scholarly journals Drug utilization study of anti-hypertensive drugs at a tertiary care hospital

Author(s):  
Pritpal Singh Ahluwalia ◽  
Mirza Shiraz Baig ◽  
Meenakshi Bhattacharya

Background: The increasing prevalence of hypertension influence the prescribing patterns of antihypertensive drug. Prescribing against evidence-based guidelines in hypertension treatment leads to the increase cost of medications and problems in providing affordable prescriptions to population. The aim of present study was to analyse anti-hypertensive prescribing pattern in Government Medical College and Hospital, Aurangabad, Maharashtra, India.Methods: Study was prospective, observational, open label and descriptive clinical study. It included 336 patients admitted in MICU during January 2018 to June 2019 fulfilling inclusion criteria.Results: 54.46% patients were between 51-70 years of age, followed by 33.63% in 31 to 50 age group. Of total enrolled hypertensive patients 69% patients had various comorbidities. Drug prescribed was 28.27% ARBs, 26.84% CCBs, 17.62% beta blockers, 6.14% high ceiling diuretics, 4.50% ACE inhibitors, 2.45% thiazide diuretics and 2.04% received alpha blocker. As monotherapy, 31.82% patients received telmisartan as most commonly prescribed drug followed by 27.31% patients received Amlodipine followed by other drugs. In combination therapy telmisartan and hydrochlorothiazide was prescribed most commonly followed by beta blocker and CCB and ARB and CCB. 33.60% of drugs were prescribed in generic names while 66.39% of drugs prescribed in brand names. Average number of drugs prescribed per prescription was 1.45 of which 33.60% of drugs were prescribed by generic names.Conclusions: With average number of drugs per prescription in hypertension 1.45, the study showed that poly pharmacy is unavoidable in hypertension due to associated comorbid conditions.

Author(s):  
Pritpal Singh Ahluwalia ◽  
Mirza Shiraz Baig ◽  
Amarnath Awargaonkar ◽  
Varsha Nandedkar

Background: Drug utilisation studies in present clinical practice have played significant role to promote rational drug use in the current health care system. The aim of present study was to analyse the prescribing pattern of drugs for various ocular conditions in Ophthalmology Department of Government Medical College and Hospital, Aurangabad, Maharashtra, India.Methods: Study was prospective, observational open label and descriptive clinical study which included 100 patients in OPD and IPD during November 2018 to February 2019 fulfilling inclusion criteria.Results: Out of the 100 study subjects, 56% were males and 46% were females, with the maximum number of patients falling in the age group 61-80 years. 38.26% patients received antibiotics as most prescribed drug while 69 % patients received analgesics and 47% anti-inflammatory. Among the antibiotics prescribed, fluoroquinolones were the most prescribed antimicrobial class. WHO prescribing indicators as analysed from the data collected were: average number of drugs per prescriptions was 3.79. Percentage of medicines prescribed by branded name- 33.79% and generic were 66.21%. 54% of the total drugs prescribed were from the National List of Essential Medicines 2017.Conclusions: Ocular ailments and conditions are frequently associated with high levels of utilization of drugs for their treatment. Thus, analysis of utilization of these drugs becomes very essential. In the present study, the drugs prescribed at our tertiary care hospital were found rational.


Author(s):  
Neeta Sawhney ◽  
Vineeta Sawhney ◽  
Vijay Khajuria

Background: The objective of the study was to study the prescribing pattern of the antibiotics in postoperative patients admitted in gynaecology and obstetrics.Methods: Current prospective observational study was conducted in the department of pharmacology, Government Medical College, Kathua in collaboration with department of gynaecology and obstetrics for a period of six months duration from 1st May 2019 to 31st October 2019. The case sheets of all post operated patients above eighteen years of age admitted were studied and analyzed.Results: Total of 1807 case sheets were analyzed and showed that 4245 antibiotics were prescribed with an average of 2.3 antibiotics prescribed. Oral cefuroxime (17.3%) was maximally prescribed in patients who delivered normal presentation with episiotomy and injection ceftriaxone along with tinidazole and gentamycin were prescribed (58.4%) where caesarean section was done. While injection ceftriaxone and sulbactum along with tinidazole and gentamycin (17.09%) was prescribed in patients who were operated for gynaecological diseases. Maximum (80%) of the antibiotics were prescribed under brand name.Conclusions: Cephalosporin’s are commonly prescribed antibiotic and in eighty percent brand names were prescribed. Results underscore that antibiotic in generic name should be encouraged.


