scholarly journals PRESCRIBING PATTERN IN GERIATRIC PATIENTS IN MEDICAL OPD OF A TERTIARY CARE TEACHING HOSPITAL

Author(s):  
KANIKA KHAJURIA ◽  
VIJAY KHAJURIA

Objectives: Geriatric population is increasing globally and they suffer from multiple disorders necessitating administration of number of drugs. The objective of the present study was to examine the prescribing pattern in geriatric patients in a medical OPD. Methods: An observational, cross-sectional study was conducted in medical OPD of Government Medical College, Jammu, over a period of a month after approval of the Institutional Ethics Committee. Patients above 65 years of age who gave consent were included in the study. The prescriptions were analyzed for demographic profile (age and gender), average number of drugs per prescription, drugs by generic or brand names, fixed drug combinations (FDCs), and percentage of potentially inappropriate as per Beers criteria. Results: A total of 200 patients were included comprised 64% of males and 36% of females. The most of patients were in the age group of 65–69 years (37.5%). A total of 200 prescriptions contained 1128 drugs amounting to average 5.64 number of drugs per prescription. Maximum prescriptions had 1–5 drugs (61%) followed by 6–10 drugs (38.5%). Majority of drugs were prescribed by brand name (93.26%) and only 6.73% of drugs were prescribed by generic name. About 10.46% FDCs were prescribed. Maximum drugs prescribed were from respiratory system (20.3.1%), followed by GIT (18.4%), antimicrobials (17.2%), cardiovascular (10.99%), NSAIDs (9.3%), and vitamins (8.4%). Forty-one drugs (20.5%) in patients were potentially in appropriate drugs based Beers criteria and belonged mostly to anticholinergic, antihistaminic, sedatives, NSAIDs, and H2 blockers. Conclusions: The present study demonstrates that polypharmacy and potentially inappropriate medication are still present in OPD prescription of geriatric population. Generic prescribing still lacks. Application of Beers criteria and increasing awareness about polypharmacy should be encouraged.

Author(s):  
Mustafa K. Mahmood ◽  
Zinah M. Anwer

Potentially inappropriate prescribing is the prescribing of a medication that may cause more harm than benefit, the elderly population aged 65 years or older is more prone to potentially inappropriate prescribing because of alterations in their physiology, pharmacokinetics, and pharmacodynamics as well as polypharmacy and comorbidities, Beers list is a screening tool that help doctors to detect potentially inappropriate prescribing in geriatric patients and is designed to solve this problem, the aim of this study is to measure the prevalence of potentially inappropriate prescribing among psychiatric patients using the Beers criteria as an assessment tool and find the relationship between duration of hospitalization, comorbidities and polypharmacy with potentially inappropriate prescribing in elderly. This cross-sectional study was carried out using electronic medical records in Ibn Rushud psychiatry and addiction hospital in Baghdad and 369 patients were included. The mean age of the patients was (68.59 ± 3.75 years) and 177 (48%) of them had comorbidities, 100 (27.1%) of them had polypharmacy and 17 (4.6%) stayed in the hospital for more than 3 weeks, the most used drug classes were antipsychotics in (39.9%) of patients and benzodiazepines in (17.6%) of patients. The prevalence of potentially inappropriate prescribing according to Beers criteria was found to be 74.3% among study patients, the most prevalent inappropriately used drug class was benzodiazepines, and there was a significant association between the prescribing of a potentially inappropriate medication with gender (p=0.018), with comorbidities (p=0.022), and a very significant association with polypharmacy (p<0.001)


2019 ◽  
pp. 40-42
Author(s):  
Haresh A Desai ◽  
Bhagya Manoj Sattigeri

Aim & Objective:The study aimed to evaluate the disease pattern, drugs used & the prescribing patterns to the geriatric patients at rural hospital. Materials and Methods: A total of 300 patients were enrolled in the prospective, cross sectional study. The demographic details, drugs used condition for which the drugs were prescribed and other related factors; names by which they were prescribed, use of fixed dose combinations were recorded and subjected to analysis. Observation and Results: Enrolled patients belonged to the age between 65 to 74 years, who presented with cardiovascular (21.22%) followed by musculoskeletal conditions (17.44%). Medicines were mostly prescribed by brand names 72.11%, Ranitidine was most frequently prescribed followed by Aceclofenac. About 20.35% were prescribes as FDCs for ex; Aceclofenac + Paracetamol was most commonly prescribed FDC followed by Amoxicillin + Clavulanic Acid. Conclusion: Cautious use of medicines in geriatric patients is essential which can be provided by rational prescribing.


