ABSTRACT
Background: Altered hepatic, renal and GIT function along with multiple comorbidities makes use of certaindrugs inappropriate in geriatric population. Identification and rectification of mistakes and lacunae in thecurrent prescribing pattern is crucial for ensuring appropriate and rational prescribing. Purpose: To study theprescribing pattern and medication inappropriateness in geriatric patients in a tertiary care teaching hospital.Material and Methods: Details of the prescribed drugs were obtained from the files of the 60 hospitalisedgeriatric patients and the prescribing pattern was studied. Medication inappropriateness was assessed and theinappropriate drugs were classified into various categories using Beers criteria given by American GeriatricSociety. Number of prescriptions having potential for drug interactions was also calculated. Results: Averagenumber of drugs per prescription was 7.7 with antibiotics being the most commonly prescribed drugs.49.13% were prescribed by brand names. 12.12% drugs were prescribed inappropriately and 20% prescriptionshad one or more inappropriate drug. Potential drug-drug interactions that should be avoided in older adultswere found in 11.6% prescriptions. Conclusion: A considerable fraction of the prescriptions of geriatricpatients were inappropriate and incidence of polypharmacy was very high. There is a pressing need to educatethe physicians about the mistakes in the prescribing pattern of geriatric patients and the adverse effect it canhave on the health of these patients.
ABSTRACT
Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’sexpertise. Analysis of quality of prescriptions can be carried out by various methods and by using certain toolsas well. Prescription Quality Index (PQI) is one such validated tool for analyzing the prescription quality. Thepresent study was undertaken on 2155 prescriptions to analyse the prescriptions of outdoor patients by usingPrescription Quality Index tool. Each prescription was evaluated by using questionnaire of PQI tool. The toolconsists of 22 questions, based on the answers of which a score was calculated for each prescription. Thena collective mean score for all the prescriptions was calculated. Depending upon individual scores, theprescriptions were graded in to poor, medium and high-quality prescriptions. The mean PQI score for all the2155 prescriptions was 28.94 ± 0.23. We found that 1015 (46.10 %) prescriptions were of poor quality, 46(2.13 %) were of medium quality and 1094 (50.77 %) were of good quality. The overall mean score of all theprescriptions falls in to the poor-quality prescription category according to PQI. It was concluded that therewere many lacunas that require the attention of prescribers in order to attain and maintain high standardprescription quality.
ABSTRACT
Background: Antibiotics are considered to be commonly used drugs in hospital setting due to higher prevalence of infectious diseases especially in India. So, the present study was conducted to assess the incidence of adverse drug reactions (ADRs) due to antibiotics and analyze for causality of adverse drug events reported.Methods: The present retrospective and observational, study was conducted in BPS GMC for women, Khanpur Kalan, Sonepat, Haryana which is a 500 bedded government medical hospital situated in rural area between March 2016 to February 2019 (i.e., 3 years). Patients of either sex or age who developed ADRs by any route were included in the study.Results: 300 (38.65%) cases were reported due to antibiotics out of total 776 ADR cases. 3% cases were serious. Adults (65%) were found to be most commonly affected by ADRs. Among antibiotics, cephalosporins and penicillins (15.98%) were the major culprit to cause adverse events followed by nitroimidazoles (15.2%) and antitubercular drugs and fluoro quinolones (13.16%). The most affected organ system was skin (49.33%) followed by the gastrointestinal system (33%). As per WHO scale of causality assessment, 33.33% and 67.67% reported cases were found to probably and possibly related to adverse events respectively.Conclusions: Antibiotics are most commonly prescribed drugs so its monitoring regarding ADRs may benefit the clinicians in early identification and management of ADRs so that quality of life of patient can be safeguarded at an earliest.
ABSTRACT
Background: Writing a prescription is a combination of science and art. Good quality prescriptions are a sign of prescriber’s expertise. World Health Organization has defined certain parameters to promote rational drug use in all countries. This study was designed to assess the prescription writing practices in a government tertiary care hospital in Haryana by using WHO prescribing indicators.Methods: A total of 2155 prescriptions were evaluated. Each prescription was evaluated for average number of drugs prescribed per patient per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic prescribed, percentage of encounters with an injection prescribed and percentage of medicines from Essential drug list prescribed. These indicators help us to check polypharmacy, practice of prescribing drugs by brand names, antibiotic overuse, preference of injectables and non-adherence to Essential drug list.Results: The average number of drugs prescribed per patient per encounter was calculated to be 3.25±0.24. The percentage of medicines prescribed by generic names was 35.89%. Percentage of encounters with an antibiotic prescribed was 48.21 % and with an injection prescribed was 1.85%. The percentage of medicines form NLEM was 76.36%.Conclusions: The values of WHO prescribing indicators obtained from this study show that there are some areas where the prescribers need to improve their prescribing practices.
ABSTRACT
Background: Adiposity and hypertensive states are major burden for community. It causes many health-related issues, including problems related to respiratory system. It is proposed that pulmonary functions can be affected in obese hypertensive and obese normotensive adults compared to non-obese normotensive adults. The objective of the study was to find out the effect of adiposity and hypertensive states on the airway dynamics.Methods: About 30 male obese normotensives and 30 male obese hypertensive subjects were selected as study participants. 30 age-controlled non-obese, normotensive males were selected as controls. All participants were in the age group of 40 to 60 years. The pulmonary functions measured were FVC, FEV1, FEV1% and PEFR. All the participants performed 3 attempts of spirometry and maximum among the three recordings were used for analysis. ANOVA followed by Post hoc analysis to find out any significant differences between these groups. Spearman’s rank correlation was used.Results: There was a statistically significant differences in BMI between the group I and group II and III. There was a significant difference in SBP and DBP between obese normotensive (group II) and obese hypertensive (group III) subjects. There were significant decline in % predicted values of PFT parameters, on comparing obese normotensive and obese hypertensive when compared to non-obese normotensive participants. There were statistically significant negative correlations between age and FEV1 as well as BMI and PEFR.Conclusions: There was a significant decrease the pulmonary functions in obese normotensive and obese hypertensive adults in comparison to non-obese normotensive adults. It can be concluded that body weight and adiposity as well as high blood pressure creates deleterious effect on airway dynamics.