scholarly journals DRUG UTILIZATION PATTERN FOR SKIN DISEASES IN DERMATOLOGY OPD AT TERTIARY CARE HOSPITAL OF WESTERN MAHARASHTRA

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.

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


2021 ◽  
Vol 19 (3) ◽  
pp. 23-29
Author(s):  
Yogita G Bavaskar ◽  

Background: Most of the countries including India have witnessed two or more waves of Covid 19 pandemic. The present study was conducted to compare the differences in clinico-demographic characteristics and outcomes of Covid 19 patients admitted in first and second wave of Covid 19 pandemic in a tertiary care hospital at Jalgaon, Maharashtra. Methods: A retrospective observational study was conducted at a tertiary care Dedicated Covid hospital for Covid 19 at Jalgaon, Maharashtra. All microbiologically proven corona positive patients were included in the study. The demographic records and clinical history was extracted from the case history sheets of the patients from first as well as second wave using standardized data collection form. Clinical outcome of the patients, i.e., development of complications, death or discharge was also recorded for each enrolled subject. Results: 3845 patients of Covid-19 admitted in the hospital during the first wave of epidemic and 2956 patients during second wave of the epidemic were included in the study. The mean age of patients admitted in the second wave was significantly lower as compared to first [48.77(15.31) years vs 50.23 (14.33) years, P<0.005]. There is increase in proportion of patients in the age group of < 15 years in second wave as compared to first wave (74/2956, 2.5% vs 52/3845, 1.3%). The number of patients requiring admission in ICU at the time of admission increased by 13% in second wave as compared to first wave. [827/2956 (28%) vs 577/3845(15%), P<0.0001]. More than half of the patients who got admitted for Covid 19 in first as well as second wave were having one or more comorbidities.But the proportion of the patients with previous co-morbities was significantly higher in second wave (1684/2956, 57% vs 1960/ 3845, 51%, P= 0.0004). The mortality was also higher in second wave (533/2956, 18.03% vs 541/3845, 14%, P=0.0004). Conclusions: The demographic, clinical characteristics and outcome of Covid 19 patients was different in first and second wave of pandemic with involvement of younger patients, increased rates of admission to ICU and more mortality in the second wave as compared to first wave of the pandemic.


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

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.


Author(s):  
Varsha Medasani ◽  
Paquirissamy Oudeacoumar ◽  
Rao Chitralekhya ◽  
Saurabh Krishna Misra

<p class="abstract"><strong>Background:</strong> Skin diseases are a major health problem in the paediatric age group and are associated with significant morbidity. Dermatoses in children are more influenced by socioeconomic status, dietary habits, climatic exposure and external environment as compared to adults. The present study was undertaken to know the prevalence of paediatric dermatoses among patients attending Dermatology outpatient department in a tertiary care hospital in Puducherry.</p><p class="abstract"><strong>Methods:</strong> All newly diagnosed, untreated male and female paediatric patients (from neonates to adolescents ≤19 years of age) attending Dermatology OPD, from October 2015 to September 2017 were evaluated to study the prevalence and patterns of paediatric dermatoses. The skin disorders were classified into groups like infections, infestations, eczemas, acne, hypersensitivity disorders, sweat gland disorders, pigmentary disorders, nevi, keratinisation disorders, hair and scalp disorders, papulosquamous disorders, bullous disorders, nail disorders, drug reactions, other dermatoses.<strong></strong></p><p class="abstract"><strong>Results:</strong> The prevalence of pediatric dermatoses in our OPD is 25.21%. Incidence of pediatric dermatoses was found to be more in males 237 (59.39%) than in females 162 (40.60%) and the majority of the patients were in adolescent age group (217; 54.38%). Present study showed that majority of cases belonged to the lower socioeconomic group 186(46.6 %). In our study, majority (58.98%) of dermatoses belonged to infections and infestations group. Of the infective dermatoses, fungal infections (27.88%) were the most common.</p><p><strong>Conclusions:</strong> Infectious dermatoses were commonly seen in this study that may be due to poverty, overcrowding, poor hygiene. There is an increasing trend of fungal infections which might be related to hygiene and environment. </p>


2020 ◽  
pp. 28-30
Author(s):  
Neha Raval ◽  
Neeta K

Background: Despite alarming rise in prevalence of cardiovascular diseases (CVDs), there is paucity of Indian data in such population. Drug Utilization Study (DUS) in government clinical setup is instrumental in developing effective healthcare system of the country. The study was carried out with objectives to study the pattern of usage of drugs in CVDs in patients of Medicine Outpatient Department (MOD), Sir Sayajirao General Hospital, Vadodara and to have information about the current trends with CVDs and their correlation with different WHO indicators. Methods: A cross-sectional, observational DUS was carried out in adult patients of either sex. The data were recorded in previously prepared case record form for a period of four months (March 2014 to July 2014). The data were analyzed as per WHO prescribing indicators. Results: Among 1020 patients, 570 (55.88%) were female and 450 (44.11%) were male. Most of patients (30.49%) belonged to the age-group of 60-69 years. Total 19 CVDs were observed during the study period, with hypertension prevailing in maximum cases (70.88%). Diabetes mellitus was most frequently encountered (21.6%) non-cardiovascular comorbidity. Number of drugs prescribed by brand name was as low as 15 (19.7%) and >80%, drugs were prescribed by generic name. Number of drugs per prescription was 6.4. Conclusion: This study gives an idea of treatment measures being conducted in a large population at a tertiary care hospital in Gujarat and gives a comparative description of drug utilization pattern in similar settings across other regions of India.


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