Author(s):  
SABISHRUTHI S ◽  
KAVITHA S ◽  
JAGAN NATHAN B ◽  
KALICHETI PRIYANKA ◽  
ARSHATH A

Objective: Our objective of the study was to evaluate the prescribing patterns of drugs with cost analysis in pediatric inpatients at tertiary care hospital. Methods: It is an observational prospective study carried out in pediatric inpatients with a sample of 180 patients based on age, inclusion, and exclusion criteria for period of 3 months. The patient’s data were collected using patient case record form and analysis of the data was done. Results: Of 180 patients data were collected, the results show that majority of gender admitted in the hospital were male children 94 (52%) and many are from age group of early childhood (2–5 years) 67 (37%). Respiratory tract infections are diagnosis most commonly analyzed and off overall 236 prescribed antibiotics cephalosporins 86 (43%) and combination of amoxicillin + clavulanic acid 25 (71%) is the class of antibiotics prescribed higher than other class of drugs. Parental 173 (73%) route of administration was observed to be followed more than other route. The percentage of cost variation of antibiotics observed in the study reveals that the huge variations were seen in the cost of medication in maximum and minimum cost. Conclusion: The present study reveals that the prescribed antibiotics were as per the diagnosis of the patient and not by proceeding proper culture sensitivity testing. Hence, awareness about antibiotic must be created among practicing physicians to increase the therapeutic compliance of the patient.


Author(s):  
Vinod S. Deshmukh ◽  
Swapnil P. Chube

Background: World Health Organization (WHO) has defined diarrhoea as, ‘the passage of loose stools by an individual, at least thrice a day or more frequently than normal’. It is most commonly caused by intestinal infection, mainly viral. Every year there are about 2 billion cases of diarrhoea worldwide, a second leading cause of mortality in children below the age of 5 years. WHO estimated that antibiotic treatment was necessary in only one in twenty cases of childhood diarrhoea. Yet huge resources are currently spent on anti-diarrhoeal drugs annually, most rendered useless or harmful. This study was proposed to evaluate the utilization pattern of drugs prescribed for diarrhoea in children, in a government tertiary care hospital in Maharashtra.Methods: This cross-sectional observational study was carried out in the paediatric ward of government tertiary care hospital, Maharashtra. All patients of age less than twelve years with diarrhoea admitted to paediatric ward within the study period of January 2015 - June 2016 were included in the study. Patients older than twelve years or admitted with other gastrointestinal diseases or co-mordbid conditions were excluded. Statistical analysis was done using descriptive statistics.Results: Majority of the patients admitted were males and more than half the patient population were in the age group of less than or equal to 3 years. Polypharmacy was found to be present in the prescribing pattern, with average, more than 4 drugs prescribed for diarrhoea treatment, in each prescription. Majority drugs were prescribed using brand names and parenteral route. Use of antibiotics was also found to be inappropriate in majority of the cases.Conclusions: The study highlighted the importance of drug utilisation studies and pointed out inappropriate drug prescribing trends for diarrhoea cases in a tertiary care hospital in Maharashtra.


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.


Author(s):  
SUMAN LATA ◽  
VIJAY KHAJURIA ◽  
VINEETA SAWHNEY ◽  
SANJAY SHAH

Objective: The objective of the present study was to examine the prescribing pattern of antibiotics in the outpatient department of medicine in a tertiary care hospital. Methods: This prospective observational study was conducted in department of pharmacology in collaboration with department of medicine of Govt Medical College Kathua for a period of one month. Prescription of all patients attending medicine OPD who were prescribed antibiotics was analysed. Results: A total of 450 prescription of OPD patients were analysed. Out of these 200 prescriptions of patients had antibiotics prescribed. 98% of prescriptions had oral antibiotics and other 2% were prescribed injectable antibiotics. 70 % of prescriptions were on the single antibiotic and in 30% of prescriptions, fixed-dose combination were prescribed. Cefpodoxime antibiotic was most commonly prescribed in the cephalosporin group, followed by amoxy-clavulanic acid, azithromycin. Irrational prescribing of antibiotics was 34% and it was quite high in our study. Conclusions: Cefpodoxime was most commonly prescribed in cephalosporin group among all antibiotics. Irrational prescribing was quite high in present study. Our result calls for the urgency of refresher courses like stewardship programmes regarding antibiotic use to avoid irrational usage.


Author(s):  
Venkatesh Perumal M. ◽  
Surendra Kumar Bouddh ◽  
Nirmal S. R. ◽  
Ashok Deshpande ◽  
Jai Singh ◽  
...  

