Study on drug use pattern in the management of the cardiovascular diseases and with comorbidities

Background: Cardiovascular drugs are the number one cause of death globally; more people die annually from CVDs then from any other cause CVD. The purpose of this study to identify the rationality of drug prescribed for cardiovascular diseases with its comorbidities. Along with medication adherence and cost analysis. To assess the drug use pattern and to observe the drug related complications in patients with cardiovascular diseases.Methods: A hospital based prospective observational study was conducted at department of medicine in RMMCH. A total of 79 patients were enrolled based on inclusion criteria and the data was collected using designed data collection form.Results: Data of 79 patients were collected over 6 months mean age of patients with 19.95-60.5. Male to female ratio was 1.43:1. In cardiovascular diseases, most common disease conditions are systemic hypertension and acute coronary syndrome seen in our study population. Average drugs prescribed per patient was 4-9. Most frequently prescribed drug classes were beta blocker, antiplatelet, hypolipidemic agent. In these few minor drug interactions have been found. Study has no adverse drug reaction. The average cost of drugs was prescribed for 2500-3200 IND. Before patient counseling medication adherence and outcomes were less after counseling, medication adherence and outcomes are increased from 5% to 65%.Conclusions: The study concludes that most of the drugs were prescribed rationally according to world health organization/ESC guidelines. As behalf of this study, we could provide the information about the risk factor, leading commodities. Importance of medication adherence and cost of medications to cardiovascular drugs.

Assessment of drug use pattern using WHO core drug use indicators in selected general hospitals: a cross-sectional study in Tigray region, Ethiopia

ObjectiveInappropriate use of medicine is a global challenge with greater impact on developing countries. Assessment of drug use pattern is used to identify gaps in medicine utilisation to implement strategies for promoting rational drug use. This study aimed to assess drug use pattern using the WHO drug use indicators in selected general hospitals in Tigray region, Ethiopia.DesignA cross-sectional study was conducted using WHO drug use indicators in two public hospitals located in Tigray.SettingPrescriptions recorded from 1 January 2017 to 1 June 2019 were randomly selected, and participants who visited the public hospitals from 1 March 2019 to 30 August 2019 and hospital pharmacies were interviewed.Participants100 patients who visited both outpatient clinics and hospital pharmacy departments of the public hospitals.ResultsThe average number of medicines per prescription was 1.69 (±0.81). Prescriptions containing antibiotics and injectables were 58.2% and 15.9%, respectively. The percentages of medicines prescribed with a generic name from essential medicines list of Ethiopia were 97.5% (974) and 88.1% (970) in Mekelle Hospital and Quiha Hospital, respectively. The patients spent an average of 6.6(±3.5) min with their general practitioners, while only 22.8 (±21.7) s with their pharmacists. Of the patients interviewed, 56.9% knew their dosing regimen and 32.7% of them had their medication labelled.ConclusionThe finding of the present study revealed deviation of drug use pattern from the WHO optimal levels suggesting the hospitals had limitations in appropriate utilisation of medicines. Understanding the factors attributed to the observed gaps and implementing corrective measures are required to conform with the recommended standards of appropriate drug utilisation.

Individual Characteristics And The Gateway Hypothesis Among Drug User Patient In Indonesia

Drug abuse has become severe not just in the world but also in Indonesia. To address this problem, public policies and researcher try to understand the drug use pattern. One of the famous concept in drug use pattern is gatheway hypothesis. The gateway hypothesis refers to the pattern of substance use initiate softer drug lead to the harder drug. However, many literature shows drug use pattern is not just gateway pattern, there is reversal pattern and using both gateway and reversal pattern. Many studies have discussed the relationship between drug use and individual characteristics. However, few of them are relatively link between individual characteristics and the sequential order in drug use. The purpose of this study is to evaluate how individual characteristics are associated with the gateway pattern and other pattern for different types of drugs. We use a secondary dataset of individual drug user patients from the Rehabilitation Center of National Narcotics Board aged 14–67 years assessed using the Addiction Severity Index (ASI), employing probit and multinominal logit model. Duration are associated with initial soft drug user with gateway pattern. While alcohol use and have high education level related with initial hard drug user with reversal pattern. Interestingly, duration and alcohol use correlated with initial intermediate drug user with all kind of pattern. Prevention and intervention efforts should be targeting high-risk characteristics of people at an initial stage of drug use and progression to the next stage.

