scholarly journals A PROSPECTIVE STUDY ON GERIATRIC PRESCRIBING PATTERN AND MEDICATION ADHERENCE IN A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 10 (12) ◽  
pp. 220
Author(s):  
Seema Anjum M ◽  
Chinchu Jacob ◽  
Chinchu Jacob ◽  
Akhil Benchamin ◽  
Akhil Benchamin ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Tertiary Care ◽  
General Medicine ◽  
Study Data ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Disease Pattern ◽  
A Prospective Study

  Objectives: To identify potentially inappropriate medications (PIMs) using Beers criteria 2015 and to recommend safer alternative medication for the above. To assess the medication adherence in geriatric patients and to categorize according to their adherence.Methods: This is prospective, interventional study. A total of 90 patients aged 65 years and above were involved in the study. Data were collected and recorded. The prescriptions were analyzed for appropriateness using updated Beers criteria 2015 and assess medication adherence using 8-item Morisky questionnaire.Results: Majority of the patients were in the age group of 65-74 years. Males (53%) showed predominance than females. The highest rate of (53%) polypharmacy was found in general medicine department than other departments. Out of 147 disease conditions observed, chronic renal failure (21.1%) was the most common condition. A total of 66 patients had comorbid conditions. Most frequently prescribed medications belonged to cardiovascular drugs (56; 14.62%). A total of 46 patients received PIMs; majority belonged to Category 1 - amitriptyline. Commonly prescribed medication in PIMs belonged to central nervous system medications (20%). Majority of patients were low adherent (51.11%) in which female patients showed preponderance in low adherence.Conclusion: Study showed prevalence of disease pattern, medication use, polypharmacy, PIMs, and medication adherence. It is important for pharmacists to stay updated and prescribers need to be educated and encouraged about Beers criteria for rational prescription for better pharmaceutical care and increased medication adherence.

scholarly journals A Prospective Study on Usage Pattern of Corticosteroids in a Tertiary Care Hospital

2019 ◽  
Vol 11 (05) ◽  
Author(s):  
V. V. Rajesham ◽  
Ch. Swethasri ◽  
E. Mamatha ◽  
Keerti Tiwari ◽  
P. Pooja Raj
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
General Medicine ◽  
Defined Daily Dose ◽  
Care Hospital ◽  
Usage Pattern ◽  
Prescribing Pattern ◽  
Dermatology Department ◽  
Daily Dose ◽  
A Prospective Study

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.

scholarly journals Assessment of Potentially Inappropriate Medications and Prescription Appropriateness in Geriatics at Teritiary Care Hospital

2020 ◽  
Vol 10 (6) ◽  
pp. 42-48
Author(s):  
Wahiba Mohammed Wazir ◽  
Saba Afreen ◽  
FARIA IFFATH ◽  
Amtul Muqeet Rafia ◽  
Mohammed Ateeq Ur Rahman
Keyword(s):  
Tertiary Care ◽  
Research Work ◽  
General Medicine ◽  
Future Research ◽  
P Value ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Care Hospital ◽  
Prescribing Indicators ◽  
Inappropriate Medications

Background: Elder people are a diversified group commonly presenting with multiple comorbid illnesses resulting into multiple prescriptions which in turn increases adverse effects and polypharmacy. Potentially inappropriate medications (PIM) further contribute to this risk. Therefore, the aim of this study was to assess the prescription appropriateness and (PIM) in geriatrics as per WHO core prescribing indicators and Beer’s Criteria, 2015 respectively. Methods: A prospective observational study was conducted in Osmania General Hospital, a Tertiary Care Teaching Hospital from December 2018 to May 2019. A total of 100 case records of inpatients greater than or equal to 60 years of age, in general medicine wards were reviewed. Relevant information was recorded in a structured proforma and data was evaluated. Results: Out of 100 patients, 70 patients were male and 30 patients were female. Majority of them were from the age group of 65-70 years. There were 34% patients prescribed at least one PIM. Polypharmacy was observed in all patients. Average no. of drugs per prescription was 10.5%.Percentage of drugs prescribed from EDL (Essential drug list) were 84%.The p value of WHO core prescribing indicators was assessed using chi square test and was found to be significant. Conclusion: Our study found WHO core prescribing indicators to be deviated from the optimum values set by WHO and high prevalence of Potentially Inappropriate Medications as per Beers criteria 2015. This highlights the need of future research work, strategies and regulatory measures focusing on geriatric patients and also encouraging prescribers to use the WHO core prescribing indicators and Beers criteria while prescribing elderly for providing optimum healthcare. Keywords: Beer’s criteria, Geriatrics, WHO prescribing indicators, Polypharmacy. Ageing, Potentially Inappropriate Medications.

