scholarly journals A STUDY OF DRUG UTILIZATION PATTERN OF THE GERIATRIC PATIENTS IN THE DEPARTMENT OF GERIATRIC MEDICINE IN A TERTIARY CARE HOSPITAL IN ASSAM, INDIA

Author(s):  
Lakhimi Borah ◽  
Diptimayee Devi ◽  
Prasanjit Kumar Debnath ◽  
Dibyajyoti Deka

Objective: To investigate the drug utilization pattern and the prevalence of potentially inappropriate medications (PIMs) using updated AGS Beers criteria 2012 among the elderly patients who attended the geriatric outpatient departments as well as admitted  indoor patients ina tertiary care Hospital at Guwahati, Assam, India.Method: A hospital based prospective, observational and cross sectional study, involving patients aged 65 years and above was planned and conducted over a period of 6 months from January 2016 to June 2016. Patients were visited daily, interviewed and case records were collected. Data were analyzed using Microsoft Office Excel Sheets.Results: A total of 150 patients aged 65 years and above were analyzed. 97 patients (65%) were males and 53 (35%) were females. Majority of the patients (61 numbers, 41%) belonged to the age group of 65-70 years, and least were in the age group of 86-90 years (13 numbers, 9%). Prescription of five or more medications (polypharmacy) was observed in 117 (78%) patients. Majority of the patients presented with diseases of cardiovascular system (25.7%). Using WHO drug use indicators, the average number of drugs per prescription was found to be 5.6. The percentage of drugs prescribed by generic name was 86%. The percentage of encounters in which antibiotics were prescribed was  61%. Injection was prescribed was 65% cases and the percentage of drugs prescribed from the NLEM (National List of Essential Medicines of India) was 96%.  43 patients received PIMs from Beers list; majority were belonging to category 1. Spironolactone was most commonly prescribed PIM.Conclusion:  Irrational prescribing practices and polypharmacy were detected in our study.Prescribers should be educated about rational use of drugs and Beers criteria for elderly. Keywords: Beers criteria, WHO prescribing indicators, Potentially inappropriate medications, Elderly patients, Polypharmacy

Author(s):  
Kiran P Vakade ◽  
Vishal A Indurkar ◽  
Aayush H Chordia

Background: Periodic auditing of prescriptions in terms of drug utilization study is an important tool to enhance the efficacy of the treatment, to decrease the risk of the adverse effects, to give cost-effective treatment and to provide useful feedback to the clinician. Prevalence of dermatological diseases is very high throughout the world, and in day to day practice, a quarter of the cases are related to dermatological manifestations. In studies conducted in the Out Patient  Department (OPD) of dermatology in North Palestine and Western Nepal, irrationalities in the prescriptions have been reported. Aim: To study the drug utilization pattern for skin diseases in dermatology OPD at tertiary care hospital of Western Maharashtra. Methodology: The retrospective analysis of dermatology OPD records of 6 months (1st March 2018- 31st August 2018) was carried out during the study period (1st September 2018 to 30th November 2018). The proforma for collecting data was designed. Demographic details, diagnosis and treatment are given for each patient were recorded. The data collected was condensed, and the master chart was prepared for data analysis. Result: During the study period, a total of 3869 patient’s case records were studied and analysed. A maximum number of patients (26.5%) found in the age group 31-40 years, followed by 23.5% of patients in the age group 21- 30 years. Fungal infection was found in 39.6 % of patients followed by acne in 14.2% patients and eczema in 9.1% of patients. Drugs most commonly prescribed were antihistaminics (45.02%) followed by antifungal (39.6%) and steroids (27.8%). Levocetirizine (74.07%) and hydroxyzine (16.5%) were the most commonly prescribed antihistaminics. Itraconazole (58.17%) and Griseofulvin (24.67%) were the most commonly used oral antifungal drugs. Miconazole (73.73%) was the most commonly used topical antifungal drug, followed by ketoconazole (12.45%). Among steroids, prednisone (52%) and betamethasone (38.05%) were the most commonly used steroids by oral route while clobetasol (68.09%) and mometasone (19.5%) were the most commonly used steroids by topical route. Our study revealed that the percentage of drugs prescribed by the WHO essential drug list was only 23.87%. Drugs which prescribed by the generic names were less than <1%. Conclusion: Treatment protocols used in the management of skin disorders were near to the standard guidelines.  Keywords: Drug utilization; Prescription pattern; Dermatology; Skin disorders.


