Prescribing Trends of Amlodipine in Outpatient Setting

Aim: This study aims to illustrate the Prescribing Trendsof Amlodipine in Outpatient Setting in Al-Kharj city.Methodology:This is a retrospective study that was conducted in a public hospital in Alkharjcity. The outpatient prescriptions were reviewed to evaluate the prescription patternsof Amlodipine. The data were collected and analyzed using Excel software, the descriptive data were represented by frequencies and percentages. Results:The majority of amlodipine prescriptions were for patients more than 40 years old.The most prescribed departments were internal medicine followed by emergency and cardiology department. Amlodipine was mainly prescribed by resident physicians.Conclusion:Amlodipine is one of the most prescribed antihypertensivedrugs. It is prescribed mainly by residents, many of them without sufficient experiences. This may lead to inappropriate prescribing patterns, as a result more efforts needed to increase the knowledge of prescribers regarding the appropriate use of cardiovascular medicines including amlodipine

Outpatient Doxycycline Therapy: Frequency of Its Use and Its Prescribing Patterns in a Public Hospital

Aim: The aim of this study was to identify the outpatient doxycycline therapy: Frequency of its use and its prescribing patterns in a public hospital.Methodology: This was a retrospective study which was conducted in a public hospital in Alkharj City in 2018. The outpatient prescriptions were reviewed to evaluate the prescription patternsof Doxycycline.Results:The study results found that about 48.38% of the patients were female and about 62.90% were from Saudi Arabia. Doxycycline was prescribed mainly by resident physicians. Doxycycline was prescribed mainly in the emergency department followed by obstetrics & gynecology department.Conclusion: Doxycycline was prescribed infrequently in the outpatient settings; it is reserved only for specific conditions. It is important to use antibiotics wisely by the patients and to prescribe and dispense antibiotics including doxycycline appropriately by health care professionals.

A cross sectional study on prescription pattern of drugs in upper respiratory tract infections in a tertiary care hospital

Background: Upper respiratory tract infections are one of the leading causes of hospital visits worldwide. Judicious use of antibiotics is challenging for upper respiratory tract infections (URTIs) in developing countries like India. This leads to inappropriate use of antibiotics causing many dreaded conditions like antibacterial resistance among other things. Hence rational use of drugs, mainly antibacterial, is a priority to reduce the burden of treatment failure. The objective of this study is to study the prescribing patterns and rationality of drugs prescribed in the management of URTIs.Methods: This was a cross-sectional study. Data was collected from records of 300 outpatients clinically diagnosed as URTIs from SSIMS and RC Hospital, Davangere between January 2015 and June 2016. The prescribing patterns, approval status and listing of drugs in World Health Organization (WHO) essential medicines list/ National List of Essential Medicines (NLEM) were analysed. The data was presented as percentages, mean and standard deviations.Results: A total of 300 cases were studied. Among these, acute pharyngitis (29%) and acute sinusitis (26%) are the most common infections. Of the 300 cases studied, 283 (94.3%) were prescribed antimicrobials. Of the total 740 medications prescribed, 393 (53.1%) were fixed-dose combinations (FDCs). A total of 724 medications (97.8%) were approved by Drugs Controller General of India and 248 (33.5%) by Food and Drug Administration. Only 5.8% of the prescribed drugs have been listed in WHO’s and NLEM. The most common class of antibacterials prescribed was Beta-lactams.Conclusions: Oral formulations were preferred over parenteral formulations and FDCs were preferred over single drug formulations. Beta-lactams comprised the major class of antibacterial prescribed.

Drug utilisation study in surgery outpatient department at Ashwini Rural Medical College, Kumbhari, Solapur

