids accounted for majority of the drugs prescribed. Appendicectomy (34.84%) was most commonly performed surgical procedure. Percentage of encounters in which an antibiotic prescribed was 99.8%. Percentage of encounters with an injection prescribed was 100%. Percentage of drugs prescribed by generic name was 43.93%. Percentage of drugs prescribed from National List of Essential Medicines 2015 was 99.3%.Conclusion: Our study gave us an in general pattern about the use of drugs in post-operative patients in the surgical ward of a tertiary care hospital. Widespread polypharmacy, particularly in case of the antibiotics, lack of generic prescribing are some concerns that need to be addressed to conform to rational drug therapy. However, prescribing according to the national essential list of medicines is good in our study.

scholarly journals A pilot study comparing pattern of damage sustained among instruments from different surgical units in a tertiary care centre in Nepal – reappraising the role of instrument reprocessing in retaining their value

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 102
Author(s):  
Sunil Munakomi ◽  
Roshan Shah ◽  
Sangam Shrestha
Keyword(s):  
Tertiary Care ◽  
Health Spending ◽  
Pivotal Role ◽  
World Health ◽  
Tertiary Care Centre ◽  
Surgical Equipment ◽  
Surgical Units ◽  
Wear And Tear ◽  
Health Organization

Background: The quality of instruments plays a pivotal role in governing safe operating room culture. The reprocessing system followed in the institution determines their durability thereby ensuring patient safety as well as minimizing health spending. Rigorous reprocessing in a centralized instrument reprocessing department by well trained staff following formulated guidelines helps to achieve the target of “safe surgery saves lives” as formulated by the World Health Organization. Methods: We sought to determine the patterns of wear and tear sustained among sets of surgical equipment from two surgical units that had been sent to the repair department within a year of their purchase. Analysis of similar changes in the joints of the instrument, as well as pattern of fractures sustained was performed. Results: All patterns of wear and tear were common in both the general surgical arm and neurosurgical counterpart, with the exception of fractures and mal-alignments. Similar study was performed examining changes in the joints. Stains were the most commonly observed change pattern in both sets of instruments. Fractures were most frequent in the working ends in both sets of instruments. Conclusion: There is an alarming incidence of wear and tear patterns in the instruments used in the surgical units, even within the first year of their use. This supports the strict implementation of reprocessing guidelines by well trained workers and their quality assessments via audit checks. The quality of the purchased instruments also plays a pivotal role.

scholarly journals Evaluation of rational drug use pattern using WHO prescribing indicators in a medical intensive care unit of a tertiary teaching hospital in Kerala, India

2017 ◽  
Vol 6 (6) ◽  
pp. 1328
Author(s):  
Shobha P. ◽  
Messaline Sunitha
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Prescribing Practices ◽  
Essential Drug ◽  
Prescribing Pattern ◽  
Respiratory Problems ◽  
Essential Drug List ◽  
Drug List ◽  
Tertiary Teaching ◽  
Set Up

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.

Increment in Phototherapy After Adopting Delayed Cord Clamping Practice

2021 ◽  
pp. 097321792110607
Author(s):  
Chinmay Chetan ◽  
Nishant Banait ◽  
Vikramaditya Athelli ◽  
Bhvya Gupta ◽  
Prince Pareek ◽  
...  
Keyword(s):  
Tertiary Care ◽  
World Health ◽  
Care Hospital ◽  
Delayed Cord Clamping ◽  
Term Infants ◽  
Cord Clamping ◽  
Early Cord Clamping ◽  
Baseline Characteristics ◽  
Health Organization ◽  
Larger Sample

Introduction: World Health Organization (WHO) in 2014 recommended delayed cord clamping (DCC) in all babies who cry immediately after birth. Despite many benefits, there are concerns of increased rate of phototherapy in babies receiving DCC. This study was done to determine the increment in the rate of phototherapy required in infants managed with DCC vs infants managed with early cord clamping (ECC). Methods: A retrospective observational study was conducted in a tertiary care hospital in Pune, India. All the infants born between January 2018 and July 2018, for whom ECC was done, were compared with infants who were born between January 2019 and July 2019, after DCC policy was adopted. All the infants with birth weight ≥2 kg and gestation ≥35 weeks, who were with their mother, were included. Baseline characteristics were compared for both the groups. American Academy of Pediatrics guidelines for treatment of neonatal jaundice were used to determine the need for phototherapy. Number of infants in both the groups who required phototherapy were compared. Results: The ECC group had 565 infants while DCC group had 731 infants. There was no difference in the baseline characteristics of the 2 groups. Jaundice requiring phototherapy was noted in 31% of infants in the ECC group, compared to 45% in infants in the DCC group (relative risk: 1.47 [1.27-1.71] [ P < .001]). Conclusion: In this study, DCC increased the need for phototherapy by 47% in late preterm and term infants. Randomized control trials with larger sample size are required to confirm this finding.

scholarly journals DRUG UTILIZATION STUDY IN OPHTHALMOLOGY OUTPATIENT DEPARTMENT IN A GOVERNMENT TERTIARY CARE HOSPITAL IN MAHARASHTRA

2018 ◽  
Vol 11 (7) ◽  
pp. 167
Author(s):  
Nishandar Tb ◽  
Kale As ◽  
Pise Hn ◽  
Jambhrunkar Sd
Keyword(s):  
Drug Utilization ◽  
Drug Exposure ◽  
Tertiary Care Hospital ◽  
Drug Prescription ◽  
Tertiary Care ◽  
Outpatient Department ◽  
Essential Medicines ◽  
World Health ◽  
Care Hospital ◽  
Age Group

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.

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