ABSTRACT
Background: There are multiple protocols currently being followed worldwide for effective management of COVID-19 depending on the disease severity as a consequence, of which the prescribing patterns and therapeutic choices still remain unclear. Drug utilization studies provide insight into the current prescribing practices and help us in facilitating the rational use of drugs. Aim and Objectives: The aims of this study were to evaluate utilization pattern of medications used to treat COVID-19 in hospitalized patients with moderate disease as defined by Indian Council of Medical Research (ICMR) guidelines. Materials and Methods: Hospital-based prospective, observational, and cross-sectional study was conducted in Designated COVID Hospital, Bidar Institute of Medical Sciences, Bidar for 4 months from March 1, 2021, to June 31, 2021. Data were collected from patients, every 10th inpatient was randomly selected. Rationality of prescriptions was evaluated using the WHO core drug prescribing indicators. A total of 234 hospitalized patients aged more than 18 years with laboratory confirmed COVID-19 of moderate severity according to ICMR guidelines were included in the study. Results: In our study, we found average number of drugs per encounter as 7.29. Percentage of drugs prescribed by generic name as 89.05%. Percentage of encounters with antibiotic as 96.58%. Percentage of encounters with an injection prescribed as 100%. Percentage of drugs prescribed from essential drug list as 83.25%. Conclusion: Drug utilization in COVID-19 is diverse and is in accordance with the existing guidelines. Medications used are highly corresponding to the disease severity. Polypharmacy detected, here, is not irrational as it suppressed the COVID-related mortality. Steroids, anticoagulants and oxygen being the key determinants.
ABSTRACT
Background: Drug utilization studies are useful for understanding the pattern of drug use in any particular healthcare set-up. This data gives an insight to improve the medical treatment at different layers in the health system. The oobjective of the present study was to assess drug utilization patterns by using core prescribing indicators of WHO and to assess most commonly observed skin disease in Dermatology out patients department (OPD) of tertiary care hospital.Methods: 246 prescriptions from Dermatology OPD were audited. Common skin diseases and the prescribing patterns were analysed from the prescriptions.Results: Average 2.4 drugs per prescription were seen in this study. 38.7% drugs were from National Essential Drug List of India. All the drugs were prescribed by brand names. The fixed dose combinations accounted for 20.6% drugs prescribed. Dosage, dose and duration of treatment were written for 100% of prescriptions. Around 44 different skin diseases were diagnosed amongst 246 patients predominantly cutaneous fungal infections, acne, dermatitis, eczema and psoriasis. About 591 different drugs were used mainly corticosteroids (21%), antibiotics (17%), anti-allergic (16%), antifungals (11%). Common skin conditions receiving corticosteroids were dermatitis (9.9%), eczema (9.1%). Antibiotics (17%), antifungals (11%) and antivirals (1%) were commonly used antimicrobial agents. 55.2% drugs were administered topically while 44.6% received orally.Conclusions: Prescriptions revealed a higher incidence of fungal and bacterial infections. All the medications were prescribed rationally. All prescriptions had proper dosage form, frequency of administration, duration of therapy and diagnosis. However, prescriber should be motivated for prescription of generic drugs and those from essential drug list.
ABSTRACT
Background: As medical students start their clinical training, more effort goes in the direction of proper diagnosis and appropriate methods of treatment, leading to improper training in prescription writing causing prescription errors. Physicians should also be encouraged to prescribe unbranded generic medicines which are available at a cheaper price with a comparable bioavailability of drugs and not have a misconception of being less efficacious.Methods: A cross-sectional observational study was carried out over a period of 2 months (September to October 2018). Around 256 prescriptions were randomly collected from general medicine out-patient department. Informed consent was obtained verbally, and confidentiality assured. The collected data was analyzed as per descriptive statistics and compared with the derived standard values for WHO prescribing indicators.Results: The analyzed data showed an average of 2.23±1.03 drugs per prescription. 23% of the prescriptions had at least one drug prescribed by generic name, 25% of prescriptions contained an antibiotic and 31% of prescriptions had an injection. The percentage of drugs prescribed from NLEM (National list of Essential Medicines) was only 57% as compared to the recommended 100%. Additional only 22.4% of the total number of FDCs prescribed were from NLEM.Conclusions: The average number of drugs per prescription was slightly high, indicating polypharmacy. Brand name prescribing dominates as doctors are still reluctant to use generic names being doubtful of the efficacy. Regular prescription audit with reporting might help to bring awareness among doctors to follow the recommended guidelines and minimize prescription errors.
ABSTRACT
Drug Utilization Evaluation (DUE) promotes rational use of drugs. The aim of present study was to conduct DUE of anticancer drugs. Newly diagnosed and/or known case of carcinoma which required treatment with chemotherapy, patients of both sex, and age >18 years were included in the study. Patients diagnosed as having carcinoma that also required surgical intervention, radiotherapy or other modality of management were excluded from the study. WHO core prescribing indicators are used to know about polypharmacy, excessive use of antibiotics, percentage of drugs prescribed by from Essential Drugs List (EDL). Females were commonly affected than males. Patients of age group 41-50 years (mean 52.43, SD ±7.77) constituted the highest number, 34% and 13% in rural and urban population respectively. 5-Flurouracil and Cisplatin are most commonly prescribed anticancer drugs followed by Cyclophosphamide. The most commonly used adjuvant drugs in our study are Diclofenac, B-Complex, Granisetron, Ranitidine, Dexamethasone, Ondansetron, and Mannitol. The cytoprotectant drugs observed in our study are Leucovorin, Mesna and Peg-Filgrastim. Average number of Cytotoxic Drugs per prescription was 1.97. Average number of drugs per prescription was 8.16. Percentage of drugs prescribed from Essential Drugs List (EDL) was 88.4%. Percentage of encounters with an antibiotic prescribed was 54.8%. Polypharmacy, unnecessary antibiotic and injection prescribing were not observed. The percentage of drugs from EDL may be improved.
ABSTRACT
Background: According to a report by World Health Organization (WHO) in 2003, approximately 50% of all patients fail to take their medicine correctly. This is due to errors in prescription, underuse or misuse of medicines and ignorance of prescribers, dispensers, and patients. Methods: It is a hospital-based interventional-study carried out in a secondary level multispecialty hospital of Delhi. Investigators collected 536 prescriptions from the outpatient department of various departments and studied according to WHO core prescribing indicators for assessing drug prescription writing pattern. Interventions to improve the prescribing pattern included one continued medical education session and one workshop on prescription writing (providing essential drug list [EDL] etc.,), sharing the baseline data with the physicians and administrative approach. Evaluation of the prescribing pattern after 6 weeks of the intervention was done to find out the impact. Results: On an average 3.43 drug per encounter before intervention increased to 3.46 drugs per encounter. Inclusion of generic drugs and from EDL increased significantly from 54.8% to 73.4% and 76.9% to 88.4% respectively.. Prescribing antibiotics and injectables showed no significant reduction from baseline. The completeness of the prescriptions with respect to the various components improved significantly. Conclusion: Combining different intervention seems a noble approach to improve the prescription writing practices with respect to completeness and inclusion of generic drugs, drugs from EDL.