scholarly journals PRESCRIPTION PATTERN OF DIURETICS IN A TERTIARY CARE HOSPITAL

2019 ◽  
Vol 8 (3) ◽  
Author(s):  
P G Chithara ◽  
Dr. Yogananda R ◽  
Dr. Bharathi DR
Keyword(s):  
Drug Interaction ◽  
Tertiary Care ◽  
General Medicine ◽  
Oral Route ◽  
Prescribing Patterns ◽  
Research Centre ◽  
Intravenous Route ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Drug Drug Interaction

Diuretics are drugs that increase the rate of urine flow; clinically useful diuretics also increase the rate of excretion of Na+ (natriuresis) and an accompanying anion, usually Cl. Diuretics are a mainstay of therapy for a wide variety of diseases ranging from hypertension to the nephrotic syndrome. Objective: To study the prescribing patterns of diuretics in General Medicine and ICU. To assess the drug-drug interaction of diuretics. To study the route of administration of diureics. Materials and methods: A prospective observational study was conducted over a period of six months at general medicine and ICU department of Basaveshwara Medical College and Hospital and Research Centre, Chitradurga.a otal of 100 in-patients are included as study subject. Results: Mostly prescribed diuretic in this study were furosemide (52.9%), followed by mannitol (28.1%), spironolactone (11.57%), torsemide (5.79%), amiloride (0.82%) and hydrochlorothiazide (0.82%). Out of 100 prescriptions 84.4% of diuretics prescribed in intravenous route, 15.6% of diuretics prescribed in oral route. Out of 100 prescriptions total 89 drug interactions with diuretics are found. In that 2.3% major interactions and 67.4% moderate interactions and 30.3% minor interactions are found. Conclusion: Prescription monitoring helped to reduce the diuretic usage errors with respect to dose and drug-drug interaction with other prescribed drugs to provide better patient care. Keywords:  prescribing pattern, drug-drug intraction, diuretics

scholarly journals A prospective study on antibiotic prescribing pattern among in-patients of medicine department of a tertiary care hospital

2020 ◽  
Vol 9 (6) ◽  
pp. 902
Author(s):  
Anulakshmi S. ◽  
Annapurna Yadavalli
Keyword(s):  
Antibiotic Resistance ◽  
Tertiary Care ◽  
Essential Medicines ◽  
Oral Drug ◽  
Antibiotic Prescribing ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Strict Adherence ◽  
Antibiotic Policy ◽  
A Prospective Study

Background: Irrational prescription is a major contributor to the antimicrobial resistance. Tertiary care centres in a state are the centres of excellence where policies are framed. So, they have an important role in promoting rational antibiotic prescription.Methods: The study was conducted on in-patients of medicine ward in government medical college, Calicut, for a period of 2 months (January to February 2018), The data was collected from IP case records of patients. The parameters checked includes appropriateness of the antibiotic as, to whether it is according to our hospital antibiotic policy, whether de-escalation and change to oral drug was done, whether it is prescribed by generic name, is it given as fixed drug combination (FDC), is it from national list of essential medicine.Results: Among the 135-prescription analyzed, total 225 antibiotics were used. Cephalosporins (32%) were the most commonly used. Of this only 40% was given by generic prescription. 27% was FDCs. 55% was from national list of essential medicines and 69% of them were ‘WATCH’ drug according to WHO Antibiotic Policy. Regarding appropriateness of prescriptions around 56% included right drug, 93% had right dose and frequency, and 70% had right duration and 100% were given through right route.Conclusions: Strict adherence to hospital antibiotic policy and plan for effective teaching programs regarding antibiotic resistance and importance of rational prescription of antibiotics can improve the quality of antibiotic prescription and minimize antibiotic resistance.

