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 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 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 Prescribing trends of HMG Co-A reductase inhibitors in outdoor patients at tertiary care teaching hospital of central India: a retrospective observational study

2018 ◽  
Vol 7 (5) ◽  
pp. 1020
Author(s):  
Sudharam T. Bhagwate ◽  
Renuka S. Harwani ◽  
Dheeraj S. Jeswani ◽  
Sagar N. Yalgundee ◽  
Rupesh A. Warbhe
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Lipid Profiles ◽  
Prescribing Patterns ◽  
Common Disease ◽  
Defined Daily Dose ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Prescribing Trends ◽  
Daily Dose

Background: To analyze the prescribing patterns of statins a hypolipidemic agents by using HMIS database in outdoor patients at tertiary care teaching hospital of central India.Methods: In this retrospective study Using HMIS database, 1000 prescriptions were analyzed for statin use for various WHO prescription indicators using ATC code of statins, the ratio of prescribed daily dose (PDD) and defined daily dose (DDD) was calculated.Results: Atorvastatin was the only statin which was prescribed as monotherapy (61.1%), whereas as combination with aspirin (38.9%). While analyzing the prescriptions, it was found that patients having abnormal lipid profiles (51.8%) and normal lipid profiles (48.2%) were prescribed atorvastatin. Hypertension with diabetes (37%) was the most common disease followed by hypertension (21.2%) and diabetes mellitus (21%) for which atorvastatin was prescribed. The average number of drugs per prescription were 3.8±1.65.Conclusions: This study depicts the use of atorvastatin in various disease conditions, both as primary and secondary preventive measures. There was no polypharmacy. Such studies should be done to educate the physicians on good prescribing practices and to rationalize use of hypolipidemic drugs.

scholarly journals Utilization of drug in patients admitted with abnormal uterine bleeding in a tertiary care teaching hospital

2020 ◽  
Vol 9 (8) ◽  
pp. 1258
Author(s):  
Dhivya Govindasamy ◽  
Padmavathi Karunakaran ◽  
Rajalakshmi Ramesh ◽  
Kamalavarshini Paramasivamsasanger ◽  
Rajalakshmi Ponnusamy
Keyword(s):  
Ferrous Sulfate ◽  
Tamil Nadu ◽  
Tertiary Care ◽  
Age Groups ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Defined Daily Dose ◽  
Care Teaching ◽  
Medical College ◽  
Daily Dose

Background: The objective of the study was assessing utilization of drug in patients admitted with Abnormal Uterine Bleeding in a tertiary care teaching hospital.Methods: The observational study was conducted at Department of Obstetrics and Gynecology, Rajah Muthiah Medical College and Hospital, Annamalai University, Annamalai Nagar, Tamil Nadu, from the period of July 2019 to September 2019. A total 30 gynecology patients were included.Results: A total 30 patients most of the patients were between the age groups of 36-45 years 66.6%. The most common clinical condition AUB and co-morbidities condition were 19 (63.3%). The majority of patient were prescribed with ferrous sulfate 27 (90%). The defined daily dose (DDD) per patient for norethisterone 36 followed by ferrous sulfate 23.11. The average number of drugs per prescription 10.8, percentage of drug prescribed in generic name 69.56% and number of drugs prescribed from NLEM-2015 86.95%, number of drugs prescribed from EDL-2019 were 69.56% and percentage of prescription with antibiotic 80%, percentage of prescription with injection 70%.Conclusions: This study has shown the utilization of drugs prescribed in AUB patient. The most commonly prescribed drug was ferrous sulfate and most prescribed antifibrinolytic drug was tranexamic acid for treating AUB.

scholarly journals Evaluating antimicrobial prescribing in a Tertiary Healthcare Institution in Nigeria

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Angus Nnamdi Oli ◽  
Nwanneka Onyeaso ◽  
Stephen Chijioke Emencheta ◽  
Chijioke M. Ofomata ◽  
James-Paul Kretchy ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
Defined Daily Dose ◽  
Essential Drug ◽  
Chi Square ◽  
Essential Drug List ◽  
Drug List ◽  
Daily Dose ◽  
Generic Prescribing ◽  
Tertiary Healthcare ◽  
Chi Square Test

