Evaluation of Drug Utilization Pattern among Geriatric Patients in a District Head Quarters Government Hospital using World Health Organization Indicators

Introduction: Assessment of drug utilization pattern using the World Health Organization (WHO) prescribing indicators is important to promote rational drug therapy.It needs to be evaluated periodically to obtain information about drug utilization pattern, to detect early signals of irrational use of drugs and to provide feedback to prescribers. Objective: The objective of the present study was to assess the drug prescribing patterns in the Otorhinolaryngology OPD based on the WHO prescribing indicators. Methodology: A cross-sectional study was conducted among 148 outpatients at Otorhinolaryngology and HNS department of B.P. Koirala Institute of Health Sciences for six month duration. Patients aged 18 years and above and prescribed at least one drug were enrolled. Medical case sheets of the every fifth patients visiting the OPD were reviewed to collect the relevant data on a self-designed proforma. Descriptive statistics and WHO prescribing indicators were calculated using SPSS version 11.0. The study was approved by Institutional Review Committee, B.P. Koirala Institute of Health Sciences Results: A total of 322 drugs were prescribed to 148 patients. Most of the drugs were prescribe through oral route (69.3%). Levocetrizine (10.6%) was the commonest prescribed drug followed by Ibuprofen+Paracetamol (10.2%) and Pantoprazole (10.2%). Among systemic antibiotics, Amoxicillin+Clavulanic acid (35.9%) was the most frequently prescribed followed by Cefixime (12.8%) and Levofloxacin (12.8%). Ofloxacin + Dexamethasone (22.9%) was the most frequently prescribed topical drug followed by Mometasone (17.7%). The average number of drugs prescribed per encounter or mean was 2.2 (range 1-5). The percentage of encounters in which an antibiotic was prescribed was 33.2%. The percentage of drugs prescribed by generic name and from National List of Essential Medicine (NLEM) was 28% and 31.9% respectively. Conclusions: The drug utilization pattern did not comply with the most of the WHO prescribing indicators. The average number of drug per prescription was higher than recommended by WHO, generic prescribing was remarkably lower and prescribing from NLEM was also low.

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Drug utilization pattern and appropriateness of prescription in IPD geriatric patients in a tertiary care teaching hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20205538 ◽

2020 ◽

Vol 10 (1) ◽

pp. 55

Author(s):

Shuchisuta P. Pathy ◽

Sachchidanand Pandey ◽

Bhabagrahi Rath ◽

Rinu Rani Dash

Keyword(s):

Drug Use ◽

Drug Utilization ◽

Geriatric Patients ◽

Tertiary Care ◽

World Health ◽

Potentially Inappropriate Medications ◽

Utilization Pattern ◽

Geriatric Population ◽

Prescribing Indicators ◽

Inappropriate Medications

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.

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Analyzing Antidiabetes Drug Prescriptions With World Health Organization Anatomical Therapeutic Chemical/Defined Daily Dose Index to Assess Drug Utilization Pattern in Elderly Population of Rural Eastern India

Indian Journal of Clinical Medicine ◽

10.1177/1177393617703343 ◽

2017 ◽

Vol 8 ◽

pp. 117739361770334 ◽

Cited By ~ 1

Author(s):

Sandeep Lahiry ◽

Avijit Kundu ◽

Ayan Mukherjee ◽

Shouvik Choudhury ◽

Rajasree Sinha

Keyword(s):

World Health Organization ◽

Drug Utilization ◽

West Bengal ◽

Anatomical Therapeutic Chemical ◽

World Health ◽

Defined Daily Dose ◽

Prescription Data ◽

Daily Dose ◽

Health Organization

Objective: To analyze drug utilization (DU) pattern of antidiabetes drug (ADD) prescription in elderly type 2 diabetes mellitus (T2DM) in rural West Bengal based on 2016 World Health Organization (WHO) Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) Index. Methods: This was a prospective observational study. Prescription data of 600 elderly patients (age > 60 years) attending outpatient clinic were screened over 12 months (January 2015 to January 2016) from 5 different rural hospitals in West Bengal. Pooled data were sorted and classified in accordance with 2016 ATC/DDD WHO Index. Direct cost associated and consumption of ADD were measured as DDD/1000 patients/day. The adverse drug reactions (ADRs) related to antidiabetic medicines were monitored. Results: During the study period, mean age of patients recorded was 66.4 ± 5.0 years, with 66.6% (n = 396) having history of T2DM > 5 years. Follow-up encounters (n = 2328) revealed metformin (94.67%), sulfonylureas (SUs) (50.54%), pioglitazone (24.22%), voglibose (22.50%), insulin (9.75%), and acarbose (6.82%) to be more prevalent, constituting DU 90% (92.01%). Combination of metformin plus SU was recorded in most of the patients (56%). Insulin, however, was found to be an underutilized class ( P < .005). The DDD/1000 patients/day of metformin (2.918), glimepiride (1.577), and gliclazide (0.069) conformed to 2016 WHO ATC/DDD Index. The total ADD consumption during study period was 5.03 DDD/1000 patients/day. The average drug cost per encounter per day was Rs 11.24 ± 2.01. Nineteen ADRs were reported and their descriptions were found to be of hypoglycemia (n = 9), pedal edema (n = 2), and gastrointestinal upsets (n = 8). Target glycemic status was achieved in 40% monthly follow-up encounters. Low-store drug availability and poor compliance to treatment (>60%) were major determinants. Lack of regular aerobic exercises (>85%) and proper knowledge regarding medical nutrition therapy (MNT) (>80%) and low average consultation time (3.5 ± 0.6 minutes) were important contributing factors. Conclusions: The study exhibited increased utilization of 2 drug combinations of oral ADD and lower utilization of insulin during study period. Such inferences merit further exploration.

