scholarly journals Pattern of medication use among elderly patients attending medicine department in a tertiary care hospital in India

Author(s):  
Swathi Burla

Objective: The present study was aimed to assess the drug prescribing pattern and analyze the prescribing pattern using Beers criteria among elderly patients aged over 60 years Materials and Methods: The present study was a prospective observational study conducted in the outpatient department of general medicine in a tertiary care hospital for the duration of three months. Institutional ethics committee approval was taken prior to initiation of the study. Written informed consent was taken from each study subject. A total of 287 subjects who were aged more than 60 years recruited into the study. The data was collected in a pre structured case record form. Subjects’ demographic details, medical conditions and drugs included in prescription their dose; frequency and duration were noted in case record form. Results: Among 287 subjects 91.64% subjects belonged to 61-70years age group, remaining 8.36% subjects were >71year older and 57.14% were males and 42.86% were females. Hypertension was the most common cause of attending hospital followed by diabetes mellitus, CNS disorders, respiratory, cardiovascular disorders other than hypertension and infectious diseases. A total of 1574 formulations containing 1669 active ingredients and 90 FDCs were prescribed. And only 152 formulations were prescribed from outside hospital formulary. The average number of drugs per prescription was 5.48±2.00. Among the individual drugs vitamin B complex was the most commonly prescribed drug Conclusion:  There is need for more rational prescribing and to form guidelines for safe and effective use of medicines in elderly patients.

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):  
DUDHE BG ◽  
CHAKRAVORTY ASHISH D ◽  
MANKAR NN ◽  
PISE HN

Objective: The objective of the study was to assess the current use of antimicrobial agents (AMAs) and to assess prescription writing as per the WHO guidelines in the medicine intensive care unit (MICU). Methods: The present study was conducted on admitted patients in MICU of a tertiary care hospital. The demographic and clinical treatment data of patients were collected in specially designed pro forma from the case record form. Results: Of 400 patients enrolled in the study, 55.50% were male and 44.50% were female. A common indication of AMAs use was infection (61.75%), symptomatic (21.50%), and prophylactic (10.50%) use. In 65% patients, antimicrobial therapy was considered to be rational. The majority of patients have good recovery (61%). Polypharmacy was seen in 89.75% of patients. The average number of drugs prescribed per patient was 8.84±2.55. 1.90±1.20 was average number of AMAs per patient. Commonest AMAs prescribed are ceftriaxone (27.64%), metronidazole, and amoxicillin+clavulanic acid. Conclusion: This study visibly highlights the practice of polypharmacy, low uses of generic drugs, high usage of antibiotic, and injection. Cephalosporins are the most prescribed AMAs in the ICUs. Remedy of this situation requires regulation, education, awareness, compliance with protocol, and guidelines of AMAs use.


Author(s):  
V. V. Rajesham ◽  
Ch. Swethasri ◽  
E. Mamatha ◽  
Keerti Tiwari ◽  
P. Pooja Raj

Rational use of corticosteroids is very essential for improving patient safety on long term use. The present study aimed to study the prescribing usage pattern of corticosteroids in a tertiary care hospital. A prospective observational study was conducted in the department of dermatology, gynecology and general medicine in a tertiary care teaching hospital for the period of 6 months (August-February). All patients receiving any category of Steroid therapy were included and the prescribing and tapering pattern of steroids were reviewed. Prescribing pattern was observed and analysed in 132 participants during the study period. Cases were collected from the departments of Dermatology, General Medicine, Pediatrics and Gynecology in Gandhi Hospital, Secunderabad. All the prescriptions containing steroids were included in this study and the parameters evaluated were gender distribution, age of the patients, types of steroids according to the route of administration, number of prescribed daily dose (PDD) where compared with defined daily dose (DDD). In the collected 132 cases, 162 times corticosteroids were prescribed. The steroid utilization was found to be more in female patients, the maximum number of cases with corticosteroids was found in Dermatology department (39.4%). Particularly Injection Dexamethasone (24.7%) and Tablet Prednisolone (24.7%) are mostly prescribed. Most drugs were prescribed rationally although some factors like improper history,drug administration time and tapering were deviating away from rationality. Although most of the drugs were prescribed rationally, involvement of a Clinical pharmacist in patient care can help in more rational prescribing along with prevention and early detection of ADRs which can directly promote drug safety and better patient outcomes.