2021 ◽  
Vol 12 (1) ◽  
pp. 40-45
Author(s):  
Lakshmi P ◽  
Ramya Kuber B

Introduction: Older patients are considered as special population, the pharmaceutical care with focus of increasing medication appropriateness and reducing medication related problems is needed. Elderly patients have a higher prevalence of chronic and multiple illness and physiological changes associated with aging may masquerade as illness. Aim & Objectives: To assess and evaluate the drug prescribing pattern and inappropriate prescribing by using beers criteria 2015 among Geriatric patients. Materials & Methodology: A prospective observational study was conducted in general medicine out-patient department, SVRRGGH, Tirupati for period of 6months.The patients of general medicine out-patient department with age above 65yrs old were included in the study. The Patients who are not willing to participate in the study, inpatients and terminally ill patients were excluded from the study. Results & Discussion: Among 200 patients, distribution of age majority of the patients is male (71%) followed by females (29%), Most of patients have multiple diseases (64%) followed by Single disease (29%). All potentially inappropriate medicines (PIMS) are classified as category A, B, C. Drugs have to be avoided in geriatric patients (Category A) being the most common category of inappropriate as per Beers criteria updated by American Geriatric Society 2015.Our study reported 174 drugs as PIMs. Conclusion: It is also necessary to improve the geriatric care, as this age group possess risk for many diseases and medication use. In future a multidisciplinary approach, steps to be taken involving physicians, nurses and pharmacists has a team for bringing out rational drug use in geriatric population.


2014 ◽  
Vol 50 (4) ◽  
pp. 911-918 ◽  
Author(s):  
Mariana Martins Gonzaga Nascimento ◽  
Andréia Queiroz Ribeiro ◽  
Mariana Linhares Pereira ◽  
Adriana Cristina Soares ◽  
Antônio Ignácio de Loyola Filho ◽  
...  

The objective of this study was to determine the prevalence of Potentially Inappropriate Medication (PIM) use and associated factors, as well as the prevalence of Prescribing Omissions (PO). A cross-sectional study was conducted in a philanthropic Brazilian nursing home involving 46 individuals aged 60 years or older. The following information was collected from medical records and drug prescriptions: gender, age, health conditions and drugs used in the past thirty days. PIM and PO were identified according to the Beers' Criteria and the STOPP/START screening tools. Over one third (37%) of the population used at least one PIM according to the Beers' Criteria (n=17) and 60.9% according to the STOPP tool. A significant association was found between polypharmacy (use of five or more drugs) and use of PIM according to the Beers' Criteria, but not according to the STOPP. Eight residents (17.4%) were exposed to eight PO. This study allowed the diagnosis of a concerning drug utilization profile with use of a high number of PIMs. Thus, there is an evident need to implement strategies for improving geriatric prescription.


Author(s):  
Rakesh R. Jadhav ◽  
Rushikesh S. Kulkarni ◽  
Arati V. Rathod

Background: Establishment of Pradhan Mantri Bhartiya Janaushadhi Kendras through Pradhan Mantri Janaushadhi Pariyojana (PMBJP) is a breakthrough step to reduce expenses in healthcare due to costly branded names in prescription. Medical council of India also amended clause 1.5 of the Indian Medical Council Regulations, 2002 mandating the doctors to prescribe medicines by generic names in place of brand names. Moreover, medical practitioner nowadays has raised concern about education/qualification of the chemist who is being made the decision maker.Methods: In this questionnaire based cross-sectional observational study, all students admitted to post graduation course in academic year 2018 were included and those who were not willing to give consent were excluded from study. A knowledge, attitude and practices (KAP) questionnaire containing 12 questions was assessed by using true/false type and Likert scale-based questions. Descriptive statistics used to generate frequencies, percentages and proportions.Results: Majority of the population have answered positively about knowledge questions. Surprisingly 72.41% population don’t know about process of new drug approval. Most of them agreed to pros and cons of generic drug prescribing. 58.14% population always write generic names in their prescription. Shockingly 74.42% population write prescription based on their knowledge from promotional literature by a medical representative.Conclusions: Findings of present study highlights usefulness of the practice of writing generic names in prescriptions. It also raises concern about professional qualification of the chemist who will be decision maker in drug delivery to consumers.


Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 219
Author(s):  
Rishabh Sharma ◽  
Manik Chhabra ◽  
Kota Vidyasagar ◽  
Muhammed Rashid ◽  
Daniela Fialova ◽  
...  

