scholarly journals Drug utilization pattern among geriatrics according to anatomical therapeutic chemical and defined daily dose classification in a tertiary care hospital

2019 ◽  
Vol 8 (9) ◽  
pp. 1989
Author(s):  
T. Muneswar Reddy ◽  
Thammi Setty Durga Prasad ◽  
Allikesam Hemalatha ◽  
Vanam Chanukya ◽  
Bandi Lakshmi Sirisha
Keyword(s):  
Drug Utilization ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Care ◽  
Essential Medicines ◽  
World Health ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Utilization Pattern ◽  
Geriatric Population ◽  
Daily Dose

Background: This study was conducted to determine the drug utilization pattern among geriatric inpatients in general medicine department of the hospital.Methods: An observational, prospective study was conducted for a period of six months (November 2016 to April 2017) among 200 geriatric patients; demographic details, education, occupation, diagnosis and drug details were recorded. The drugs were categorized by anatomical therapeutic classification (ATC) and defined daily dose (DDD) was calculated. The World Health Organization (WHO) prescribing indicators were assessed.Results: The majority of the patients (59%) were in age group of 60-69 years. Cardiovascular diseases were common among geriatrics. Most commonly prescribed drug was Pantoprazole (81.7%). Drugs were assigned with ATC/DDD codes according to the guidelines of WHO. Drugs prescribed by their generic names were 56.64% and 43% of drugs that were included in the National Essential Medicines List.Conclusions: Clinical pharmacist have to collaborate and work together with physicians in selecting and adjusting the dose among geriatric population in order to reduce development of potential adverse drug reactions, serious drug related complications and drug interaction.

scholarly journals Study on antibiotic use among geriatric patients based on anatomical therapeutic classification or defined daily dose methodology and world health organization-essential medicine list access, watch and reserve concept in tertiary care hospital of South India

2020 ◽  
Vol 9 (7) ◽  
pp. 1106
Author(s):  
Subash Senthilkumar ◽  
Arun Raaj S. A. ◽  
Padmavathi K. ◽  
Dhanapal C. K. ◽  
Periasamy K.
Keyword(s):  
Geriatric Patients ◽  
Tertiary Care ◽  
Essential Medicine ◽  
Antibiotic Use ◽  
Essential Medicines ◽  
World Health ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Daily Dose ◽  
Tract Infections

Background: Geriatric patients are more vulnerable to infections and need special consideration on antibiotic use. Resistance to antibiotics among infectious bacteria has developed within a short span. There is a direct correlation between the consumption of antibiotics and the development of resistance. And surprisingly very few literatures were available on antibiotic consumption in geriatric population using defined daily dose (DDD) concept which paved the idea to conduct this study.Methods: A prospective observational study was carried out from November 2018 to April 2019. A total of 206 prescriptions of elderly patients were included in the study. The antibiotics were categorized by anatomical therapeutic classification (ATC) and DDD indicator/1000 inhabitants/day (DID) was used to figure out antibiotic consumption.Results: About 25.2% of patients were treated with antibiotics for respiratory tract infections. The patients received antibiotics empirically (53.8%) and without bacteriological investigation (58.73%). The overall consumption of antibiotics was 20.47 DID in which oral antibiotics was (8.5 DID) 42% and parenteral antibiotics (11.8 DID) 58%. Cephalosporins was observed to be the most consumed antibiotics (33.2%), specifically cefotaxime (14.6%) and ceftriaxone (12.6%). Moreover, 54.4% of antibiotics consumed from watch category of World Health Organisation (WHO) essential medicines list (EML) which was completely against WHO standard proportion.Conclusions: Higher consumption of cephalosporins, which falls into watch category was analysed in geriatric patients. These broad-spectrum antibiotics have high potential to develop antimicrobial resistance. A strict antibiotic policy is needed to be framed that enhance rational prescribing practices in geriatrics.

scholarly journals Assessment of drug utilization among geriatric patients based on defined daily dose concept in a rural tertiary care teaching hospital

