A Retrospective Drug Utilization Study on Psychiatric Illness in a Tertiary Care Teaching Hospital

Psychiatric disorders are now widely recognized as a major contributor to the global burden of disease. It has been described that there is an increased risk of adverse effects when more than one psychotropic drug is prescribed. Knowledge of the pattern of utilization of drugs in the general population can be achieved through the conduct of drug utilization studies. The present study has therefore been conducted to observe the pattern of drug use in psychiatry patients in a tertiary care hospital. Aim and Objective: To assess the epidemiology of various psychiatric illnesses among the study population To assess the Prescribing Pattern of drugs in Psychiatric Illness. To assess the drug-drug interactions in the prescription using MICROMEDEX. Methodology: A retrospective descriptive observational study was performed in a tertiary care hospital. A total of 100 prescriptions were collected from MRD. Results: The study reported that 66% of patients were males and 34% were females. The average number of drugs and psychotropic drugs per prescription is six and four respectively. Around 61.98% of drugs in the prescription are psychotropic drugs, among that 40.17% of benzodiazepines are majorly used, followed by 34.27% of antipsychotics. Almost 95 prescriptions had a minimum of one drug-drug interaction. The average number of psychotropics per prescription was higher than in studies. The average number of drugs per prescription was 5.84, which lead to polypharmacy. Conclusion: Using WHO indicators prescription analysis was done and it showed some deviation from the standard value which can be improved. Polypharmacy was noted in this study. Most of the drug is prescribed in the brand name which should be avoided.

Antibiotic Prescriptions for Respiratory Tract Viral Infections in the Colombian Population

Antimicrobials are frequently inappropriately prescribed for the management of upper respiratory tract infections (URTIs); therefore, the frequency of antibiotic prescriptions for patients with viral URTIs was assessed in this study. A cross-sectional study, including ambulatory patients diagnosed with viral URTI, was conducted, and records of antimicrobial prescriptions were obtained. Sociodemographic, clinical (diagnostic), and pharmacological (antimicrobial) variables were assessed. Through multivariate analysis, variables associated with the use of antibiotics for viral infections were identified. A total of 341,182 patients with viral URTIs were identified. The patients, who were from 26 different departments of Colombia, had a mean age of 29.7 ± 23.5 years and a female predominance of 58.7% (n = 200,195). The most frequent viral infections were as follows: acute rhinopharyngitis (common cold) (n = 206,211; 60.4%); unspecified acute tonsillitis (n = 27,432; 8.0%); and acute pharyngitis (n = 26,411; 7.7%). A total of 24.8% of the patients (n = 84,453) received a prescription for antibiotics, predominantly penicillins (n = 61,871; 18.1%) and cephalosporins (n = 10,926; 3.2%). Patients treated in Atlántico, Valle, and Risaralda departments, along with those older than 5 years, were more likely to receive antibiotics for the treatment of viral infections. Antibiotics are frequently prescribed for the management of URTIs, which is considered an inappropriate practice due to a lack of clinical benefits, increased generation of antimicrobial resistance, and a risk of adverse reactions due to the use of medications that patients do not require. Drug utilization studies are a great tool for monitoring how antibiotics are being used and planning interventions to improve their use.

Measuring Medicine Use: Applying ATC/DDD Methodology to Real-World Data

Medicines are essential for the treatment of acute, communicable, and non-communicable diseases. The World Health Organization developed a toolkit for drug (medicine) utilization studies to assist in reviewing and evaluating the prescribing, dispensing, and use of medicines. There is a growing need for rigorous studies of medicine use in low- and middle-income countries (LMIC) using standard approaches, especially in the context of universal health coverage. This commentary provides a succinct summary of how to use the WHO anatomical therapeutic chemical (ATC)/defined daily dose (DDD) methodology in pharmacoepidemiological studies, with a focus on LMIC contexts. We drew on information from WHO resources and published literature, citing examples and case studies. We encourage readers to publish their drug utilization studies, although we caution about predatory journals. We recommend the use of the RECORD-PE initiative which focuses on methods for doing pharmacoepidemiological research and evaluating the quality of published papers.

DRUG UTILIZATION PATTERN AMONG GERIATRIC PATIENTS IN A TERTIARY CARE TEACHING HOSPITAL

The present study was conducted with the aim to evaluate the drug utilization pattern among geriatric patients of a tertiary care teaching hospital. A cross sectional study was conducted on elderly patients admitted in departments of Medicine and Surgery in a tertiary care teaching hospital. All the prescriptions were evaluated using WHO prescribing indicators. Total 200 prescriptions were collected during the study period. Most of the patients were in the age group of 65-69 years (68.5%) with male preponderance. Surgical conditions were the most common cause requiring hospitalization. Total 2045 drugs were prescribed to study participants with average number of drugs per prescription as 10.23 ± 3.14. Generic prescribing constituted 59.8% while antibiotics were prescribed in 15.5% of prescriptions. The total number of injections prescribed was 41.7% and drugs prescribed from WHO-EML constituted 41.5%. The present study highlights the signicance of drug utilization studies in geriatric

Evaluation of the Drug Utilization Pattern of Pre and Post Operative Medicines used in Surgical Department: A Prospective Observational Study

