ABSTRACT
Abstract Diabetic mellitus is an emerging disease in Saudi Arabia. In this regard, a cross-sectional retrospective study was conducted to evaluate drug utilization pattern and the cost associated with non-insulin-dependent diabetes mellitus disease management in Saudi Arabia. Data retrieved from the electronic pharmacy records during the last one year were employed in this study. World Health Organization (WHO) Defined Daily Dose (DDD) method was employed to compute the daily price of each oral hypoglycaemic agent. The American Diabetes Association (ADA) guidelines and protocols were used to evaluate the level of adherence. A total of 17057 patients were enrolled in the study. Out of the 17057 patients enrolled in the study, 60.06 % (10246) were males and the rest females. In monotherapy, biguanides (metformin) were the most recommended and utilised drugs among 5673 patients (33.25%). The most commonly used drug combination was found to be sitagliptin+metformin (1754 units). The cost per unit dose was highest for liraglutide (A10BJ02) 258.32SR (68.79USD), and lowest for metformin (A10BA02) 0.49SR (0.13 USD). Metformin was the choice drug for the diabetes patients; biguanides (metformin) and DPP-4 (sitagliptins) were the most familiar established dose combination employed. Generic drugs should be used in order to reduce overall cost.
ABSTRACT
Background: Antimicrobial agents (AMAs) are the most frequently used drugs in the intensive care units (ICU) and regular auditing can prevent the development of resistance to AMAs, reduce the cost and incidence of adverse drug reactions. The present study was conducted to assess the drug utilisation pattern by measuring the defined daily dose (DDD) per 100 bed days for the AMAs used and their correlation with the APACHE score II.Methods: This was a prospective observational study, conducted in the Central ICU of SCB Medical College and Hospital, Cuttack, Odisha for 4 months. Data regarding demographic profile, diagnosis, APACHE II score, microbiologic investigation, length of stay, outcome and utilisation pattern of AMAs assessing anatomic therapeutic chemical (ATC) classification and measuring the antimicrobial consumption index (ACI) equal to DDD per 100 bed days were collected and subjected to descriptive analysis. Multinomial logistic regression model was used to predict probabilities of different possible outcomes of categorically distributed variables and independent variables.Results: Mean age of study population was 44.70±14.814 with male and female ratio of 1.63:1. Septicaemia was the most common cause of admission. AMAs were prescribed to 92.66% of patients during their stay which constitutes 37.32% of the total drugs used. The DDD per 100 bed days for the AMAs were 118.59 and ceftriaxone was found to be most frequently used. Patients having higher APACHE II score received more no of AMAs (4.20±1.30). Patients having low APACHE II Scores received less number of antibiotics as compared to patients having higher score.Conclusions: AMAs were prescribed to 92.66% patients in the central ICU and there is significant relation between the APACHE II score and number of AMAs prescribed.
ABSTRACT
Background: Epilepsy is the most common neurological condition with 65 million cases of active epilepsy found worldwide. The incidence is approximately 0.3 - 0.5% in different world populations with a prevalence rate of five to ten per thousand people. The aim of the present study was to evaluate the prescriptions according to WHO/INRUD drug use indicators and to study the adverse effects to antiepileptic drugs (AEDs).Methods: A cross sectional survey based observational study of 1year duration was conducted at tertiary healthcare hospital. Prescription data of patients (n=361) with Epilepsy from Neurology department was analysed using WHO indicators. The demographic data, type of seizures, AEDs prescribed and adverse drug reactions (ADRs) reported by the patients were recorded. Statistical analysis was done using Microsoft excel 2013.Results: A total of 593 AEDs were prescribed to 361 patients. Average number of AEDs prescribed per prescription was 1.65±0.78 (S.D) with only 02% of newer AEDs. Generalized Tonic Clonic (GTC) was the most common seizure with 55.68%. Phenytoin (32%) was commonly prescribed followed by valproate for GTCS. Carbamazepine was commonly prescribed for partial seizures. Out of 15 ADR cases that has been recorded, phenytoin (73%) was associated with most ADRs followed by valproate (20%). 53% patients were on Monotherapy, 31% on dual drug therapy.Conclusions: Older AEDs are still commonly prescribed drugs. Prescription of newer AEDs to be encouraged, as study revealed majority of adverse effects to drugs like phenytoin and valproate. Study concludes the need of creating awareness of reporting of adverse event to AEDs, in treating physician.