Background: Drug utilization studies should be regularly conducted to increase therapeutic efficacy, decrease adverse effects and provide feedback to prescribers to promote the rational use of drugs. Systematic audit of prescriptions in Surgery Outpatient Department are very few in India. This study was conducted to study drug prescription pattern in Surgery Outpatient Department (OPD) in Ashwini Rural Medical College, Kumbhari.Methods: Six hundred prescriptions were screened and analyzed as per the study parameters at Surgery OPD of Ashwini Rural Medical College, Kumbhari. Study parameters like demographic profile of the patient like age, sex and diagnosis were recorded. Also groups of drugs commonly prescribed, number of drugs per patient, drug profile and drawbacks of prescription if any were recorded and analyzed. The percentage of the drugs prescribed by generic names and from the essential drug list was calculated.Results: Most common group of drugs prescribed by physicians were drugs for peptic ulcer (27.26%), followed by antimicrobials (20.89%). The average number of drugs prescribed per patient was 2.98. Drug prescription by generic name was low (8.82%). The incidence of polypharmacy was common occurrence and some prescriptions had small drawbacks like absence of diagnosis, absence of doctor’s signature, absence of patient age etc.Conclusions: Prescribing by generic name and from the essential drug lists should be encouraged. Training sessions on the correct method of writing prescriptions are needed.

Antipsychotic Prescribing Pattern In Elderly Patients With Psychiatric Disorders

The elderly people are more prone to develop psychiatric disorders due to a number of factors like changes in the brain, other illnesses etc. They represent the most vulnerable group as they are most sensitive to the effects of drugs and are at increased risk of developing adverse drug reactions. This warrants the need to make the prescribers cautious about rational prescribing of antipsychotics to the Elderly. The study included elderly inpatients and outpatients visiting psychiatry ward with psychiatric disorders. Descriptive weighed analysis was performed to determine the prescribing practices of atypical antipsychotics. Among the 70 patients who were involved in the study, 36 patients were diagnosed with neurotic disorders and 30 patients were diagnosed with psychotic disorders and 4 were diagnosed with degenerative disorders (dementia). In our study neurotic disorders (51%) were the major diagnosis. 6 different atypical antipsychotic drugs were prescribed to the patients suffering from different psychiatric disorders. Among them olanzapine (43%) was the most commonly prescribed drug, followed by quetiapine (30%), risperidone (21%), clozapine (3.2%), lurasidone (1%), and aripiprazole (1%). This study has concluded that atypical antipsychotics are preferred over typical antipsychotics and Olanzapine is the most commonly prescribed drug for the elderly patients suffering from psychiatric disorders. On comparison of the prescribed daily doses with the maximum daily dose we have observed that the prescribed daily doses for the elderly patients were well within the maximum daily dose of the drugs and in our study no adverse drug reactions were reported in the study subjects that were involved.

An Analysis on Prescribing Patterns of Alzheimer's Dementia Treatment and Choline Alfoscerate using HIRA Claims Data

BACKGROUND: Alzheimer's dementia is the most common dementia. However, recently, choline alfoscerate is prescribed for treating Alzheimer's dementia, although it is not a treatment for this disease. PURPOSE: To analyze the prescription patterns of choline alfoscerate as a dementia treatment for patients with Alzheimer's disease and to analyze, as well as the factors affecting choline alfoscerate prescription. METHOD: The 2016 HIRA-NPS data was used in this study. The code of Alzheimer's dementia is F00 in the ICD-10 disease classification code. We analyzed the demographic, clinical, and regional characteristics associated with donepezil, rivastigmine, galantamine, memantine, and choline alfoscerate prescriptions. All statistical and data analyse were conducted by SAS 9.4 and Excel. RESULTS: For patients with Alzheimer's disease, choline alfoscerate was the second most prescribed after donepezil. Analysis results showed that choline alfoscerate was more likely to be prescribed to men than to women, and more likely to be prescribed by local health centers than by medical institutions. Moreover, choline alfoscerate was highly likely to be prescribed at neurosurgical departments, among medical departments. CONCLUSION: This study confirmed that choline alfoscerate was prescribed considerably for patients with Alzheimer's dementia. Further studies valuating its clinical validity should be performed to clarify whether choline alfoscerate prescription is appropriate for treating Alzheimer's dementia.