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Evaluation Of Drug Utilization Patterns Based On World Health Organization Drug Use Indicators At Outpatients Clinics

Advanced Materials Letters ◽

10.5185/amlett.2020.031489 ◽

2020 ◽

Vol 11 (3) ◽

pp. 20031489-20031489

Author(s):

Kayamkani Abedulla Khan

Keyword(s):

Drug Use ◽

World Health Organization ◽

Drug Utilization ◽

World Health ◽

Utilization Patterns ◽

Health Organization

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Growth and Malnutrition Assessment of Neonates Admitted to a Government Hospital in Nakuru, Kenya

International Journal of Child Health and Nutrition ◽

10.6000/1929-4247.2021.10.02.2 ◽

2021 ◽

Vol 10 (2) ◽

pp. 51-58

Author(s):

Melissa Thoene ◽

◽

Nora Switchenko ◽

Anya Morozov ◽

Elizabeth Kibaru ◽

...

Keyword(s):

Birth Weight ◽

World Health Organization ◽

Hospital Length Of Stay ◽

World Health ◽

P Value ◽

Growth Chart ◽

Z Score ◽

Government Hospital ◽

Score Change ◽

Health Organization

Background and Aims: Inadequate nutrient provision causes neonatal growth failure and malnutrition. Therefore, this study aimed to 1) quantify infant growth velocity from birth to hospital discharge, 2) determine the incidence of neonatal malnutrition at the time of discharge from a government hospital newborn unit in Nakuru, Kenya. Methods: After ethical approval, data was collected for infants (n=104) hospitalized >14 days (June 2016 - December 2018) including: birth gestational age (GA), birth and discharge weight (grams, g) with z-scores (2013 Fenton Preterm or 2006 World Health Organization 0-2 Year growth chart), hospital length of stay (LOS) days. Growth during hospitalization was calculated in g/day [(discharge weight – birth weight)/LOS] and g/kilogram(kg)/day [1000xln(birth weight/discharge weight)/LOS). Malnutrition was diagnosed by birth to discharge weight z-score change (decline): mild = 0.8-1.2 standard deviations (SD), moderate = >1.2-2.0 SD, severe = >2.0 SD. P-value <0.05 was significant. Results: 94/104 (90.4%) infants were preterm with median birth GA 32 weeks, weight 1500 g (z-score -0.33), LOS 21 days and discharge weight 1735 g (z-score -1.95). Median weight gain was 8.2 g/day or 5.2 g/kg/day with weight z-score change -1.34 SD. Linear regression predicted each hospital day decreased z-score by -0.031 (p<0.001). At discharge, 81.7% of infants met malnutrition criteria—27.1% mild, 49.4% moderate, 23.5% severe. Conclusions: Infants with LOS >14 days in a government hospital newborn unit in Nakuru, Kenya, experience growth rates below recommended velocities by the World Health Organization (23-34 grams/day from 0-4 months). Nutrition intervention is necessary to support appropriate growth.

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DRUG UTILIZATION PATTERN IN PAEDIATRIC PATIENTS IN A SECONDARY CARE HOSPITAL

International Journal of Pharmacy and Pharmaceutical Sciences ◽

10.22159/ijpps.2019v11i4.30746 ◽

2019 ◽

pp. 69-74 ◽

Cited By ~ 1

Author(s):

R. SENTHILSELVI ◽

M. BOOPANA ◽

Linta Sathyan ◽

PRIYA VISUVASAM ◽

V. GANESAN

Keyword(s):

World Health Organization ◽

Drug Utilization ◽

World Health ◽

Drug Prescribing ◽

Essential Drug ◽

Essential Drug List ◽

Drug List ◽

Rational Drug ◽

The World ◽

Health Organization

Objective: The study was carried out to generate research on drug utilization pattern in paediatric patients in government headquarters hospital, Tiruppur, Tamilnadu, India using world health organization (WHO) and international network for rational use of drugs (INRUD) core indicator. Methods: The core prescribing indicators of the world health organization was used to assess the appropriate use of drugs. Index of rational drug prescribing (IRDP) developed by Zhang and Zhi was also used to find out the performance of a health care system in terms of drug utilization. Results: Out of 859 drugs in 200 cases the highest prescribed drug class is antibiotics 304(35.39%) and the majority of drugs were administered in injectable form 412(47.94%). It was analysed that a majority of prescriptions 117(58.5%) were discharged in between 4-7 d. 161(80.5%) patients were dismissed after completion of treatment. On analysing world health organization (WHO) prescribing core indicators, the average number of drugs per prescription was 4.29 which is higher than double the average number (i.e., 2). This indicates poly-pharmacy practice. 97.78% of drugs were prescribed were the generic name and percentage of encounters with antibiotic prescribed was 90.5% which is thrice greater than world health organization (WHO) standard<30%. Prescribing of injections is not within the world health organization (WHO) recommended range<20% and it was far higher showing 97.5% which is essential for paediatric inpatients. The prescribing practice in paediatric ward is in complete adherence to national essential drug list (EDL) or formulary. The mean value of the index of rational drug prescribing (IRDP) obtained was 3.09 which is very similar to that of optimal value world health organization (WHO). Conclusion: Prescription by generic name, prescribing drugs from essential drug list (EDL) and free government supply are encouraging findings in this hospital. The result shows poly-pharmacy and overuse of antibiotics are the areas to be concerned. The better clinical outcome shows rational prescribing is practised well.

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