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

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):  
Arun Patil ◽  
Darshana Dighe ◽  
Shrikrishna Kolte ◽  
Pradeep R. Jadhav ◽  
Y. A. Deshmukh

Background: Skin diseases are common and cause a huge disease burden globally. Different class of drugs and combinational products are available in dermatology for treatment. Periodic prescription analysis in the form of drug utilization study can improve the quality of prescription and curb the menace of irrational prescribing. Aim and objective of the study were to study the prescribing pattern and drug utilization trends in Dermatology outpatient department at a tertiary care hospital in Navi Mumbai.Methods: A cross-sectional, observational study was conducted over a period of three months in dermatology department of a tertiary care teaching hospital, Navi-Mumbai. A total of 102 adult patients visiting dermatology OPD were included and their prescriptions were analyzed with WHO prescribing indicators and additional indices.Results: Analysis showed that the average number of drugs per prescription was 3.27. Percentage of drugs prescribed by generic name was 31.1%. Percentage of drugs prescribed from National Essential drug list (NEDL) was 44.2%. The commonest prescribed drugs were antihistaminics followed by antifungals. Oral tablets were the commonest prescribed dosage form.Conclusions: Antihistaminics and antifungals dominated the prescribing pattern in this study with restraint on polypharmacy, but showed ample scope for improvement to prescribe generic and selection of essential drugs.


Author(s):  
Ankit Bhardwaj ◽  
Kaveri Kapoor ◽  
Vivek Singh

Background: Aim of the study was to assess trend in antibiotics consumption pattern from 2016 to 2019 using AWaRe classification, ATC and Defined daily dose methodology (DDD) in a tertiary care hospital. Antibiotics are crucial for treating infectious diseases and have significantly improved the prognosis of patients with infectious diseases, reducing morbidity and mortality. The aim of the study is to classify the antibiotic based on WHO AWaRe classification and compare their four-year consumption trends. The study was conducted at a tertiary care center, Pilakhuwa, Hapur. Antibiotic procurement data for a period of 4 years (2016-2019) was collected from the Central medical store.Methods: This is a retrospective time series analysis of systemic antibiotics with no intervention at patient level. Antibiotic procurement was taken as proxy for consumption assuming that same has been used.  ATC for systemic use (ATC code J01) antibacterial was used and defined daily dose (DDD) per 100 bed days was calculated. Antibiotics were further classified as Access, Watch, and Reserve (WHO AWaRe classification).  Antibiotics consumption was ranked based on their volume of DDD i.e., drug utilization (DU90%) was calculated. Non-parametric Pearson’s correlation coefficient was used for the comparison of consumption.Results: Mean antibiotic procurement increased 1.25 folds from 140.3 DDD in 2016 to 201 DDD in 2018. A significant fall was seen in total DDDs in year 2019 (p value <0.05). A total of 41 antibiotics agents (Access 12, Watch 21, Reserve 6 and Not recommended 2) were procured. Reserve category antibiotics were procured from 2017 onwards. Out of 41 antibiotics procured 11 antibiotics (Access 3 and watch 8) accounted for DU 90%.Conclusions: Antibiotics consumption of watch group was high and increasing antibiotic consumption trend was observed. Hospital antimicrobial stewardship program should be implemented to shift to use of Access group antibiotics and restrict use of Watch antibiotics.


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):  
Seema Anjum M ◽  
Chinchu Jacob ◽  
Chinchu Jacob ◽  
Akhil Benchamin ◽  
Akhil Benchamin ◽  
...  

  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.


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