Assessment of prescribing trends for rational use of drugs

Background: Nowadays irrational use of drugs is a major problem inspite of extensive programs being carried out on rational use of medicines. Therefore, in present study we evaluated OPD prescriptions for rationality and their adherence to prescription format.Methods: A prospective, observational study was carried out in 511 outdoor patients for a period of three months. Quality of prescription writing was assessed for completeness of information and legibility. Rationality was analyzed using WHO core prescribing indicators.Results: Basic information of patient and name of department were written in all the prescriptions. Diagnosis was mentioned in 76.33% cases. Dosage forms, dose, frequency and duration of treatment were mentioned in 97.26%, 73%, 80.04% and 80.23% of prescriptions respectively. About 73.78% prescriptions were legible. Doctor’s name, signature and registration number were present in 80.82%, 82.97% and 15.66%. Total number of drugs in 511 cases was 1074. Average number of drugs/ prescriptions was 2.1±0.8. Drugs were prescribed by generic name in 25.14% cases; drugs from EDL were 57.36%. Antimicrobial agents, injectable drugs and FDCs were prescribed in 25.83%, 12.13% and 39.14% cases. The most commonly prescribed drugs were analgesics, GIT and cardiovascular drugs.Conclusions:This study shows possible areas of improvement in prescription practice that is generic prescribing, use of essential medicines, restraint in use of irrational fixed dose combinations and better quality of prescribing in terms of inclusiveness of information, legibility and doctor’s details.

Prescribing patterns of antimicrobial usage in ophthalmology out patients department at tertiary care teaching hospital.

Background: Drug utilization provides prescribing behaviors of prescriber. Rational prescribing of antimicrobial drugs plays a crucial role in reducing the antibiotic resistance. The study aim was to analyze the patterns of antimicrobial prescribed ophthalmology outpatient department (OPD) patients. Methods: The study was an observational study completed over a period of 6 months, from July 2014 to December 2014. The study was conducted in Department of Ophthalmology, MGM Medical College, and Hospital Navi Mumbai. A questionnaire was specifi cally designed factoring patients’ demographical profi le, diagnosis of disease, drug regimen. Results: A total 125 prescriptions of patients were analyzed who visited ophthalmology OPD department. Maximum patients belonged to the age group of 41-50 years (27.2%), followed by age group of 31-40 years (25.6%). The proportion of male (59%) patients was more as compared to female patients (41%). Total drug prescribed was 296. Average drug per prescription was 2.36. Among 296 drugs, 144 were antibiotic prescribed. Average antibiotic per prescription was 1.15. Most commonly antibiotic prescribed was moxifloxacin. Most common fixed dose combination (FDC) of antibiotic prescribed was tobramycin plus loteprednol. Among total 125 patients, maximum patients were diagnosed with cataract (25%), followed by meibomitis (12%), conjunctivitis (24%), blephritis (9%), foreign body in eye (12%), psedophakia (10%) and other disease (8%). 96% of antimicrobial were prescribed from essential drug list. The FDC of antimicrobial (40%), fl uroquinolone (19%), aminoglycoside (13%), broad spectrum (12%), macrolide (9%), anti-viral (7%) was prescribed. Maximum number of drugs was found in the form eye drops (72%). Conclusion: The present study found that FDC of antibiotic was prescribed maximum. Most common dosage form of prescribed drug was eye drop. Prescription of drugs by brand name was a matter of concern

Prescription appetite suppressants: A drug utilization study using a claims database.

The primary aim of the study was to determine the prescribing and cost of prescription appetite suppressants in a defined private sector patient population. A retrospective drug utilisation study was conducted on a medical insurance claims database in South Africa for 2010 and 2011. In 2010, 37 patients (86.49% females) were prescribed 44 appetite suppressants at a cost of R9 813.39. The average age of patients was 40.95 (SD=12.37) years. In 2011, 27 patients (77.78% females) received 42 prescriptions for appetite suppressants at a cost of R9 967.73. The average age of patients was 40.04 years (SD=10.41). Most products were for phentermine (77.91%), followed by d-norpseudoephedrine (17.44%) and diethylpropion (2.33%). Prescribing patterns in 2010 and 2011 were relatively similar. In 2011, patients were prescribed a total of 630 products (all therapeutic classes). The most often other prescribed medicines in 2011 were gastrointestinal tract products (14.60%), cardiovascular agents (11.11%) and antimicrobial products (9.52%). The most frequently prescribed subclasses were HMG-CoA reductase inhibitors (statins), analgesic combinations, non-selective COX-inhibitors and selective serotonin re-uptake inhibitors. Appetite suppressants were not reimbursed by patients’ medical insurance benefits. A limited number of strictly regulated appetite suppressants were prescribed. Consumer studies that include over-the-counter appetite suppressants are recommended.

