Prescription audit study in a tertiary care hospital using the anatomical therapeutic chemical and defined daily dose classification concept

Background: This study was conducted to determine the drug utilization pattern among geriatric inpatients in general medicine department of the hospital.Methods: An observational, prospective study was conducted for a period of six months (November 2016 to April 2017) among 200 geriatric patients; demographic details, education, occupation, diagnosis and drug details were recorded. The drugs were categorized by anatomical therapeutic classification (ATC) and defined daily dose (DDD) was calculated. The World Health Organization (WHO) prescribing indicators were assessed.Results: The majority of the patients (59%) were in age group of 60-69 years. Cardiovascular diseases were common among geriatrics. Most commonly prescribed drug was Pantoprazole (81.7%). Drugs were assigned with ATC/DDD codes according to the guidelines of WHO. Drugs prescribed by their generic names were 56.64% and 43% of drugs that were included in the National Essential Medicines List.Conclusions: Clinical pharmacist have to collaborate and work together with physicians in selecting and adjusting the dose among geriatric population in order to reduce development of potential adverse drug reactions, serious drug related complications and drug interaction.

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

International Journal of Pharmaceutical Sciences and Drug Research ◽

10.25004/ijpsdr.2019.110501 ◽

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.

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Trend analysis of antibiotics consumption using WHO AWaRe classification in tertiary care hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20204493 ◽

2020 ◽

Vol 9 (11) ◽

pp. 1675

Author(s):

Ankit Bhardwaj ◽

Kaveri Kapoor ◽

Vivek Singh

Keyword(s):

Infectious Diseases ◽

Tertiary Care Hospital ◽

Care Center ◽

Tertiary Care ◽

Consumption Pattern ◽

P Value ◽

Defined Daily Dose ◽

Care Hospital ◽

Stewardship Program ◽

Daily Dose

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.

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Assessment of drug utilization among geriatric patients based on defined daily dose concept in a rural tertiary care teaching hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20204092 ◽

2020 ◽

Vol 9 (10) ◽

pp. 1538

Author(s):

K. Padmavathi ◽

S. A. Arun Raaj ◽

S. Subash ◽

C. K. Dhanapal ◽

S. Periasamy

Keyword(s):

Drug Utilization ◽

Geriatric Patients ◽

Anatomical Therapeutic Chemical ◽

Tertiary Care ◽

Defined Daily Dose ◽

College Hospital ◽

Care Teaching ◽

Essential Drug List ◽

Daily Dose ◽

Collection Form

Background: The objectives of the study were to use the anatomical therapeutic chemical classification (ATC) /defined daily dose (DDD) concept to study the drug utilization pattern in geriatric patients in a rural tertiary care teaching hospital.Methods: An observational study was conducted at Rajah Muthiah Medical College Hospital (OPD and IPD) over a period of six months from November 2018 to April 2019. The data was collected from 204 patients using specially designed data collection form. The patients were selected based on inclusion and exclusion criteria. Results: A total of 204 patients were included in this study. The study population consisting of males 130 (63.7%) and females 74 (36.2%). Diseases related to the cardiovascular system 67 (32.84%) were the most common cause for the geriatric patients to attend the hospital, followed by surgical diseases 47 (23.03%), Oncological diseases 2 (0.98%) were the least frequency encountered. The average number of drugs prescribed per prescription was 8.79. Out of 1795 drugs prescribed, 60.86% of drugs were prescribed in generic form, and 39.14% were prescribed in brand name. The study analysed that 71.25% of drugs prescribed were from essential drug list (EDL) 2016-2018. Number of prescriptions with an injection was 74.04%. Paracetamol (N02B01) was the most frequently prescribed drug, followed by Amlodipine (C08CA01), Dexamethasone (H02AB02), Clopidogrel (B01AC04), Ferrous sulfate (B03AA07), Acetylsalicylic acid (B01AC06), Hydrocortisone (H02AB09), Tamsulosin (G04CA02), Atorvastatin (C10AA05), Furosemide (C03CA01).Conclusions: Drug utilization study can help in evaluating the quality of care given to the geriatric patients and promote rational use of medicines.