2020 ◽  
Vol 9 (10) ◽  
pp. 1538
Author(s):  
K. Padmavathi ◽  
S. A. Arun Raaj ◽  
S. Subash ◽  
C. K. Dhanapal ◽  
S. Periasamy
Keyword(s):  
Drug Utilization ◽  
Geriatric Patients ◽  
Anatomical Therapeutic Chemical ◽  
Tertiary Care ◽  
Defined Daily Dose ◽  
College Hospital ◽  
Care Teaching ◽  
Essential Drug List ◽  
Daily Dose ◽  
Collection Form

Background: The objectives of the study were to use the anatomical therapeutic chemical classification (ATC) /defined daily dose (DDD) concept to study the drug utilization pattern in geriatric patients in a rural tertiary care teaching hospital.Methods: An observational study was conducted at Rajah Muthiah Medical College Hospital (OPD and IPD) over a period of six months from November 2018 to April 2019. The data was collected from 204 patients using specially designed data collection form. The patients were selected based on inclusion and exclusion criteria. Results: A total of 204 patients were included in this study. The study population consisting of males 130 (63.7%) and females 74 (36.2%). Diseases related to the cardiovascular system 67 (32.84%) were the most common cause for the geriatric patients to attend the hospital, followed by surgical diseases 47 (23.03%), Oncological diseases 2 (0.98%) were the least frequency encountered. The average number of drugs prescribed per prescription was 8.79. Out of 1795 drugs prescribed, 60.86% of drugs were prescribed in generic form, and 39.14% were prescribed in brand name. The study analysed that 71.25% of drugs prescribed were from essential drug list (EDL) 2016-2018. Number of prescriptions with an injection was 74.04%. Paracetamol (N02B01) was the most frequently prescribed drug, followed by Amlodipine (C08CA01), Dexamethasone (H02AB02), Clopidogrel (B01AC04), Ferrous sulfate (B03AA07), Acetylsalicylic acid (B01AC06), Hydrocortisone (H02AB09), Tamsulosin (G04CA02), Atorvastatin (C10AA05), Furosemide (C03CA01).Conclusions: Drug utilization study can help in evaluating the quality of care given to the geriatric patients and promote rational use of medicines.

scholarly journals Drug utilization pattern and appropriateness of prescription in IPD geriatric patients in a tertiary care teaching hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 55
Author(s):  
Shuchisuta P. Pathy ◽  
Sachchidanand Pandey ◽  
Bhabagrahi Rath ◽  
Rinu Rani Dash
Keyword(s):  
Drug Use ◽  
Drug Utilization ◽  
Geriatric Patients ◽  
Tertiary Care ◽  
World Health ◽  
Potentially Inappropriate Medications ◽  
Utilization Pattern ◽  
Geriatric Population ◽  
Prescribing Indicators ◽  
Inappropriate Medications

Background: Drug utilization research provides insights into different aspects of drug use and drug prescribing such as pattern, quality, determinants and outcomes of drug use. Polypharmacy is considered to be hazardous for the elderly, because of their greater vulnerability to drugs and multiple drug use. Prescription of potentially inappropriate medications (PIMs) has been found to be a common cause of morbidity and mortality among the geriatric population and has necessitated the creation of criteria for the safe use of medicines among them. Objectives of the study were to assess the drug utilization pattern in geriatric patients and analyse their prescriptions as per the World Health Organization (WHO) core prescribing indicators and STOPP and START criteria.Methods: An observational, cross-sectional study was conducted from May 2019 to August 2019 in inpatient department of general medicine of VIMSAR, Burla. Prescriptions of ≥65 year patients were collected and documented by active surveillance from the medicine ward.Results: Majority of the patients were in age group of 65-75. Stroke is the more common comorbidities among geriatric population. Average number of medication per prescription is 5.42. About 78.74% of drugs are injectable. The percentage of antibiotics prescribed to patient is 27.75%. Based on STOPP criteria potentially inappropriate medications PIM is 7% and START criteria PIM is 29%.Conclusions: Our study suggests that prevalence of polypharmacy was high which is usually unavoidable in geriatric patients and less PIM is suggestive of adherence to WHO core prescribing indicators, and prescription of drugs as per STOPP and START guidelines are indicative of scope for improvement.