Assessment of Antimicrobial Utilization and Prescribing Pattern among the Health Care Professionals at a Tertiary Care Rural Teaching Hospital in Southern India.

Aims: To monitor the antimicrobial utilization; identify the preferred group of antibiotics in outpatient services, determine the prescribing pattern of antibiotics by consultants in a rural teaching hospital, evaluate the inappropriate usage of antibiotics among population and evaluate the patients knowledge about use of antimicrobials taken for their illness. Methodology: A period of 24 months of investigation is carried out towards prescribing antibiotics and the inappropriate usage of antibiotics among rural population who attended outpatient departments were elicited by Questionnaires survey method and analysed in relation to rational use of antibiotics. The patients were also interviewed for their knowledge regarding drugs, sources, dose, duration and frequency of the drugs. Results: The percentage of distribution of various group of antibiotics in the years of 2009-2010 and 2010-2011 were Sulphonamide (SULP) (4.42%, 1.1%), Penicillin (Pn) (52.4%, 9%), Fluroquinolones (FQs) (24.9%, 44%), Cephalosporins (CPs) (1.2%, 5.2%), Broad spectrum antibiotics (BSA) (3.4%, 3.6%), Macrolide (Mac) (1.3%, 5.2%), Antiprotozoal drug (APD)-metronidazole (12.3%, 12.7%) and fixed dose combination (FDC) (0.2%, 3.6%) respectively. Many practitioners were not aware of Multidrug Resistance (MDR) (50.5%) nor the type of infections (52.6%) or the group of antibiotics (57.9%) exhibiting resistance. Conclusion: Antibiotics are considered as the second most prescribed drugs in the world. In our study, 76.2% were prescribed with antibiotics in their prescription. Analysis of utilization of antibiotics in pharmacy during the year of 2010-2011 revealed a reduction in antibiotic use compared to 2009–2010. Further awareness required to the prescribers and beneficiaries regarding antimicrobial resistance.

Prescribing patterns of ophthalmological products in a private sector patient population in South Africa.

Studies on the prescribing patterns of ophthalmological products are scarce. The primary aim of the study was to determine the prescribing patterns of ophthalmological products in a private sector patient population in South Africa. A retrospective drug utilization study was conducted on a 2011 database containing 2 298 312 records for medicine, procedures and medical devices. All records for ophthalmological products were extracted and analysed. A total of 8 428 patients (52.81% males) received 17 087 ophthalmological products. The average age of patients was 36.83 (SD=21.32) years, with 35.92% of products prescribed to patients between 40 and 59 years of age. Anti-infectives accounted for 25.45% of prescribing frequency and 10.63% of prescribing cost, and antiinfectives combined with corticosteroids for 15.44% of prescribing frequency and 17.78% of cost. Only 4.38% of patients received products for glaucoma, accounting for 12.09% of prescribing frequency and 24.66% of cost. The average age of patients on glaucoma products was 61.64 (SD=16.07) years. Antiviral products had the highest average cost (only one trade name, no generic equivalent was available for this product). A third of products were prescribed on a chronic basis. More studies are needed to determine the treatment of eye conditions in South Africa.

Prescribing patterns for Parkinson’s disease in a South African patient population.

The primary aim of the study was to analyse the treatment of Parkinson’s disease in a defined patient population in South Africa. A cross-sectional, retrospective drug utilization study was conducted on prescription data of a national community pharmacy group for 2010. A total of 25 523 products were prescribed to 5 168 patients. Most patients (59.17%) were females. The average age of patients was 69.57±10.37 years. Levodopa-containing products constituted 46.50% of prescribing frequency. The highest sales value was attributed to a generic levodopa/carbidopa 100/25mg preparation, with the second being the innovator product of the same strength. Dopamine agonists (pramipexole and ropinirole) constituted 39.80% of prescribing frequency, followed by anticholinergic agents (9.20%), the MAO-B inhibitor selegiline (2.12%) and amantadine (1.80%). The cost of levodopa products in combination with a dopa decarboxylase inhibitor was 45.00% of the total expenditure on antiparkinsonian medication. Levodopa remained the gold standard for the treatment of Parkinson’s disease. Further investigations need to focus on dosages, side effects, compliance and continuity of medication.