2018 ◽  
Vol 5 (2) ◽  
pp. 3542-3544 ◽  
Author(s):  
Dr Aswin Rajeev ◽  
Dr George Paul ◽  
Dr Sobha George ◽  
Dr Priya Vijayakumar

Introduction : Elderly patients are the most common group who use heath care facilities. This study assesses the prevalence of polypharmacy and use of potentially inappropriate medications in elderly patients presenting to the geriatric clinic of a tertiary care hospital in Kerala for first time. Materials and methods : The study was a hospital based retrospective study. The data from patients presenting to Geriatrics clinic from period of 1 st January 2016 to 31 st December 2016 were retrieved from the medical records and assessed for polypharmacy (taking >5 medications at a time) and potentially inappropriate drugs in accord with modified 2012 Beer’s criteria. Results : A total of 275 patients were included in the study of which 110 (40%) were males and 165 (60%) were females. The prevalence of polypharmacy found to be 22.9%. 63 out of total 275 patients took more than 5 medications at a time. 81 (29.5%) out of 275 patients had at least one potentially inappropriate medication. Conclusion : The prescription of potentially inappropriate medications is a serious problem which can affect overall quality of health care. Hence regular medication review and  reconciliation practices should be implemented to prevent this to an extent.


2013 ◽  
Vol 4 (8) ◽  
pp. 205-210
Author(s):  
Pooja Prajwal ◽  
Mohandas Rai ◽  
Sharath K Kumar ◽  
Srinivas U Bhat ◽  
Floyd Vernon Dsouza

Author(s):  
Shuchisuta P. Pathy ◽  
Sachchidanand Pandey ◽  
Bhabagrahi Rath ◽  
Rinu Rani Dash

Background: Drug utilization research provides insights into different aspects of drug use and drug prescribing such as pattern, quality, determinants and outcomes of drug use. Polypharmacy is considered to be hazardous for the elderly, because of their greater vulnerability to drugs and multiple drug use. Prescription of potentially inappropriate medications (PIMs) has been found to be a common cause of morbidity and mortality among the geriatric population and has necessitated the creation of criteria for the safe use of medicines among them. Objectives of the study were to assess the drug utilization pattern in geriatric patients and analyse their prescriptions as per the World Health Organization (WHO) core prescribing indicators and STOPP and START criteria.Methods: An observational, cross-sectional study was conducted from May 2019 to August 2019 in inpatient department of general medicine of VIMSAR, Burla. Prescriptions of ≥65 year patients were collected and documented by active surveillance from the medicine ward.Results: Majority of the patients were in age group of 65-75. Stroke is the more common comorbidities among geriatric population. Average number of medication per prescription is 5.42. About 78.74% of drugs are injectable. The percentage of antibiotics prescribed to patient is 27.75%. Based on STOPP criteria potentially inappropriate medications PIM is 7% and START criteria PIM is 29%.Conclusions: Our study suggests that prevalence of polypharmacy was high which is usually unavoidable in geriatric patients and less PIM is suggestive of adherence to WHO core prescribing indicators, and prescription of drugs as per STOPP and START guidelines are indicative of scope for improvement.


Author(s):  
Nishandar Tb ◽  
Kale As ◽  
Pise Hn ◽  
Jambhrunkar Sd

Objective: Drug utilization research is an essential part of pharmacoepidemiology as it describes the extent, nature, and determinants of drug exposure. Indiscriminate use of topical antibiotics, steroids, and nonsteroidal anti-inflammatory drugs causes histological and structural changes in the conjunctiva. The present study was proposed to investigate prescription and drug utilization practices in ophthalmology outpatient department (OPD) in a government tertiary care hospital in Maharashtra.Methodology: An observational, cross-sectional study was conducted in a tertiary care teaching hospital of rural Maharashtra, India, from January 2015 to June 2016 after approval of the institutional ethics committee. Patients of all age group and of either gender attending ophthalmology OPD in a tertiary care hospital were included in the study. Patients not willing to consent as well as follow-up patients were excluded from the study. Data collection was done in a predesigned pro forma. Prescriptions were evaluated for demographic data, World Health Organization (WHO) core drug prescription indicators. Statistical analysis was performed using Microsoft Office Excel® 2007.Results: In a total of 600 patients, females outnumbered males. A bit less than a half of patients belonged to the age group of 19–45 years. An average number of drugs per encounter was (1080/600), i.e. 1.8. Of 1080 total drugs prescribed, 678 drugs (62.78%) were prescribed by their generic name. 1027/1080 (95.09%) drugs were prescribed from the National List of Essential Medicines and 671/1080 (62.13%) drugs prescribed were from the WHO- Essential medicines List. Total encounters having antibiotics and injectable formulations were 274 (45.66%) and 4 (0.66%), respectively.Discussion: Drug utilization studies (DUS) are a tool for assessing the prescribing, dispensing, and distribution of drugs. The main aim of DUS is to facilitate rational use of medicines. Overall findings of the study suggest that ophthalmologists’ drug prescribing habits were appropriate to a larger extent in the current setting.


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