A drug utilization study of antihyperglycemic agents in diabetes mellitus cases of a South Indian tertiary care hospital

ABSTRACT

Background: Polytherapy and comorbidities are a significant component of drug prescriptions in type 2 Diabetes mellitus (T2DM) patients. Irrational prescriptions and increased cost and number of drug therapies in T2DM put a considerable burden on patients as well as health authorities. Drug utilization studies are a very important tool in the evaluation of such prescriptions for logistical planning and medical audit of a health care setup. Aims and Objectives: To determine the drug utilization patterns of Antihyperglycaemic agents in diabetic patients attending medicine outpatient department and to assess average cost per prescription and to assess the economic implication. Materials and Methods: A prospective observational drug audit was carried out between January 2017 to June 2018 to determine drug utilization patterns of antihyperglycemic and other agents in T2DM patients attending medicine outpatient department of Konaseema Institute of Medical Science General Hospital, Amalapuram. The data were assessed using the World Health Organization indicators for drug utilization and analyzed using mean percentage and Chi-square tests. Value of P < 0.05 was taken as significant. Results: Metformin had highest Defined Daily Dose of 0.77 and was the most common drug prescribed both as monotherapy (14%) and in combination therapy with glimepiride (42.5%). Amlodipine (15.5%) was the most common non-diabetic drug prescribed in our patients. Average number of drugs per prescription was 3.05, while average number of antihyperglycemic agents per prescription was 1.81. Average cost per prescription was under rupees 50 in 30% of patients and all drugs were prescribed by their brand names. Conclusion: Metformin should be available in sufficient quantities in health care system for T2DM patients and drugs should be prescribed by generic names to reduce cost of drug treatment.