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Prevalence of Carbapenem Resistant Enterobacteriaceae in a Tertiary Care Hospital of Gujarat, India

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47332.14627 ◽

2021 ◽

Author(s):

Chirag Manojkumar Modi ◽

Suman Praveen Singh ◽

Yagnesh Gajanand Pandya ◽

Chirag Premjibhai Patel ◽

Rupal Minesh Patel

Keyword(s):

Tertiary Care Hospital ◽

Demographic Data ◽

Treatment Options ◽

Tertiary Care ◽

Carbapenem Resistance ◽

Defined Daily Dose ◽

Sample Type ◽

Care Hospital ◽

Carbapenem Resistant ◽

Carbapenem Resistant Enterobacteriaceae

Introduction: Carbapenem Resistant Enterobacteriaceae (CRE) are major cause of community as well as healthcare associated infections and have limited treatment options. Measuring the magnitude of the problem of CRE, it is important for making strategies to lower its spread. Aim: To assess the incidence and prevalence rate of CRE in a tertiary care hospital of Gujarat, India. Materials and Methods: Retrospective data was collected for a period from 2014 to 2018 using Laboratory Information System (LIS). Prevalence of CRE was determined as number of CRE isolated per 100 Enterobacteriaceae isolated during the study period whereas incidence rate was determined as number of CRE cases per 1000 patient-days. Consumption of Carbapenems was calculated as Defined Daily Dose (DDD) per 1000 patient-days. Demographic data including age, gender, location in the hospital and sample type from which CRE was isolated was also analysed using Microsoft Excel. Results: The incidence of CRE cases per 1000 patient-days in 2014 to 2018 was 1.66, 2.11, 1.90, 2.26 and 1.91, respectively with an overall incidence of 1.99 per 1000 patient-days. The overall prevalence of CRE over a period of five years was found to be 29.07%. Klebsiellasp. was the most common CRE and had the highest percentage of Carbapenem resistance among all Enterobacteriaceae. Conclusion: The rate of CRE in present study was high and worrisome. Screening of the patient for CRE, source isolation and stringent implementation of infection control practices is required to confine the spread of CRE in this institute.

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Prescription audit for evaluation of present prescribing trends in a rural tertiary care hospital in South India: an observational study

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20163242 ◽

2016 ◽

pp. 2094-2097

Author(s):

Nagashree N. ◽

Ravi Manchukonda

Keyword(s):

Observational Study ◽

South India ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Care Hospital ◽

Prescription Audit ◽

Prescribing Trends

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DRUG UTILIZATION EVALUATION OF BENZODIAZEPINES IN A TERTIARY CARE HOSPITAL

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2019v11i11.35359 ◽

2019 ◽

pp. 6-9

Author(s):

P. RAMA ◽

R. MONISHA ◽

SUSAN VARGHESE PAUL ◽

VARSHA ELSA SCARIA ◽

P. JANANI ◽

...

Keyword(s):

Drug Utilization ◽

Anatomical Therapeutic Chemical ◽

Low Cost ◽

Tertiary Care ◽

Defined Daily Dose ◽

Care Hospital ◽

Probability Scale ◽

Related Information ◽

A Prospective Study ◽

Drug Utilization Evaluation

Objective: To assess the rationale use of benzodiazepines among various departments in a multi-speciality hospital. Methods: A prospective study was conducted with a sample size of 200 for a period of six months. Data was collected from patients based on inclusion and exclusion criteria. Naranjo Adverse Drug Reaction Probability Scale and Drug Interaction Probability Scale (DIPS) were used as a study tool to measure the causality of adverse drug reactions and drug interactions. Based on the dosage of various benzodiazepines DDD was calculated and compared with WHO Anatomical Therapeutic Chemical (ATC) classification Defined Daily Dose (DDD). Results: BZD’s were mostly prescribed in males (74.5%) and married patients (86.5%) were more exposed to benzodiazepines compared to others. Lorazepam (70.1%) was found to be the most commonly used drug, mainly prescribed for sedation, followed by anxiety. DDD was calculated and majority of patients had DDD in accordance with WHO standard. Based on cost analysis, Clobazam was found to be the high cost and Lorazepam being the low-cost drug. The results of drug utilization evaluation of benzodiazepines study were compiled and reported to the respected department physician and their feedback was collected. Conclusion: The study showed a rational utilization of benzodiazepines and the negative outcomes of BZDs can be reduced by providing drug-related information to the prescribers and consumers.

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