Background: Older patients with type 2 diabetes mellitus (T2DM) are at greater risk of receiving potentially inappropriate medications (PIM) during hospitalization which may result in adverse outcomes. Aim: To evaluate the extent of PIM use in the older population with T2DM during hospitalization in a tertiary care hospital in India. Methods: A cross-sectional study was carried out from August 2019 to January 2020 in a tertiary care teaching hospital among the older population (aged ≥ 65 years) hospitalized with T2DM. Medications prescribed during hospitalization were reviewed following Beers Criteria 2019 to identify the extent of polypharmacy and PIM use. Binary logistic regression was applied to determine the factors associated with PIM use. Results: The mean age of the 150 patients hospitalized with T2DM was 68.85 ± 5.51 years, most of whom were men (54.7%). The participants had at least four comorbidities and were receiving an average of nine medications per day; the median length of hospital stay was 8 days (interquartile range (IQR): 4–19 days). Overall, three quarters (74%) of the participants had at least one PIM prescribed during their hospitalization as per Beers Criteria. Significant factors associated with the use of PIM during hospitalization are patients taking a higher number of medications (odds ratio (OR): 7.85, 95% CI 1.49–41.10), lower creatinine clearance values (OR: 12.90, 95% CI 2.81–59.28) and female patients (OR: 2.29; 95% CI: 1.05–4.97). Conclusions: PIM use is frequently observed in older T2DM patients during hospitalization. Polypharmacy, reduced renal function and female gender are associated with higher PIM use. Engaging clinical pharmacists in evaluating medication appropriateness can improve the outcomes of older patients.


2017 ◽  
Vol 29 (1) ◽  
pp. 10-13
Author(s):  
Mohammad Tariqul Alam ◽  
Mohammad Muntasir Maruf ◽  
Mekhala Sarkar ◽  
Helal Uddin Ahmed ◽  
Mahfuza Akhter

Pattern of prescriptions for psychiatric patients varies which is influenced by patient variation, types of disorders, cultural and environmental influences, socioeconomic status, availability of drugs and psychiatrists own preference. The aim of this study was to determine the patterns of prescribing psychotropic drugs in psychiatry Outpatient Department (OPD) in a tertiary care hospital. The cross-sectional study was conducted in the OPD of National Institute of Mental Health (NIMH), Dhaka from January to June, 2016. In the study, the prescriptions prescribed by psychiatrists were considered as study population. Using convenient sampling method, data were collected by observation using checklist from selected 604 latest prescriptions prescribed by psychiatrists in OPD of NIMH for the patients coming there for treatment. The data on the psychotropic drugs collected for the study were antipsychotics, antidepressants, mood stabilizers and sedative-hypnotics. Results showed that a total of 1802 psychotropic drugs were prescribed with an average of 2.98 psychotropics per prescription. The most common drug group prescribed was antipsychotics (44.8%). Majority (49.7%) of the prescriptions contained 3 psychotropics simultaneously. Most common (27.8%) combination was that of antipsychotics and sedativehypnotics. Dosage regimen was twice/day for the majority (55.6%). There was a combination of oral and parenteral drugs in 48.3% of prescriptions. All the drugs were prescribed by brand names. There was no diagnosis written in 60.9% of the prescriptions. The prescription pattern was not rational and this should be intervened by educating prescribers about rational prescribing in psychiatry.Bang J Psychiatry June 2015; 29(1): 10-13


Author(s):  
Manju Gari ◽  
Megha Bansal

ABSTRACTBackground: The objective of the present study was to evaluate the prescribing pattern of hypolipidaemic drugs in the outpatient department of cardiology in a tertiary care hospital.Methods: A cross-sectional study was conducted in the department of cardiology for the period of 3 months. A total of 526 prescriptions were analyzed for variants such as the disease patterns, the type of hypolipidaemic drugs which are prescribed for those diseases, the prescribing daily dose of the hypolipidaemic drugs and the prescribing daily dose/daily defined dose ratio of the drugs.Results: On evaluation of the prescriptions, it was conferred that both the patients of normal lipid profile (34.77%) and abnormal lipid profile (65.18%) were prescribed hypolipidaemic drug. Diabetes with hypertension (35.74%) was the most common disease for which hypolipidaemic drugs were prescribed. Atorvastatin (30.98%) was the most common drug which was prescribed as monotherapy, whereas atorvastatin with aspirin and clopidogrel (17.49%) was the most common drug prescribed in combination.Conclusions: Use of statin has become very prevalent with increasing trends of use in both normal and abnormal lipid profile patients, suggesting consideration of rational use of statins to follow good prescribing pattern so that morbidity and mortality can be prevented.


Author(s):  
Roshi . ◽  
Vishal R. Tandon ◽  
Brij Mohan Gupta ◽  
Sanjeev Gupta

Background: Prescribing drugs for any disease is not complete until it is rationally done. Irrational prescriptions often lead to treatment failure, toxicity or drug interactions which may prove detrimental to the patient. Antibiotics are very much prescribed in day to day practice but their rational use prevents treatment failure, resistance.Methods: A cross sectional study was conducted in a tertiary care hospital to see the antibiotic prescribing pattern. Prescriptions were screened one time from different OPDs with prior permission from the doctor attending the respective OPD.Results: A total of 200 prescriptions were assessed out of which 121 had monotherapies prescribed, 79 had FDCs. Antibiotics were the most commonly prescribed drugs. Prescriptions having drug combinations were assessed and pantoprazole domperidone was the most commonly prescribed (32.91%).Conclusions: Drugs should be prescribed rationally for proper therapeutic benefit. It encourages the patient to properly use the medicine and properly comply to it.


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