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Background: The pattern of drug use in a hospital setting needs to be monitored intermittently to analyze their rationality. Aim and Objective: The aim of this study was to assess the prescribing pattern as per World Health Organization core drug use indicators. Materials and Methods: This is a prospective cross-sectional, single-center, and observational study. A total of 620 prescriptions were included and analyzed in dermatology outpatient attendees at a tertiary care teaching hospital. A predesigned pro forma was used to collect and compile data. All the statistical analysis was performed with the Microsoft Excel office 2019 version. Results: The average number of drugs per encounter was 4.03. The percentage of encounters with antibiotics was 33.38%. There was no prescription having an injection. The drugs prescribed by their generic names were 16.61%. Drugs prescribed from local institutional essential drugs list were 42.11%. Conclusion: Studies based on drug prescribing patterns are a very important tool not only to guide physicians to improve their prescribing habits but also for hospital administration to recognize the lacunae in drug prescribing and formulate guidelines to facilitate rational drug use.
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Objective:The data mining method was used to analyze the medication rules of the ancient prescriptions for yin deficiency syndrome, so as to provide reference for clinical treatment of yin deficiency syndrome.Methods:We searched the database of ancient prescriptions, selected the prescriptions for yin deficiency syndrome, used the Ancient and Modern Medical Case Cloud Platform V2.2.3 to count the frequency and attribute of drug use, and carried out hierarchical cluster analysis to find the core prescription. MATLAB was used to analyze the association rules, and the law of drug compatibility was found. The Pajek64 5.13 was used for complex network analysis to find out the core traditional Chinese medicine.Results:There were 467 prescriptions that meet the requirements, 302 kinds of drugs were used in total. The four properties of the drugs were mainly cold, the five flavors mainly sweet, the meridian of the drugs mainly kidney meridian. The core drugs were Rehmanniae Radix Praeparata, Ophiopogonis Radix, Rehmanniae Radix, and Poria. The most commonly used drug pair was Dioscoreae Rhizoma- Rehmanniae Radix Praeparata, the second was Corni Fructus- Rehmanniae Radix Praeparata, Poria-Rehmanniae Radix Praeparata. The commonly used drugs can be clustered into two categories. Conclusion:We can preliminarily reveal that the ancient medication law of yin deficiency syndrome is mainly nourishing Yin liquid and reducing fire, paying attention to nourishing kidney yin, using Yin nourishing medicine often combined with medicine of tonifying lung, liver, spleen yin and diverging to reduce fever. It can provide certain reference for clinical treatment of yin deficiency syndrome.
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Effective drugs for chronic obstructive pulmonary disease(COPD), a complex chronic lung disease, have long been difficultly determined, while traditional Chinese medicine(TCM) has played a critical effect in the treatment of such disease. A new approach for the prediction based on data analysis by integrating TCM basic theories and modern science is urgently needed apart from clinical experiments. In this study, an efficacy evaluation system of COPD was established based on the multi-target efficacy evaluation system of Chinese medicine to analyze the medication regularity and characteristics, such as efficacies, properties, meridian tropism,and core combinations of Chinese medicines. The characteristics of classical prescriptions in the intervention of COPD were explored from modern pharmacology. The results showed that the Chinese medicines in the classical prescriptions in the treatment of COPD were dominated by heat-clearing, phlegm-resolving, dampness-dispelling, exterior-releasing, deficiency-tonifying, and interior-warming drugs. Among them, dampness-dispelling, interior-warming, and heat-clearing drugs resulted in higher perturbation efficiency in the disease network than some western medicines on the market, suggesting that these drugs possessed better efficacies in the treatment of COPD. In the classic prescriptions, warm-heat drugs were equivalent to cold-cool drugs in number, while the proportion of warm-heat drugs gradually raised with the increase in the perturbation efficiency. Additionally, core combinations in the classical prescriptions,such as heat-clearing/heat-clearing, dampness-dispelling/dampness-dispelling, and phlegm-resolving/heat-clearing, could achieve better efficacy for COPD. The present study preliminarily screened out the efficacies of Chinese medicines in the treatment of COPD based on scientific data through the multi-target efficacy evaluation system to explore the effect of Chinese medicine on COPD from modern pharmacology, explain the mechanism of TCM treatment of lung diseases, and provide references for the development of drugs targeting COPD.
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Humans , Drugs, Chinese Herbal/therapeutic use , Medicine, Chinese Traditional , Meridians , Prescriptions , Pulmonary Disease, Chronic Obstructive/drug therapyABSTRACT
Background: Irrational prescribing is a universal problem that may lead to inadequate response to medication therapy, poor patient compliance and increased adverse drug reactions ultimately leading to frequent hospital admissions. Hence this study was done to assess the drug utilization pattern using WHO core drug use indicators so that the recommendation can be made towards the rational prescribing.Methods: A sample of 3650 prescriptions was analysed prospectively to assess the drug utilization patterns in the dermatology OPD of a tertiary care teaching hospital of central south India.Results: The average number of drugs per prescription was 2.74 whereas 79.26% drugs were prescribed by generic names. Percentage of encounters with an antibiotic prescribed was 18.68%. Regarding use of injections, 3.26% prescriptions contains one or more injections. Percentage of drugs prescribed from essential drugs list was 78.37%. Average consultation time was lower (2.9 minutes) than recommended.Conclusions: The data from the present study indicates that prevalence of polypharmacy, inadequate consultation and dispensing time along with poor patient’s knowledge are the areas of medication therapy to be improved. Availability of essential drugs and key drugs in stock should be improved to achieve rational therapeutic goal. Further, continued medical education regarding the rational prescribing will definitely improve the standards of health care delivery.
