scholarly journals Study of utilisation trends of drugs in patients admitted with cardiovascular diseases at a tertiary care hospital in Goa

Author(s):  
Shantadurga S. Kerkar ◽  
Padma N. Bhandare

<p class="abstract"><strong>Background:</strong> CVDs have emerged as a leading cause of mortality and morbidity in the world as well as in India. Drug usage is life saving and at times many drugs may be needed. Drug utilization studies aid to find the appropriateness of treatment, identify shortcomings if any, and provide a feedback to the healthcare providers to improve their management with drugs. So such types of studies are of vital importance in every hospital.</p><p class="abstract"><strong>Methods:</strong> This was a prospective, observational study of 180 patients with CVDs admitted in medicine and cardiology wards of a tertiary care hospital, conducted through case records and patients’ interviews. Data was represented as mean±SD, number and frequency.  </p><p class="abstract"><strong>Results:</strong> Incidence of cardiovascular diseases was more in males (56.67%) than the females (43.33%). Average number of drugs prescribed per patient was 9.16 and that of cardiovascular drugs was 5.08 ± 2.15. Antiplatelets (88.88%) were the most commonly prescribed cardiovascular drugs followed by hypolipidemics (82.22%). About 15.06% of injectables and 1.2% of fixed dose combinations (FDCs) were prescribed. Drugs prescribed by generic names were 1.6% and those from the National List of Essential Medicines were 92.79%.</p><p><strong>Conclusions:</strong> The results of this study suggested: polypharmacy, overuse of injections and low prescribing habits from essential drug list. Though antiplatelet, hypolipidemic use was higher, these are an essential part of treatment of certain CVDs. </p>

2018 ◽  
Vol 32 (2) ◽  
pp. 65-69
Author(s):  
Udoy Shankar Roy ◽  
AKM Monwarul Islam ◽  
Mohsin Ahmed ◽  
Murshidur Rahman Khan ◽  
Nihar Ranjan Sarker

Objective: The objective of the present study was to provide recent population-based information on use of cardiovascular drugs in outpatients in a tertiary care hospital of Dhaka, Bangladesh.Methods: A prospective study of cardiovascular prescriptions of Outpatient Department of Department of Cardiology of Shaheed Suhrawardy Medical college hospital Dhaka, Bangladesh was carried out. A total of 215 prescriptions were collected for the study in Shaheed Suhrawardy Medical College Hospital Dhaka, Bangladesh from July 2015 to June 2016. The prescriptions were evaluated for rationality based on WHO model list of essential medicines. The prescriptions were critically analyzed using predetermined parameters.Results: Out of 215 prescriptions collected, 120 drugs were found to be repeatedly prescribed. The results revealed that all single dose formulations prescribed were rationally in accordance with WHO essential drug list whereas fixed dose combinations prescribed remain questionable. A pattern of polypharmacy was clearly evident.Conclusion: Medications are a critical modality for prolongation and improved quality of life. Campaign and intervention should be focused on patients with more than three diagnostic cardiovascular conditions in order to minimize polypharmacy in patients particularly elderly.Bangladesh Heart Journal 2017; 32(2) : 65-69


Author(s):  
Ayan Roy ◽  
Nayan Kumar Patel

Background: Cardiovascular morbidity plays a villainous role globally as well as countries like India. Additionally, irrational prescription incurs greater damage to health and wellbeing. Drug utilization studies scrutinize the appropriateness of treatment and provide favorable feedbacks to strengthen clinical practices. The objective of the study was to describe treatment practices in cardiology outpatient and drug utilization pattern using core prescribing indicators by World Health Organization (WHO).Methods: A cross-sectional, observational study of 4-month duration was undertaken for cardiology Outdoor patients at a tertiary care hospital. 615 prescriptions were screened and analyzed.Results: Males (59.84%) were more in number than females (40.16%). Average number of the prescribed drugs per patient were 4.32±2.7 and (3.73±1.1 for cardiovascular drugs). Generic prescription was 60.98%. Percentage encounters with antibiotics 4.11, injectables 2.92%, fixed-dose combinations (FDCs) (11.8%) were documented. Drugs from the National List of Essential Medicines were 75.89%. The most common diagnosis was ischemic heart disease (68.29%). Hypolipidemics (78.25%) followed by antiplatelets (71.14%) were toppers in cardiovascular drug. Antiulcer drugs (PPI/Antacids) comprised 58.54% of total prescriptions.Conclusions: Less adherence to EDL, less generic prescriptions, use of FDC are major shortcomings. Areas to further rationalization like optimal use of evidence based medication like beta-blockers, newer anticoagulants/anti-platelet agents and newer anti-anginal agents are identified.