Evaluation of the adherence by patients treated in a psychosocial ambulatory care setting in northeastern Brazil.

In the treatment of the mental disorders, the lack of adherenceto the pharmacotherapy is observed in about 50% of people and is responsible lot more morbidity, besides being the main cause of psychiatric morbidity and rehospitalization. This work sought to evaluate the adherenceto the medical treatment frompatients attended in a Primary Health Care Center in the municipal district of Aracaju – Sergipe. For that, an exploratory, descriptive and observational studywas accomplished, with transversal design, in the period from August 2011 to November 2011, carried outthrough interview applications. This research finds that more than 55% of the sample hadlow education; 41.4% were single and 42.8% presented other health problems, besides the mental disorder. Regarding to the knowledge level on the used medications, this variable presented good results, since 60% of the patients were classified in the category “know well”. Likewise, the results revealed that 49.3% of the investigated patients did not adhere to treatment, having as main causes of non-adherence the forgetfulness (53%), the lack of the medication in the health units (47%) or the lack of financial resources for the purchase of the medication (45%) – all these were considered as unintentional causes of non-adherence. Anyway it is an unpublished study in the outpatient attention context in Mental Health in the State, the results are expected to contribute for the evaluation and planning actions in the specialized component of the Pharmaceutical Assistance and in the precepts invigoration perspective of the psychiatric reform, focusing on the full approach of the attention towards the mental health and the rational use of psychotropic medicines.

Patterns of Antipsychotic Prescription to Patients with Schizophrenia in Korea: Results from the Health Insurance Review & Assessment Service-National Patient Sample

This study aimed to analyze the patterns of antipsychotic prescription to patients with schizophrenia in Korea. Using the Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS), which was a stratified sampling from the entire population under the Korean national health security system (2009), descriptive statistics for the patterns of the monopharmacy and polypharmacy, neuropsychiatric co-medications, and prescribed individual antipsychotic for patients with schizophrenia were performed. Comparisons of socioeconomic and clinical factors were performed among patients prescribed only with first- and second-generation antipsychotics. Of 126,961 patients with schizophrenia (age 18-80 yr), 13,369 were prescribed with antipsychotic monopharmacy and the rest 113,592 with polypharmacy. Two or more antipsychotics were prescribed to 31.34% of the patients. Antiparkinson medications (66.60%), anxiolytics (65.42%), mood stabilizers (36.74%), and antidepressants (25.90%) were co-medicated. Patients who were prescribed only with first-generation antipsychotics (n=26,254) were characterized by significantly older age, greater proportion of male, higher proportion of medicaid, higher total medical cost, lower self-payment cost, and higher co-medication rates of antiparkinson agents and anxiolytics than those who were prescribed only with second-generation antipsychotics (n=67,361). In this study, it has been reported substantial prescription rates of first-generation antipsychotics and antipsychotic polypharmacy and relatively small prescription rate of clozapine to patients with schizophrenia. Since this study has firstly presented the patterns of antipsychotic prescription to schizophrenic patients in Korean national population, the findings of this study can be compared with those of later investigations about this theme.

Study of utilization pattern of anti-hypertensive drugs in hypertensive diabetic patients with or without reduced renal function at tertiary care teaching hospital.

Background: The benefits of optimum blood pressure (BP) control in patients with diabetes exceed the benefits of glycaemic control and extend to the prevention of both macro-vascular and micro-vascular complications in patients suffering from both hypertension and diabetes mellitus. Aims & Objective: To investigate the utilization patterns of anti-hypertensive drugs and to evaluate blood pressure (BP) control among diabetic-hypertensive patients with and without reduced renal function. Material and Methods: A prospective, observational study carried out at medicine department of SBKS Medical College and Research Centre, Piparia. The pattern of use of antihypertensive drugs in 50 hypertensive-diabetic patients was evaluated in correlation with its renal function and BP control achieved was compared in patients with and without reduced renal function. Results: Total 63 antihypertensive medication episodes were prescribed for 50 patients. Out of which 76% patients were receiving 1 drug, 22% receiving 2 drugs and 2% receiving 3 drugs of different antihypertensive class. Most patients were receiving Angiotensin-Converting-Enzyme-Inhibitors (ACE-I)/Angiotensin-Receptor-Blockers (ARBs) (60%), followed by CCBs (24%), beta-blockers (20%), and diuretics (16%). Patients on monotherapy were mostly receiving ACE-I/ARB (65.78%). Beta blockers were more commonly prescribed in patients with reduced renal function (p=0.005). BP control was achieved in 63.15% patients in monotherapy and 33.33% in polytherapy group. Control of systolic and diastolic BP was significantly higher in patients without reduced renal function than patients with reduced renal function (p<0.05). Conclusion: There was suboptimum use of combination therapy among diabetic-hypertensive patients in general and specifically in developing countries as reflected by control achieved in systolic and diastolic BP which requires concern of all healthcare professionals.