Illicit Drug Use Pattern, Health-Risk Behaviors, and Social Contexts Among Indonesian Students

Health-risk behaviors (smoking, alcohol consumption, and premarital sex) among Indonesian students are important issues. Understanding the association of these health-risk behaviors and adolescents’ social contexts (family, peers, and neighborhood characteristics) to illicit drug use is required to develop strategies in preventing illicit drug use in Indonesia. The study used a multi-stage cluster random sampling method to collect data from the 2016 National Narcotics Survey of Indonesian students. The sample included 31,439 students. The result shows that the illicit drug use pattern was different from previous studies: the most prevalent was at the senior high school level. Multiple logistic regression analyses showed that smoking, alcohol consumption, premarital sex, peers, sex, family, and neighborhood were associated with illicit drug use. The study highlighted the importance of health-risk behaviors, social contexts of adolescents, and the illicit drug use pattern as considering factors in developing strategies to reduce illicit drug use prevalence.

Evaluation of Prescribing Pattern in Mirpur Azad Kashmir using who Prescribing Indicators

Promotion of rational use of drugs in developing countries is necessary for improving the quality of life. Therefore, evaluation of drug use pattern using World Health Organization (WHO) indicators is necessary for assessment of rational use of drugs. 200 prescriptions were randomly collected from different pharmacies in Mirpur and evaluated to measure prescribing indicators. Data was analyzed using SPSS (version 25). Average count of drugs prescribed per prescription was 3.8 (S.D+ 2.01). Percentage of antibiotics prescribed, and injections prescribed per prescription was 42% (n=84) and 16% (n=32) respectively. The percentage of drugs prescribed from Essential Drugs List was 90.5%. It was concluded that prescribing pattern was far away from the standard WHO requirements. Greater number of drugs and overuse of antibiotics focused on close monitoring and regulation of prescribing pattern. Steps should be taken to encourage the rational use of drugs to improve the quality of life.

Clinical Profile, Treatment and Predictors during the First COVID-19 Wave: A Population-Based Registry Analysis from Castile and Leon Hospitals

The first wave of the COVID-19 pandemic collapsed the hospitals in Castile and Leon (Spain). An analysis of the clinical characteristics, drug therapies and principal outcome predictors in the COVID-19 hospitalized patients from 1 March to 31 May 2020 is presented through a population-based registry study. Hospital stay variables, ventilation mode data and clinical outcomes were observed. In Castile and Leon hospitals, 7307 COVID-19 patients were admitted, with 57.05% being male and a median of 76 years. The mortality rate was 24.43%, with a high incidence of severe acute respiratory syndrome (SARS) (14.03%) and acute kidney injury (AKI) (10.87%). The most used medicines were antibiotics (90.83%), antimalarials (42.63%), steroids (44.37%) and antivirals, such as lopinavir/ritonavir (42.63%). The use of tocilizumab (9.37%) and anti-SIRS (systemic inflammatory response syndrome) medicines (7.34%) were remarkable. Fundamentally, death occurred more likely over 65 years of age (OR: 9.05). In addition, the need for ventilation was associated with a higher probability of death (OR: 3.59), SARS (OR: 5.14) and AKI (OR: 2.31). The drug-use pattern had been modified throughout the COVID-19 first wave. Multiple factors, such as age, gender and the need for mechanical ventilation, were related to the worst evolution prognosis of the disease.

Assessment of Prescription Completeness and Drug Use Pattern in Tibebe-Ghion Comprehensive Specialized Hospital, Bahir Dar, Ethiopia

Introduction. Irrational medicine use is a global problem, and one of its manifestation is inappropriate prescribing that occurs when medicines are not prescribed in accordance with the guideline. Objective. The aim of the study was to assess prescription completeness and drug use pattern of the hospital using the WHO core drug use indicators. Methods. 1000 prescriptions were collected retrospectively from prescriptions written for 1 year from outpatient pharmacies of the hospital. Exit interview was employed to assess patient care indicators. The health facility indicators were checked by assessing the presence of drug formulary and availability of key medicines at the facility. Data were analyzed using SPSS version 20. Results. It was found that only name of the patients was filled in all the prescriptions. Other informations were below the standard. The average number of drugs per prescription was 1.65. Percentages of encounter by generic name, with antibiotic and injections, were 85.78%, 41%, and 25%, respectively. The percentage of drugs prescribed from an essential drug list was 98.48%. The mean consultation time and dispensing time were 14.49 and 2.16 minutes, respectively. More than half patients had knowledge on drug dispensed to them (68%). The percentage of drugs actually dispensed was 65%, but none of the drugs dispensed were adequately labelled. A copy of EDL and 84% of the key drugs were available in the hospital. Conclusion. From the results of our study, it can be concluded that all prescriptions were not complete, and except the average number of drugs prescribed per encounter, the other drug use pattern indicators were out of the WHO recommendation. Therefore, effective intervention program, like training, for promotion of rational drug use practice was recommended.