ABSTRACT
Background: Drug utilization study can increase our understanding of how drugs are being used. This study was done to evaluate the current drug prescribing trend in management of indoor patient of orthopaedic department and to comment on rationality of the prescribed medicines.Methods: This is a prospective observational study conducted for 12 months, in Chandrikaben Rashmikant Gardi Hospital, a 600 bedded tertiary care rural based, teaching hospital. Total 611 patients were included in this study.Results: Total 5416 drugs were prescribed in 611 prescriptions. Average number of drugs per prescription was 8.86. Average duration of prescription was 10.7 days. Percentage of drugs prescribed by generic name was 28.8%. Percentage of encounter with an Antibiotic prescribed was 60.23% i.e. out of 611 prescriptions antibiotics were prescribed in 368. Percentage of encounter with an Injection prescribed was 63% which means out of 611 prescriptions, injectables were prescribed in 385. Percentage of drugs prescribed from National Essential Medicine List was 52.63%. Percentage of drugs prescribed from WHO model List was 32.46%. Diclofenac (14.25%) was most commonly prescribed drug. Incidence of polypharmacy was quite high in context of Analgesics. Almost 40% of prescriptions had 2 drugs. Orally prescribed Analgesics were 62.6%, Injectables 34.38% and Topical 3.02%.Conclusions: This study reveals that the pattern of prescription in terms of rationality is poor. Special attention needs to be given to the irrational prescribing in terms of polypharmacy and long duration. Continuing medical education regarding appropriate use of drugs, knowledge of adverse effects and standard prescription guidelines will play pivotal role in rational prescription of drugs.
ABSTRACT
Background: The main objective of study is to monitor and analyze the adverse drug reactions (ADRs) of ART and to assess causality and severity of the ADRs detected.Methods: It is a prospective observational study conducted in the ART centre of a tertiary care teaching hospital in central India. The data collected were recorded on standard ADR reporting forms. Causality was assessed by Naranjo’s algorithm. Severity of ADR’s was assessed by modified Hartwig and Seigel scale. Modified Shumock and Thorton criteria used for preventability assessment.Results: In twelve months duration 351 patients on ART were observed for ADRs. Total 166 ADRs detected in 96 patients. Incidence of ADRs was slightly more in female. The common systems involved were gastrointestinal 42.77% followed by nervous system 18.07%, musculoskeletal 15.06% skin/mucous membrane 07.83%, metabolic and nutritional 04.82%, red blood cell disorders 01.20 %, endocrinal 00.60 % and others 09.64%. The causality assessment as per Naranjo’s scale showed that out of 166 ADRs, 28.92% were probable and 71.08% were possible. Severity assessment by modified Hartwig and Siegel scale showed that 83.34% ADRs were mild and 15.66% were moderate. 46.39 % ADRs were probably preventable.Conclusions: Considering the magnitude of ADR related problems, there is a need for greater awareness among health care professionals, to detect and report them. These ADRs if recognized in time and managed properly can prevent treatment interruption.
ABSTRACT
The main objective of study is to compare the adverse drug reactions (ADRs) of Zidovudine and Stavudine containing regimens. It is a prospective observational study conducted in the ART centre of a tertiary care teaching hospital in central India. The data collected were recorded on standard ADR reporting forms. Standard scales were used for assessment of ADRs. In twelve months duration total 263 patients on ART were observed for ADRs. 128 patients on Stavudine based regimen and 135 patients were on Zidovudine based regimen. Total 72 ADRs detected in 68 patients. Incidence of ADRs was more in Zidovudine based regimen. Zidovudine associated with early and mild ADRs while Stavudine associated with late and distressing ADRs. Considering the magnitude of ADR related problems, results support the discontinuation of Stavudine based regimens