Drug Prescription Pattern in Pregnant Women Attending Antenatal Out Patient Department of a Tertiary Care Hospital.

Aims: Pregnant women requiring medication represent a challenge to healthcare providers to avoid any teratogenic risk to fetus. The purpose of this study was to provide information about the drug use among pregnant women in a tertiary care hospital, Mumbai, India. Study Design: Cross-sectional study. Place and Duration of Study: Department of Obstetrics and Gynecology and Department of Pharmacology, Seth GSMC & KEM Hospital, between July 2011 and December 2011. Methodology: A cross sectional study was conducted by reviewing the antenatal care Outpatient department case papers of 760 random pregnant women. Demographic profile, detailed medical history and drug intake in current pregnancy was noted. The prescription pattern was assessed and the drugs were classified based on the US FDA Risk Classification. Results: Out of 760 women, one third (33.18%) women were anemic. Majority drugs were prescribed for the treatment of upper respiratory tract infection, vaginal discharge fever with chills, nausea and vomiting. The average number of drugs per prescription was 2.27. Only 4% drugs were prescribed by their brand name and 96 % by generic name. Iron, folic acid and calcium were prescribed to all pregnant women. Majority of the patients were prescribed Category A and B drugs. No patient was given Category X drugs. Conclusion: Findings of our study showed that all pregnant women were provided with prophylactic iron and folic acid therapy. The occurrence of contraindicated medicines was desirably low, thereby minimizing overall risk to developing fetus. Thus prescribing pattern observed in our study sets a good example, as selection of drugs was rational in most of the cases.

Trends of prescribing for out-door geriatric patients in a private hospital of Bangladesh.

The present study was performed to find out the prescribing patterns of the doctors for geriatric patients, to characterize the behavior of the outdoor geriatric patients of a selected private hospital and to investigate whether polypharmacy is a suitable indicator for occurrence of unnecessary or irrational drug therapy. A prospective study was carried out with the help of a structured questionnaire and the prescriptions of the patients. Patients aged 65 year and above were included in the study. A total of 35 patients were interviewed and their prescriptions were collected after taking their consent. Among the patients, hypertension was found to be most prevalent (46%) followed by diabetes mellitus (16%). Chief complaints were chest pain (41%), joint pain (37%), muscle pain (34%) and respiratory distress (27%). About 34% of the patients did not comply with the prescription and 75% did not take regular physical exercise. Stress (49%) and insomnia (41%) were common among the patients. Polypharmacy was observed in 69% of the patients and an average of 5.5 drugs was given to them. Losartan potassium was the mostly prescribed (31%) drugs followed by esomeprazole (20%) and multivitamins (17%). Unnecessary drug use problem can be prevented by the rational prescribing of drugs by the practitioners. Any medications without therapeutic benefit, goal or indication should be avoided during prescribing for geriatric patients. This study reveals the prescription trends, and indicates possible areas of improvement in prescribing practice.

Study of Prescribing Pattern for Rational Drug Theraphy

The present study of prescribing pattern for evaluation of rational drug therapy was carried out in Jammu city for a period of six months. Two hundred prescriptions written by qualified medical graduate and postgraduate doctors were collected and studied for their correctness and rationality. The doctor's identity, patient's name, age and address, superscription, route of administration and administration of therapy were mentioned in 27%,100%, 27%, 5%,63%,20% and 66% of prescriptions respectively. Drug use has been found to be inappropriate in 33 % of the drugs and large number of prescriptions do not conform to the ideal pattern .