Author(s):  
Vasundhara Yerkade ◽  
Riyaz Ahmed Siddiqui

Background: In psychiatric practice, antidepressant drugs are widely used group of drugs. Number of drugs are available in this group with diverse type of mechanisms and efficacy/safety profile. The objective for the study was to identify the prescribing pattern of antidepressant drugs in psychiatric patients at a tertiary care hospital and to see the distribution of antidepressant drugs in the sociodemographic group.Methods: It was a record based descriptive study which was carried out at NKP Salve Institute of Medical Sciences and Research Centre, Nagpur. Case record files of all the patients suffering from depression and other psychiatric disorders and treated with antidepressant drugs during the period of from 1st January 2015 to 31st December 2015 by institutional psychiatrists were analyzed for prescription pattern of antidepressant drugs and their age and sex wise distribution.Results: A total no. of 300 patients received antidepressant drugs. The most commonly prescribed drug was escitalopram in 121 (40.3%) patients followed by fluoxetine in 61 (20.3%) and clomipramine in 30 (10%) patients. Other drugs that were prescribed were mirtazapine in 24 (8%), nortryptiline in 21 (7%), venlafaxine in 13 (4.3%), fluvoxamine in 12 (4%), amitryptiline in 9 (3%), dothiepin in 5 (1.6%) and duloxetine in 4 (1.3%) patients. Also patients in the age group of 31-40 yrs and 21-30 yrs received most number of antidepressants i.e. 129 (40.3%) and 83 (27.6%) patients respectively. Females have received more antidepressant drugs as compared to males.Conclusions: Selective Serotonin Reuptake Inhibitors (SSRIs) are the most commonly prescribed group of antidepressant drugs. Escitalopram followed by Fluoxetine were the most commonly prescribed drugs for the management of depression and other psychiatric disorders because of their better efficacy, safety, tolerability and less side effects as compared to TCAs. Females suffer more from depression and other psychiatric disorders as compared to males and the most vulnerable is 21 to 40 yrs of age.


Author(s):  
Vishwanath M. ◽  
Murgesh J. V. ◽  
Arpitha D. ◽  
Nithiya D.

Background: Hypertension is the leading non-communicable disease risk attributing to cardio vascular morbidity and mortality. Various reasons are socio-economic, behavioural, sedentary life style, nutritional, age, obesity and poor health maintenance. A wide range of antihypertensive drugs belonging to different pharmacological classes are available alone or in combinations. Present study was done to evaluate the prescribing pattern of antihypertensive drugs at a tertiary care hospital.Methods: A prospective, observational, non-interventional, hospital-based study was carried out in hypertensive patients attending outpatient department of General Medicine at Medical College Hospital attached to Vijayanagar Institute of Medical Sciences, Ballari. Data was collected from outpatient slip of patients in a predesigned case record form, which was analysed using descriptive statistics.Results: Among 200 patients analysed 95 (47.5%) were males and 105 (52.5%) were females, with maximum number of patients falling in the age group 61-70years. Among antihypertensives prescribed, amlodipine (78.5%) was most frequently prescribed drug. Frequently used drugs for monotherapy - amlodipine (37.5%), for two drug therapy - amlodipine + atenolol (25.5%), and for three drug therapy - amlodipine + atenolol + telmisartan (2.5%). WHO prescribing indicators: Average number of drugs per encounter is 2.38 (±1.19). Percentage of drugs prescribed by generic name is 76.47%. Percentage of drugs prescribed from essential drug list is 97.89%.Conclusions: Present study shows current trends in prescription of antihypertensives in tertiary care hospital and their rational use. Study emphasizes need for preventive and educative measures about hypertension in population.


Author(s):  
SAGARANANDA GIRI ◽  
GULAM MUHAMMAD KHAN

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.


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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