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.

scholarly journals Analyzing Antidiabetes Drug Prescriptions With World Health Organization Anatomical Therapeutic Chemical/Defined Daily Dose Index to Assess Drug Utilization Pattern in Elderly Population of Rural Eastern India

2017 ◽  
Vol 8 ◽  
pp. 117739361770334 ◽  
Author(s):  
Sandeep Lahiry ◽  
Avijit Kundu ◽  
Ayan Mukherjee ◽  
Shouvik Choudhury ◽  
Rajasree Sinha
Keyword(s):  
World Health Organization ◽  
Drug Utilization ◽  
West Bengal ◽  
Anatomical Therapeutic Chemical ◽  
World Health ◽  
Defined Daily Dose ◽  
Prescription Data ◽  
Daily Dose ◽  
Health Organization

Objective: To analyze drug utilization (DU) pattern of antidiabetes drug (ADD) prescription in elderly type 2 diabetes mellitus (T2DM) in rural West Bengal based on 2016 World Health Organization (WHO) Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) Index. Methods: This was a prospective observational study. Prescription data of 600 elderly patients (age > 60 years) attending outpatient clinic were screened over 12 months (January 2015 to January 2016) from 5 different rural hospitals in West Bengal. Pooled data were sorted and classified in accordance with 2016 ATC/DDD WHO Index. Direct cost associated and consumption of ADD were measured as DDD/1000 patients/day. The adverse drug reactions (ADRs) related to antidiabetic medicines were monitored. Results: During the study period, mean age of patients recorded was 66.4 ± 5.0 years, with 66.6% (n = 396) having history of T2DM > 5 years. Follow-up encounters (n = 2328) revealed metformin (94.67%), sulfonylureas (SUs) (50.54%), pioglitazone (24.22%), voglibose (22.50%), insulin (9.75%), and acarbose (6.82%) to be more prevalent, constituting DU 90% (92.01%). Combination of metformin plus SU was recorded in most of the patients (56%). Insulin, however, was found to be an underutilized class ( P < .005). The DDD/1000 patients/day of metformin (2.918), glimepiride (1.577), and gliclazide (0.069) conformed to 2016 WHO ATC/DDD Index. The total ADD consumption during study period was 5.03 DDD/1000 patients/day. The average drug cost per encounter per day was Rs 11.24 ± 2.01. Nineteen ADRs were reported and their descriptions were found to be of hypoglycemia (n = 9), pedal edema (n = 2), and gastrointestinal upsets (n = 8). Target glycemic status was achieved in 40% monthly follow-up encounters. Low-store drug availability and poor compliance to treatment (>60%) were major determinants. Lack of regular aerobic exercises (>85%) and proper knowledge regarding medical nutrition therapy (MNT) (>80%) and low average consultation time (3.5 ± 0.6 minutes) were important contributing factors. Conclusions: The study exhibited increased utilization of 2 drug combinations of oral ADD and lower utilization of insulin during study period. Such inferences merit further exploration.

scholarly journals DRUG UTILIZATION EVALUATION OF BENZODIAZEPINES IN A TERTIARY CARE HOSPITAL

2019 ◽  
pp. 6-9
Author(s):  
P. RAMA ◽  
R. MONISHA ◽  
SUSAN VARGHESE PAUL ◽  
VARSHA ELSA SCARIA ◽  
P. JANANI ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Anatomical Therapeutic Chemical ◽  
Low Cost ◽  
Tertiary Care ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Probability Scale ◽  
Related Information ◽  
A Prospective Study ◽  
Drug Utilization Evaluation

Objective: To assess the rationale use of benzodiazepines among various departments in a multi-speciality hospital. Methods: A prospective study was conducted with a sample size of 200 for a period of six months. Data was collected from patients based on inclusion and exclusion criteria. Naranjo Adverse Drug Reaction Probability Scale and Drug Interaction Probability Scale (DIPS) were used as a study tool to measure the causality of adverse drug reactions and drug interactions. Based on the dosage of various benzodiazepines DDD was calculated and compared with WHO Anatomical Therapeutic Chemical (ATC) classification Defined Daily Dose (DDD). Results: BZD’s were mostly prescribed in males (74.5%) and married patients (86.5%) were more exposed to benzodiazepines compared to others. Lorazepam (70.1%) was found to be the most commonly used drug, mainly prescribed for sedation, followed by anxiety. DDD was calculated and majority of patients had DDD in accordance with WHO standard. Based on cost analysis, Clobazam was found to be the high cost and Lorazepam being the low-cost drug. The results of drug utilization evaluation of benzodiazepines study were compiled and reported to the respected department physician and their feedback was collected. Conclusion: The study showed a rational utilization of benzodiazepines and the negative outcomes of BZDs can be reduced by providing drug-related information to the prescribers and consumers.