Abstract Background Regular evaluation of antimicrobials prescriptions is important for optimal use. Objective This study determined the prescription patterns, class and costs of antimicrobials in the adult out-patient pharmacy of a Teaching Hospital in Nigeria. Methods A 1-year retrospective study from 1st January to 31st December 2018. The data, which included identification code, age, sex, antibiotics prescribed, number of antibiotics per prescription, number of medicines per prescription, dosage form, generic prescribing, drug on the essential drug list, and cost, were used in the analysis. The Chi-square test and Analysis of Variance were used to compare our data with the WHO–developed antimicrobial prescription Guidelines for Anatomical Therapeutic Chemical and Defined Daily Dose assignment of 2019. Results From 450 patient records, significantly more females (70%) were prescribed with antimicrobials (P = 0.0038). The prescription pattern showed that antimicrobials selection by class was significantly different (P < 0.0001) (top three being Amino-penicillin > Nitroimidazoles > Fluoroquinolone). In addition, age differed significantly (P < 0.0001) with 46–50 as the highest class. Dosage forms profile showed that the percentage of encounter with injections prescribed (1.8%) was less than WHO recommendation (13.4–24.1%). Most of the prescriptions (84.22%) were from the Essential Drug List. The average cost of prescriptions with two antimicrobials was the highest ($14.0807), then three ($10.7949), and one ($6.39858). The average number of drugs per prescription that had one (4.28), two (4.46), and three (5.55) antimicrobials, respectively, were more than double the average (2) recommended by WHO. Conclusion The study showed that most of the patterns are within limit, however, highlights the need for frequent evaluation.

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 Study in Ophthalmology Outpatients at a Tertiary Care Teaching Hospital

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Pradeep R. Jadhav ◽  
Vijay V. Moghe ◽  
Yeshwant A. Deshmukh
Keyword(s):  
Drug Utilization ◽  
Teaching Hospital ◽  
Antimicrobial Agents ◽  
Tertiary Care ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Essential Drug List ◽  
Department Of Ophthalmology

In view of the advancement in drug development and availability of new ocular therapeutics in the discipline of ophthalmology, we attempted to study the drug utilization and describe the prescribing practices of ophthalmologists in a tertiary care teaching hospital. Method. A prospective, cross-sectional, observational study was conducted on patients attending Outpatient Department of Ophthalmology for curative complaints. Prescriptions of 600 patients treated were analyzed by the WHO prescribing indicators and additional indices. Results. Analysis showed that the average number of drugs per prescription was 1.49. Percentage of drugs prescribed by generic name was 2.35%. Percentage of encounters with antibiotics was 44.83%. Percentage of drugs prescribed from National Essential drug list (NEDL)/National Formulary of India (NFI) was 19.48%. Patient's knowledge of correct dosage was 93.83%. Antimicrobial agents were the most commonly prescribed drugs followed by antiallergy drugs and ocular lubricants. Fluoroquinolones accounted for 60% of the total antimicrobial drugs, of which gatifloxacin was the most frequently prescribed fluoroquinolone. Conclusion. The study indicated an awareness of polypharmacy, but showed ample scope for improvement in encouraging the ophthalmologists to prescribe by generic name and selection of essential drugs from NEDL/NFI.

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 Prescription-only drugs in Banja Luka region: Utilization analysis

2004 ◽  
Vol 57 (1-2) ◽  
pp. 72-76 ◽  
Author(s):  
Natasa Stojakovic ◽  
Ranko Skrbic ◽  
Svjetlana Stoisavljevic-Satara ◽  
Dragana Babic-Djuric ◽  
Lana Nezic ◽  
...  
Keyword(s):  
Drug Utilization ◽  
Anatomical Therapeutic Chemical ◽  
Central City ◽  
Cardiovascular Drugs ◽  
Insurance Fund ◽  
Defined Daily Dose ◽  
Epidemiological Analysis ◽  
Daily Dose ◽  
Total Analysis ◽  
Banja Luka

Introduction Using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) methodology, we analyzed utilization of prescription-only drugs in Banja Luka region in 2000 - 2001. Material and methods A retrospective study on drug utilization, according to ATC classification, was conducted on the basis of data received from Central City Pharmacy Banja Luka, and results were presented in terms of DDD/1000 inhabitants/day. Results Pharmaco-epidemiological analysis showed that the list of 20 most frequently prescribed drugs in 2000 included 8 cardiovascular drugs and 6 anti-infective drugs. In 2001, 20 most frequently prescribed drugs, included 9 cardiovascular drugs, and 4 anti-infective drugs. Regarding anti-infective agents, the most frequently prescribed antibiotics were amoxicillin, doxycyline, co-trimoxazole and gentamicin. The most frequently prescribed drug in 2000 was diazepam (5,33 DDD/1000 inhabitants/day). The use of this drug significantly increased in 2001 (7,95 DDD/1000 inhabitants/day). Discussion and conclusion Based on total analysis, it can be concluded that the positive drug list, defined by the Health Insurance Fund, significantly affected the drug utilization profile, but some drugs are considered to be irrationally prescribed.

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