Author(s):  
I. Mariraj ◽  
M. Naveen Kumar ◽  
N. S. Ani Rubitha ◽  
R. Rameshwar

Background and Objectives: Acute Coronary Syndrome (ACS) is one of the major causes for mortality and morbidity among the cardiovascular diseases in India. In this study the modifiable risk factors leading to ACS are considered and its prevalence in a Tertiary care hospital is studied. Materials and Methods: This is a prospective type of study conducted in a tertiary care hospital. A total of 100 patients diagnosed with ACS were taken in this study. Their data was taken, and results were formulated in excel data sheet. Results: Among the UA patients, 65% were found to be dyslipidaemic, 60% as obese, 45% as diabetics, 47.5% as hypertensive and 40% as smokers. Among the NSTEMI patients, 66.67% were found to be dyslipidaemic, 52.78% as hypertensive, 44.44% as smokers, 30.56% as diabetics and 27.78% as obese. Among the STEMI patients, 37.50% were found to be dyslipidemic, 25% as both diabetic and obese, 20.83% as hypertensive,12.5% as smokers. Hypertension, dyslipidemia, smoking and obesity showed significance. Conclusion: The prevalence of modifiable risk factors is a major concern for developing ACS and when they are modified there will be a great reduction in the incidence of ACS.


Author(s):  
Hooli Tanuja V. ◽  
. Srikanth ◽  
Somashekara S. C. ◽  
Suraj B.

Background: Irrational use of prescribing is on the rise due to many factors like false beliefs, following a prescribing pattern of senior doctors, inadequate knowledge, ignorance, promotional activities for the profit of professionals by pharmaceutical industry and lack of enforcement of regulations by regulatory authorities. Junior residents are exposed to variety of prescribing patterns in the first year and are the future physicians and specialists. There are very few studies among JRs, hence the present study was conducted to assess the knowledge, attitude and practice of junior residents about rational use of medicines.Methods: This was a cross-sectional, questionnaire based study conducted among JRs at a tertiary care hospital in South India in June 2015. The participants were explained about the study and consent was taken. Permission was obtained from institutional ethics committee. Identity of the residents was kept confidential. A self-developed, pre-validated, semi-structured questionnaire consisting of both open-ended and closed-ended items was used. Questionnaire was designed to obtain information about the knowledge, attitude and practice of RUM. The data was recorded and analyzed using Microsoft Excel (2013 version) and the results are explained in frequency and percentage.Results: The knowledge related to essential medicines list (EML), P drugs and schedule H drugs was limited. Participants had limited knowledge about the revision of EML list, number of fixed dose combinations (FDCs)in EML, STEP criteria for choosing a P drug and advantages of choosing a P drug Most of the JRs frequently prescribed drugs from EML. Trade name and newer drugs were prescribed around 50%. The prescription of FDCs from EML was very low (6%). Around 50% of JRs prescribe medicines with both generic and brand name.Conclusions: Majority of JRs were aware about various issues concerned with RUM but the knowledge related to EML, P drugs, schedule H drugs and number of FDCs in EML was limited.  As junior residents are future prescribers, they need to be aware of all the aspects of RUM. Inadequate/improper knowledge in the above areas is a matter of concern and needs to be addressed.


Author(s):  
Ajita Kapur ◽  
Harmeet Singh Rehan ◽  
Lalit Kumar Gupta ◽  
Madhur Yadav

Background: Type 2 diabetes mellitus (T2DM) is a leading cause of significant morbidity and mortality in developing countries. Evaluation of anti-diabetic drug use pattern guides the healthcare professionals to identify early signals of irrational prescribing and to plan interventions to optimize the benefits of pharmacotherapy.Methods: Observational descriptive study was conducted on 500 prescriptions of T2DM patients collected from Outpatient department of a tertiary care hospital. Prescriptions were analysed for type, number, generic/brand names, fixed dose combinations (FDCs) of anti-diabetic drugs and anti-diabetic drugs prescribed from within National List of Essential Medicines (NLEM) 2015.Results: Average number of anti-diabetic drugs per prescription was 2.5. Of these 49% were from within NLEM and only 39% were prescribed by their generic names. Among all the anti-diabetic groups of drugs used, biguanide (32.85%) was the most frequently prescribed followed by insulins (25.4%) and DPP-4 inhibitors (13.75%). Combined drug therapy was more prevalent than monotherapy (70% versus 30%). Metformin+sitagliptin and metformin+linagliptin were most commonly prescribed fixed dose combinations.Conclusions: Recent trend of anti-diabetic drug use included newer anti-diabetic drugs in combination with metformin to achieve better euglycemia and to minimize complications of T2DM.