Background: The Drug utilization research (DUR) compares drug use between different countries and regions and is used to assess the rationality of prescribing pattern of the drug therapy. With this background we decided to evaluate antipsychotic drugs prescribing pattern in the psychiatric patients in a tertiary care hospital.Methods: the study was carried out at Department of Psychiatry, DSMCH. It was open label, cross - sectional, prescribed Documents based study. Duration of the study was one month (May-2017). Out-Patient number, age, sex, diagnosis, prescribed generic name, brand name, dose, route of administration, duration of therapy obtained from the Prescription register of Out - Patient Department of the Psychiatry.Results: The clinical experiences of the Psychiatrist I, II and III were 17 years, 35 years and 10 years respectively. The Psychiatrist I, II and III prescribed treatment for 36 (31.9%), 61 (54%) and 16 (14.2%) patients respectively. Among overall (n=113) patients (average age 38.9 years), male n=56 (49.6%) and female=57 (50.4%) were treated by all the three psychiatrists. The percentage of prescription of various drugs used were: Escitalopram (15.7%), Clonazepam (14.6%), Sertraline (8.7%), Risperidone (7.5%), Propranolol (6.7%), Olanzapine (6.3%), Quetiapine (5.9%), Trihexyphenidyl (5.5%), Amitriptyline (5.1%) and Other prescribed drugs, were between (0.4 to 2.8%).Conclusions: From this study, it can conclude that rational usage of drugs were followed in this study. All three prescribers (Psychiatrist I, II, and III) prescriptions were found to be rationale.


Author(s):  
Indu Slathi ◽  
Pradeep R. Jadhav ◽  
Pooja Deb ◽  
Shashwat Verma

Background: Cardiovascular diseases are the most frequent cause of morbidity and mortality throughout the world particularly in South Asian population. With advent of newer, highly efficacious heterogeneous drugs and changing treatment guidelines, there’s a need to identify the cardiologist preference and prescribing patterns for rational utilization.Methods: It was an open label, prospective, cross-sectional, descriptive type of study conducted in Cardiology Outpatients at a Tertiary care hospital, Navi Mumbai. The study included 100 patients suffering from cardiovascular diseases attending cardiology outpatient department from October 2016 to March 2017. Informed consent was obtained and the currently prescribed drug details were recorded from prescription. The data was analysed for WHO core prescribing indicators and different types of drugs prescribed.Results: The average number of drug products prescribed was 3.4. Most commonly prescribed drugs were Antiplatelets (23%) followed by Statins (19.71%), β blockers (16%), Nitrates (11.70%), Angiotensin converting enzyme inhibitors (8.03%), Calcium channel blockers (5.50%), Angiotensin receptor blockers (4.70%), Diuretics (2.55%), Anticoagulant (1.83%), α+β blocker (1.46%), Cardiac glycosides ((1.09%), Potassium sparing diuretic and central sympatholytics. Majority of drugs were prescribed as single drugs (79.88%) while 20.11% as fixed dose combination (FDC). The combination of Telmisartan + Hydrochlorthiazide was the commonest prescribed FDC. Majority drugs were prescribed from NEDL 2015, but documented low generic prescribing.Conclusions: Antiplatelet and Statins dominated the prescribing pattern with high prescribing trend from national essential drug list, but showed scope for improvement in encouraging the cardiologist to prescribe by generic name.


Author(s):  
Anjani Teja Ch ◽  
Ramesh babu K ◽  
Leela subramanyam S ◽  
Janani Y ◽  
Eswar Sai Kiran K ◽  
...  

The descriptive observational study was conducted over six months among inpatients of the orthopaedics department. The aim is to observe the prescribing pattern of drugs, to find out the percentage of analgesics given and most commonly prescribed analgesic, to compare the prescribed drugs whether they are in NLEM, WHO list and calculate DDD/100 Bed-days and to analyze the drugs for WHO prescribing drugs. A total of 250 patients were included in the study. Out of this, 168 were male, and 82 were female. Most of the patients were in the age group of 31-40[45 in number with 18%]. The most common condition was found to fracture [113 in number with 95.2%]. Commonly prescribed drugs were analgesics 447 with 26.76%. Among all the NSAID's, PCM was most commonly prescribed analgesic with 34.4%. The highest no, of drugs was found to be 4drugs/prescription with 24%. Monthly one analgesic was prescribed per prescription with 38.8%. Utilization of analgesics in term of DDD/100 Bed-days was 55.26; Drugs will be evaluated per prescription as per prescribing indicators of WHO was done, the average no. of drugs per prescription was found to be 0.45, percentage of drugs prescribed by generic name was found to be 13.3%, percentage of encounters with antibiotics prescribed were found to be 94.4%, In ratio percentage of drugs prescribed from the national list of essential medicine was found to be 92.6%. This study would help to facilitate better health care delivery.


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