scholarly journals RATIONALE OF ANTIBIOTIC PRESCRIPTION IN PATIENTS VISITING A TERTIARY CARE SOUTH INDIAN HOSPITAL

2021 ◽  
pp. 27-30
Author(s):  
MOHAMED AHMED ◽  
PAWAN KUMAR ◽  
KISHORE DV ◽  
PRABHAT KUMAR ◽  
RUBEENA KAUSER ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
General Medicine ◽  
Critical Issue ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Specific Patient ◽  
South Indian

Objective: Antimicrobials are the class of drugs that are used irrationally in most cases leading to rise in instances of antimicrobial resistance altering the effect of such agents. Antimicrobial resistance has become a critical issue universally nerving the need to monitor the utilization pattern and rationality in prescribing of antibiotics. This helps in selection of most appropriate antibiotic for the specific patient and achieving the goals of the therapy. Methods: A prospective cross-sectional study with a sample size of 600 participants was conducted in department of general medicine of a tertiary care hospital. Inpatients prescribed with antibiotics were included in the study and their case sheets were reviewed to analyzing the prescribing pattern. The medication usage pattern was then assessed for rationality in prescribing was evaluated. The results obtained were statistically analyzed using SPSS Software. Results: It is noted that a more number of males participated and the greatest number of the patients were from the age group of 31-45. The diagnosis found in the majority of the patients was respiratory tract infection followed by others. On scrutinizing the prescriptions, it was noted that cephalosporins and penicillins were most often prescribed, and on an average single, antibiotic was frequently used with the preferred route of administration in most of the prescriptions being injection route. Though many of the antibiotics were prescribed empirically, it was observed that 59% of them were most appropriately dosed and maximum patients that are around 57% were cured from their illnesses. Conclusion: This study provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship programs. The culture and sensitivity testing suggested that the drug resistance was more for most commonly prescribed antibiotics in the hospital. Increased targeted prescribing based on sensitivity tests will bring down the high use of empiric broad-spectrum antibiotic use.

scholarly journals A PROSPECTIVE STUDY ON DRUG UTILIZATION PATTERN OF ANTIDEPRESSANTS IN NON-PSYCHIATRIC DEPARTMENTS IN A TERTIARY CARE TEACHING HOSPITAL

2019 ◽  
pp. 224-226
Author(s):  
ANCY SEBASTIAN ◽  
ANEESHA PK ◽  
JOSHWA AREECKAL ◽  
SONIYA DAVIS
Keyword(s):  
Drug Utilization ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
General Medicine ◽  
Care Hospital ◽  
Cross Sectional ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Cardiology Department ◽  
A Prospective Study

Objective: The aim of this study is to evaluate the pattern of prescription and utilization of antidepressants (ADs) for various non-psychiatric indications in department of general medicine, cardiology, surgery, gynecology, and orthopaedic of a tertiary care teaching hospital. Methods: A prospective cross-sectional unicentric drug utilization study of inpatients was carried out in a 450 bedded tertiary care hospital. The study included 200 subjects admitted for both psychiatric and non-psychiatric illness. Pediatric patients and those with a length of stay <48 h were excluded from the study. Results: Prescriptions of 200 patients were studied in which 55% were males and 45% were females. The most widely prescribed drug is alprazolam comprising 50% of the total drug consumption and is followed by clonazepam (19.5%), amitriptyline (13.5%), diazepam (9.5%), escitalopram (3.5%), lorazepam (3%), and zolpidem (0.5%). About 36% of the drugs were prescribed in the general medicine department, and 27.5% of the prescriptions were from the cardiology department. Prescriptions from surgery, orthopedics, and gynecology were 16%, 11.5%, and 9% of the total, respectively. Conclusion: ADs were found to be potentially useful for non-psychiatric indications such as peripheral and diabetic neuropathy, gastroenterological conditions, and urological conditions. No benefit was observed in insomnia and musculoskeletal conditions except for fibromyalgia. ADs were also found to improve the treatment outcome and quality of life of patients having comorbid psychiatric conditions being treated for non-psychiatric disorders.

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