2019 ◽  
Vol 12 (3) ◽  
pp. 1079-1083
Author(s):  
Hemanthkumar Shanmugam ◽  
Nithya Panneerselvam ◽  
Arul Amutha Lawrence

Cardiovascular diseases are prevalent in developing countries like India. Patients with cardiovascular diseases are prescribed multiple drugs, hence polypharmacy may attribute to higher incidence of adverse drug reactions in these patients. To monitor and to analyze the pattern of occurrence of adverse drug reactions reported with cardiovascular drugs in intensive cardiac care unit of a tertiary care hospital, Chennai. This was a prospective surveillance study carried out for a period of 6 months. Analysis of various adverse drug reactions reported were done using various assessment scales. Descriptive statistics was used and values were expressed in numbers and percentage. During the study period, 282 adverse reactions were reported from 389 patientsat includes 232 males and 157 females. The average age of the patients included in this study was 58.1± 16.8 years . The most common ADRs observed were electrolyte imbalance (14.89%), headache (13.12%) and gastritis (12.41%). Assessment using WHO Causality assessment scale revealed 60.28% were possible, 18.43% probable, 12.76% certain and 8.51% unlikely. According to Schumock and Thornton scale 65.9% of ADRs were preventable and 34% non preventable. Analysis with Hartwig and Seigel’s scale 62.05% of ADRs were moderate in severity, 27.95% mild and 10.99% severe. Drugs attributing to highest ADRs were Digoxin and Furosemide. The common ADRs due to cardiovascular drugs can be reduced by improving the prescription pattern. Intense monitoring and reporting of ADRs could help in minimizing the preventable ADRs, among the health care professionals.


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):  
Shantadurga S. Kerkar ◽  
Padma N. Bhandare

Background: Gastrointestinal (GI) diseases are a common problem worldwide. They are frequently encountered in non-critical as well as in critically ill hospitalized patients.Methods: This was a prospective and observational study conducted on patients admitted in CCU and ICCU of Goa Medical College and Hospital. Data was collected from the patients’ case records and was analysed referring to WHO prescribing indicators. Data was represented as Mean±SD, number and frequency.Results: A total of 2250 drugs were prescribed, out of which 376 (16.71%) were gastrointestinal drugs. Most common route of administration was oral 323 (85.90%). Prescription patterns of GI drugs were:  275 (73.14%) from National List of Essential Medicines, 20 (5.31%) as fixed dose combinations and 4 (1.06%) by generic names. Pantoprazole 183 (48.67%) was the most frequently prescribed drug for peptic ulcer in present study.Conclusions: From the findings of this study we noted that among the GI drugs used, those for peptic ulcer were the most commonly prescribed. Also majority were from the essential drug list. But prescribing by generic names was low. Review of drug utilization trends is a necessary aid to formulate and modify existing protocols and guidelines to improve treatment outcomes in a given setting.


2013 ◽  
Vol 5 (3) ◽  
pp. 129-131 ◽  
Author(s):  
Sunita Hemani ◽  
Premlata Mital

ABSTRACT Medical healthcare providers are an important link with the general public to impart knowledge regarding contraception. However, their own attitude and practice of contraception is often lacking. Objective This study was conducted to assess the attitude and practice of contraception over the last 5 years of the gynecologists themselves in a tertiary care hospital in Jaipur. Materials and methods The study was conducted on 125 female gynecologists in a tertiary care hospital in Jaipur. All were given a questionnaire which was duly filled by them and data obtained was analyzed. Results All the doctors used some form of contraception. The mean age was 29.32 years. The commonest was the barrier method (38.4%) followed by OC pills (27.2%). Twenty-one percent of the barrier users used them occasionally. Emergency contraception was used by either those using natural methods of contraception or who were occasional users of OC pills or condoms. Fifty percent of the couples relying on natural methods conceived. Conclusion Gynecologists have complete knowledge regarding contraception, yet fail to use it regularly. Proper attitude and practice is essential to prevent unintended pregnancies. How to cite this article Hemani S, Hooja N, Mital P. Attitude and Practice of Contraception among Gynecologists at a Tertiary Care Hospital. J South Asian Feder Obst Gynae 2013;5(3): 129-131.


2005 ◽  
Vol 134 (2) ◽  
pp. 315-322 ◽  
Author(s):  
M. D. TANRIOVER ◽  
G. S. GUVEN ◽  
D. SEN ◽  
S. UNAL ◽  
O. UZUN

Sepsis continues to have a substantial mortality and morbidity despite advances in the diagnosis and management of this condition. We retrospectively analysed hospital charts of patients diagnosed to have sepsis between January 2002 and June 2003. Demographic characteristics of patients, microbiological findings and predictors of survival were evaluated. Sixty-nine sepsis episodes that occurred in 63 patients were analysed. The most common underlying diseases were hypertension, malignancies and diabetes mellitus. Renal insufficiency, respiratory distress and disseminated intravascular coagulation developed in 52·2, 30·4 and 30·4% of the episodes respectively; 47·7% of the blood cultures yielded an organism. Gram-negative bacteria were the predominant microorganisms (65·9%). Fifty-five patients (87·3%) died. Mechanical ventilation and underlying renal disease were significant determinants of mortality. In conclusion, Gram-negative bacteria remain the major pathogens in sepsis. The mortality remains very high, and a change in the clinical approach to the septic patient should be employed to improve the outcome.


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