scholarly journals Drug utilization pattern in geriatric out patient in tertiary care hospital

2017 ◽  
Vol 6 (8) ◽  
pp. 2078
Author(s):  
Rakesh R. Jadhav ◽  
Asha D. Jadhav ◽  
Sudhir L. Padwal ◽  
Anand S. Kale ◽  
Harshal N. Pise
Keyword(s):  
Drug Utilization ◽  
Tertiary Care ◽  
General Medicine ◽  
Prescribing Patterns ◽  
World Health ◽  
Inappropriate Drug ◽  
Care Hospital ◽  
Utilization Pattern ◽  
Cross Sectional ◽  
The Mean

Background: Inappropriate drug prescribing is a global problem affecting the healthcare system. Aim and objective of the study was to study the drug utilization pattern in geriatric patient at rural tertiary care hospital.Methods: This was a cross- sectional observational study involving 600 geriatric outpatient. This study was carried out from Nov 2015 to May 2016. The data were collected using predesigned proforma specially designed for this purpose. Relevant information was obtained by analyzing prescription for World Health Organization (WHO) core drug indicators.Results: Total number 600 prescriptions analyzed at the end of six months were from general medicine department. The mean age of the patients was 63.9 years in which male (61.33%) outnumber the female. Total number 2598 drugs were prescribed to 600 patients for different diseases. The mean number of drugs per prescription were 4.33, drugs were prescribed by generic name 26.42%. drugs were prescribed from WHO essential drug list86.33. The type of formulations used were tablets and capsules in 88.5%, syrups in 5%, injections 3.5 % and inhalers 2%. Drug for Cardiovascular diseases were the most common (29.66) followed gastrointestinal (16.67), vitamins and minerals (14.66). Analgesic and NSAIDS (14.13) also prescribed commonly. Antimicrobial drugs prescribed in (7.46%) and common antibiotic prescribed were Amoxicillin ciprofloxacin and metronidazole.Conclusions: This study also effectively provides very useful baseline data also demonstrates the prescribing patterns of drugs in the geriatric patients.

scholarly journals Study of drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of tertiary care hospital

2018 ◽  
Vol 7 (2) ◽  
pp. 259
Author(s):  
Aruna Gurung ◽  
Jugalkishore B. Jaju ◽  
Ganesh R. Pawar ◽  
Shrikant C. Dharmadhikari ◽  
Rajvardhan R. Solunke
Keyword(s):  
Drug Utilization ◽  
Adverse Drug Reactions ◽  
Psychotropic Drugs ◽  
Tertiary Care ◽  
Psychiatric Inpatient ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Drug Reactions ◽  
Utilization Pattern ◽  
Inpatient Department

Background: Mental disorders are now widely recognized as a major contributor to the global burden of disease. The drug use in psychiatric illness is a complex process and because of this the optimal benefits of drug therapy in patient care is not achieved. This often leads to increased cost of medical care, drug resistance, adverse effects and patient mortality. Hence, this study is undertaken to study the drug utilization pattern and adverse drug reactions of psychotropic drugs in psychiatric inpatient department of a tertiary care hospital.Methods: A prospective, observational study was undertaken from 1st February 2015 to 31st July 2016. A total of 250 prescriptions were analysed. Defined daily dose of the drugs were calculated. ADR’s were recorded in the format of the National Pharmacovigilance Programme of India (PvPI).Results: In 250 prescriptions most, common drug prescribed was antipsychotics (48.5%). Total drug utilization in terms of DDD/100 bed days was 669. The total number of adverse drug reactions observed was 8%. Antipsychotics were the most common class of psychotropic drugs causing ADR’s.Conclusions: In conclusion, it has been found that the psychotropic drugs used in our psychiatry department was rational and was based on clinical knowledge, expertise and the guidelines available in the field of psychiatric practice.

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