Background: Surgery is the art of treating lesions and malformations of the human body which involves various surgical techniques. Various classes of drugs are being used in the surgery but unfortunately, the drug utilization pattern of these drugs particularly in developing countries like India is still unsatisfactory. Thus, there is a need to conduct drug utilization studies of various medicines used in the surgical department. Objective: The main objective of the current study is to evaluate the drug utilization pattern of pre and post- operative medicines used in surgery to promote the rational use of medicines. Material and Methods: A prospective observational study was carried out over a period of 6 months (November 2017 to April 2018) from in Global Hospital, Jalandhar, Punjab, India. A consent form has been designed and filled by the patients after explaining the aims and objectives of the study. The case record form (CRF) has been designed to collect all the relevant information from the surgery patients. Results: A total of 271 cases have been reported and evaluated. 58.0% of patients were female and 42.0% of patients were male. The most common surgery was nailing, plating and knee replacement. In pre and post-operative procedures, the most common medicines prescribed were a combination of antimicrobials and antacids followed by anti-emetics, analgesics. Conclusion: The prescribed medicines were less from the National Essential Medical List (EML) which should be increase in future.

Pattern of drug utilization in pediatric out patient department of a tertiary care teaching hospital

Background: Drug utilization studies have special significance among paediatric age groups as infant and children represent about 42% of the population in developing countries. This is the vital period of rapid growth and development. Therefore, drugs should be used very cautiously and rationally among these sub groups. The present study is conducted to analyse the prescribing pattern of drugs in paediatric age group for various illnesses. Methods: It was a prospective observational study, conducted in paediatric outpatient department of Raja Rajeswari medical college and research hospital for a period of 6 months after obtaining approval from institutional ethical committee. Descriptive statistical was used to determine the frequency, percentages, mean and standard deviation.Results: In the present study, fever (30.8%) followed by respiratory diseases were most common diseases seen. The commonly used drugs include antipyretics (66%), antimicrobials (53.6%), cough syrups (34.4%), antihistaminic (31.2%) and nasal decongestants (23.2%). Prescribing indicator shows existence of polypharmacy. Prescribing drugs by generic name was seen only in 8.1% and 47.82% of the drugs were prescribed from EDL. The frequency of use of injectables in our study was 5.8%. Conclusions: Irrational use of antibiotics and polypharmacy needs to be curbed. Prescribing drugs in their generic name and prescribing drugs from EDL need to be promoted. The present prescribing pattern can be improved by advocating rational drug prescribing, patient education and improving hospitals.

Review of Drug Utilization Studies in Neonatal Units: A Global Perspective

Rational prescribing is challenging in neonatology. Drug utilization studies help identify and define the problem. We performed a review of the literature on drug use in neonatal units and describe global variations. We searched databases (EMBASE, CINAHL and Medline) from inception to July 2020, screened studies and extracted relevant data (two reviewers). The search revealed 573 studies of which 84 were included. India (n = 14) and the USA (n = 13) reported the most. Data collection was prospective (n = 56) and retrospective (n = 26), mostly (n = 52) from one center only. Sixty studies described general drug use in 34 to 450,386 infants (median (IQR) 190 (91–767)) over a median (IQR) of 6 (3–18) months. Of the participants, 20–87% were preterm. The mean number of drugs per infant (range 11.1 to 1.7, pooled mean (SD) 4 (2.4)) was high with some reporting very high burden (≥30 drugs per infant in 8 studies). This was not associated with the proportion of preterm infants included. Antibiotics were the most frequently used drug. Drug use patterns were generally uniform with some variation in antibiotic use and more use of phenobarbitone in Asia. This study provides a global perspective on drug utilization in neonates and highlights the need for better quality information to assess rational prescribing.

Drug Utilization Evaluation in Dermatology Department: A Study in the Ambulatory Care Settings

The main aim of the study is to evaluate the prescribing pattern of drugs prescribed in the ambulatory patients attending the dermatology department. This was a prospective observational study conducted for a period of 6 months. Patients who were receiving treatment in the dermatological outpatient department and willing to participate were included in the study and patients in the inpatient dermatology department and also with other co morbid conditions were excluded from the study. A total of 306 cases were collected and among them, about 112 (36.6%) were males and 194 (63.4%) were females. During the study period, majority of the patients were in the age group of 21-30 years (41.2%). The most commonly prescribed classes were found to be Antibacterial drugs 312 (22.1%) followed by Antifungal drugs 258 (18.3%) and Anti-histamines 206 (14.6%). Among the antibacterial, Antibacterial soaps (35.3%) were more commonly prescribed followed by the antibiotics Mupirocin (12.8%) and Clindamycin (11.9%). In case of Antifungals, Ketoconazole (25.2%) was most commonly prescribed drug followed by Fluconazole (14%) and Clotrimazole (14%). Among the Antihistamine drug class, Levocetrizine (76.2%) was most commonly prescribed followed by Hydroxyzine (12.2%). The drug Prednisolone (26.4%) was most commonly prescribed among Corticosteroids, followed by Mometasone furoate (23.6%) and Hydroquinone (13.1%). Periodic evaluation of the prescribing pattern of the drugs can improve the quality of prescriptions. It is the responsibility of the clinical pharmacist to perform the drug utilization studies in order to know the drug prescribing patterns and also to know the prevalent disease conditions at a particular point of time. Clinical pharmacist should create awareness regarding the personal and community hygiene which would result in the prevention of dermatological diseases.