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Background: Periodic assessment of drug prescribing and dispensing pattern in a hospital facility shall play a major role in avoiding the inappropriate use of drugs which leads to potential hazards and expenses for the patients.Methods: The objective of the study was to analyse the patterns of drug use and dispensing in dermatology outpatient prescriptions from a tertiary care teaching hospital in south India. Data were collected over a period of one month from patients attending dermatology outpatient department by scrutinizing 100 prescriptions and analyzed using WHO formulated 揷ore drug use indicators� like the format, prescribing pattern and rationality of prescriptions.Results: The total number of drugs prescribed in 100 prescriptions was 233 i.e. on average 2.33 drugs were prescribed per patient. The patient's name and age were mentioned in all the prescriptions while diagnosis, dose, route of administration, dosage form, duration of therapy and prescriber's identity was written in 43.29%, 68.04%, 69.07%, 100%, 49.48% and 63.91% prescriptions respectively. Out of all drugs, 42.91% were generic drugs and 57.08% were from National Essential Drug List of India. Steroids (18.02%) were the most common group of drugs used, followed by keratolytics and emollients (15.87%). Most of the drugs were given by topical route (47.63%).Conclusions: A prescription by a doctor is a reflection of physicians� attitude towards the disease and the role of drug in its treatment. It also provides an insight into the nature of health care at that facility. Interventions to rectify over proper prescription format and prescription of generic drugs are necessary to further improve rational drug use in this facility.
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How to discover the valuable knowledge from the large amount of prescription data accumulated in the long-term medical practice of traditional Chinese medicine (TCM) is one of the important contents of TCM modernization.Based on the prescription data of Xue' s clinical practice of many years,this paper explored the method of combining TCM network and prescription network to find out Xue' s common core drug combination.Based on 9,584 prescriptions in the Hospital Information System of Guang'anmen Hospital of China Academy of Chinese Medical Sciences,prescription network and drug network were constructed according to the similarity of prescription composition and drug co-occurrence relationship.Using the complex network analysis methods,such as community analysis method,to analyze the prescription and drug compatibility,the results were evaluated and analyzed by Xue and his successors.As a result,through complex network analysis,126 modular prescriptions and 4 TCM modules were obtained.One of the core components of the prescription module included Xiao Chai Hu decoction,Yin Qiao powder,and Sheng Jiang powder compound addition and subtraction.It was in consistent with the drug composition of exogenous febrile prescriptions excavated earlier.In conclusion,using the complex network methods,we can get some core drug combinations prescribed by Prof.Xue,and achieve the common compound core drug combination for treating diseases with certain vantages,laying a foundation for further inheriting and excavating Xue' s effective experience.
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Background: Pregnancy represents a special physiological state during which the use of drug is of growing concern due to risk of teratogenicity. Anemia is common threat to mother. Therefore, our aim was to study the drug utilization, teratogenic risk among patients of anemia in pregnancy and check rationality of prescriptions. Methods: An observational, prospective study was carried out in 150 indoor patients in the tertiary care hospital. Protocol was approved by the Institutional Review Board. The data were collected in a pre-designed proforma. Data were analyzed using SPSS version 20.0 Software. Results: Among 150 patients, 23, 111, and 16 were of <20, 20-30 and more than 30 years of age respectively. Among anemic patients Pregnancy induced hypertension (18.7%), antepartum hemorrhage (12.7%) were common. About 71% women have complaint of weakness, followed by headache. Iron (93.3%) and calcium (86.0%) were the most common drugs prescribed. Iron sucrose and packed cell volume given in severe anemia. Drug risk category, Category A (90.21%) was most frequently prescribed, which is followed by Category B (8.0%) and Category C (1.8%). Percentage of drugs prescribed by generic name and from essential drug list was 70.3 and 89.2. Overall prescribing habit was rational according to Indian guideline. Conclusion: Iron, calcium, and folic acid were most commonly prescribed drugs in anemic patients. No teratogenic risk was found out during drug use. Drug and dose of the drug was rational and appropriate. There is lesser number of drugs prescribed by generic name and hospital supply.
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This study was aimed to discover core agent for the treatment of ulcerative colitis and explore the medication rules . A total of 525 ulcerative colitis medical records in the Jiangsu Province Hospital of TCM were selected from 2009 to 2013 . The records were input into the structured information acquisition system of clinical diagnosis and treatment . The complex network analysis was used to analyze core drugs of prescription and drug compatibility after data mining and rule processing . The results showed that the core drugs are Diyu , Huanglian, Muxiang, Baishao, Xianhecao, Danggui, Chaobaizhu, Huangqin, Zicao, Yiyiren, Fuling, Shanyao. It was concluded that data mining can be an objective method in the analysis of core drugs and compatibility in the treatment of ulcerative colitis. It can also be used to guide the clinical prescription medication.