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INTRODUCTION: Drug-related problem (DRP) is any undesirable event experienced by the patient, which is suspected to involve drug therapy and interferes with a desired patient outcome. Most of these DRPs are avoidable with little vigilant effort. DRP admissions need high attention as DRP-related admissions on an average accounted for 8.36%, of which 50% are avoidable. The aim of the study was to identify the risk factors associated with DRPs in tertiary care hospital. MATERIALS AND METHODS: One year prospective observational study was conducted in the departments of general medicine, dermatology, pediatrics, and gastroenterology of a tertiary care teaching hospital. A total of 148 cases, where a correlation between past medication history and current complaints was established, were included in the study. Exclusion criteria of the study were no correlation between past medication history and current complaints, social habits causing hospitalization, and herbal medication use history. RESULTS AND DISCUSSION: In this study, nonadherence (50.94%) and adverse drug reaction (ADR) (38.36%) were predominant among the identified DRPs. Children and geriatrics showed the higher incidence of nonadherence to the prescribed therapy. ADRs were the DRP with the higher incidence among adults followed by nonadherence to the prescribed therapy. Lack of knowledge about the disease, its complications, and possible adverse reactions with self-medication was identified to be the high incidence risk factor. Higher incidence of DRPs was observed in patients having a past medical history of cardiovascular system and central nervous system diseases, which require long-term management. CONCLUSION: In this study, nonadherence to prescribed therapy was found to be the DRP causing hospitalization at a higher incidence. The most commonly involved risk factors were lack of knowledge about the disease, need of adherence to the therapy as prescribed, and outcomes of the treatment provided.
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BACKGROUND: Multi-drug resistant tuberculosis (TB) is a rising peril of the TB control in India caused mostly by incomplete treatment. AIM: The aim was to assess the treatment interruption among pulmonary TB (PTB) patients. MATERIALS AND METHODS: A cross-sectional study was carried out for a period of 9 months among PTB patients. Patients admitted with active pulmonary Koch's and history of anti-TB treatment (ATT) for 1-month or more from any source and who returns to treatment after not taking ATT consecutively for 2 months or more were included in the study. The data were collected from the patients or their caretakers to obtain the source of treatment given previously before default, number of treatment interruptions, phase and reasons for treatment interruption treatment. RESULTS: A total of 107 defaulters were identified during the study period. In the present study, 62.6% of the patients interrupted treatment only once, 55.34% of the patient's early continuation (3-4 months) treatment, and 47.66% of the patient's only one reason for the treatment interruptions during the course of the treatment. The most common reason for the treatment interruptions were felt well with TB treatment (29.53%) followed by side effects (16.06%), lack of money (8.29%), and other reasons. CONCLUSION: The study revealed that most of the defaulters were in the age group between 35 and 60 years, male gender, illiterates, daily wage labor, and married. The treatment interruptions were minimized by putting the efforts to improve direct supervision; pretreatment counseling and retrieve treatment interrupters were recommended.
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OBJECTIVE: Hypertension is a leading contributor to the global burden of cardiovascular morbidity and mortality. The main objective of the present study was to assess the prescribing patterns for antihypertensives in geriatric patients. MATERIALS AND METHODS: A Prospective observational study was carried out for the period of six months in an out-patient department. Elderly patients who have been diagnosed with hypertension as per JNC-7 guidelines and patients receiving or prescribed with antihypertensive drugs were included. RESULTS: A total of 100 prescriptions were analyzed during the six-month study period. 72% of the patients were in the age group of 65-67 years and this was found to be higher in men 69%. During the study period 80% of the patients were Pre-Hypertensive systolic (80-89 mmHg) and Diastolic (120-139 mmHg) followed by Stage-I Hypertension and Stage-II Hypertension. The most common drug classes involved in the study was Calcium Channel Blockers 37% followed by Angiotensin II receptor antagonists 21% and the most commonly prescribed drugs in the study population were Amlodipine 37%, Losartan 11% and Telmisartan 10%. The most common anti-hypertensive fixed dose combination therapy involved in the study was Telmisartan + Hydrochlorothiazide 15% and most common two drug combination therapy involved in the study was Amlodipine + Atenolol 7% followed by Metoprolol + Amlodipine 1%. CONCLUSION: Our study shows that the most commonly prescribed drug classes involved were Calcium Channel Blockers followed by Angiotensin II receptor antagonists and the anti-hypertensive drug combinations among hypertensive patients were considerable and this practice positively impacted on the overall blood pressure control.
