Assessment of prescribing pattern and cost analysis of topical steroids for skin disorders in dermatological outpatient department of a tertiary care hospital

ABSTRACT

Background: Topical steroid is most commonly prescribed in non-infective dermatological conditions. Periodical Prescription audit is mandatory for the effective management. Hence the present study is designed to assess the prescribing pattern and cost analysis of topical steroids for various skin disorders in the dermatology OPD of a teaching hospital.Methods: This is a prospective observational study conducted in dermatology OPD of a teaching hospital from Jan-Mar 2019 in patients prescribed with topical steroids in all age groups after obtaining IEC approval. Data was analyzed for prescription pattern and cost analysis using descriptive statistics and expressed in percentage.Results: A total of 90 prescriptions were analyzed among which males were 45% and females were 55%, the common indications were eczema-27.7%, atopic dermatitis-25.5%, psoriasis-16.6%, dermatoses-13.3%, lichen planus-7.77% etc. Topical steroids commonly prescribed were super potent (Clobetasol 34.4% and Halobetasol 22.2%). Cream and ointment formulation were commonly used. Common adverse reactions were skin atrophy, hypopigmentation, acne. In prescribing pattern, specification of strength and quantity were lacking whereas instructions regarding area of application-44.4%, route of administration-83.3%, frequency and duration-91% were noted. In cost analysis, comparison is made between similar potency and clinical outcome. Of which, Clobetasol 0.05% and Betamethasone 0.01% is found to be cost effective compared to Halobetasol 0.05% and Mometasone 0.1% respectively.Conclusions: This study provides a limelight on prescribing pattern of topical steroids and emphasize periodic audit to rationalize the prescription with cost effectiveness.