Study of utilisation trends of drugs in patients admitted with cardiovascular diseases at a tertiary care hospital in Goa
DOI:
https://doi.org/10.18203/issn.2454-2156.IntJSciRep20175385Keywords:
Case records, Prescription screening, Inappropriate drug use, Diseases of heart and blood vesselsAbstract
Background: CVDs have emerged as a leading cause of mortality and morbidity in the world as well as in India. Drug usage is life saving and at times many drugs may be needed. Drug utilization studies aid to find the appropriateness of treatment, identify shortcomings if any, and provide a feedback to the healthcare providers to improve their management with drugs. So such types of studies are of vital importance in every hospital.
Methods: This was a prospective, observational study of 180 patients with CVDs admitted in medicine and cardiology wards of a tertiary care hospital, conducted through case records and patients’ interviews. Data was represented as mean±SD, number and frequency.
Results: Incidence of cardiovascular diseases was more in males (56.67%) than the females (43.33%). Average number of drugs prescribed per patient was 9.16 and that of cardiovascular drugs was 5.08 ± 2.15. Antiplatelets (88.88%) were the most commonly prescribed cardiovascular drugs followed by hypolipidemics (82.22%). About 15.06% of injectables and 1.2% of fixed dose combinations (FDCs) were prescribed. Drugs prescribed by generic names were 1.6% and those from the National List of Essential Medicines were 92.79%.
Conclusions: The results of this study suggested: polypharmacy, overuse of injections and low prescribing habits from essential drug list. Though antiplatelet, hypolipidemic use was higher, these are an essential part of treatment of certain CVDs.
Metrics
References
Noncommunicable Diseases Progress Monitor, 2017. Geneva: World Health Organization; 2017. Available at: http://apps.who.int/iris/bitstream/ 10665/258940/1/9789241513029-eng.pdf?ua=1. Accessed on 24 September 2017.
Cardiovascular diseases (CVDs). World Health Organization. 2017. Available at: http://www.who. int/mediacentre/factsheets/fs317/en/. Accessed on 24 September 2017.
Gaziano TA, Gaziano JM. Epidemiology of cardiovascular disease. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors. Harrison’s Principles of Internal Medicine. 18th Edition. New York: McGraw-Hill; 2012: 1998-2014.
Tripathi K. Essentials of Medical Pharmacology. 7th ed. Jaypee Brothers Medical Publishers; 2013.
Patil SB, Raikar SR, Patil S, Raikar DR. Prescription pattern of cardiovascular drugs in intensive cardiac care unit patients in a tertiary care hospital. Int J Basic Clin Pharmacol. 2015;4:1100-3.
Cahir C, Fahey T, Teeling M, Teljeur C, Feely J, Bennett K. Potentially inappropriate prescribing and cost outcomes for older people: a national population study. Br J Clinical Pharmacol. 2010;69(5):543-52.
How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators - EDM Research Series No. 007: Introduction: Objectives of a drug use study. Apps.who.int. 1993. Available at: http://apps.who.int/medicinedocs/en/d/Js2289e/1.2.html. Accessed on 24 September 2017.
Saranya KL, Gowda HN, Sadananda KS. A study of drug utilization trends in acute coronary syndrome in intensive cardiac care unit at a tertiary care hospital, Mysore. Int J Basic Clin Pharmacol. 2017;6:344-8.
Bandla A, Reddy K. A Study On Prescribing Pattern Of Cardiovascular Drugs & Potential Drug - Drug Interactions In An Inpatient Cardiology Unit Of A Cardiac - Care Hospital At Tirupathi. Eur J Pharma Med Res. 2016;3(8):294-305.
Drug and Therapeutics Committees - A Practical Guide: 6.Tools to investigate the use of medicines: 6.4 Qualitative methods to investigate causes of problems of medicine use. Apps.who.int. 2003. Available at: http://apps.who.int/medicinedocs/en/ d/Js4882e/8.4.html#Js4882e.8.4. Accessed on 24 August 2017.
Kamath A, Shanbhag T, Shenoy S. A Descriptive Study of the Influence of Age and Gender on Drug Utilization in Acute Myocardial Infarction. J Clin Diagnos Res. 2010;(4):2041-6.
Chandana N, Subash V, Kumar VG. A prospective study on drug utilization of cardiac unit in acute myocardial infarction of hosptalized patients. Inter J Pharmacotherapy. 2013;3(1):6-11.
Kaur S, Rajagopalan S, Kaur N, Shafiq N, Bhalla A, Pandhi P, et al. Drug utilization study in medical emergency unit of a tertiary care hospital in North India. Emerg Med Int. 2014;2014:973578.
Vakade KP, Thorat VM, Khanwelkar CC, Jadhav SA, Sanghishetti VM. A study of prescribing pattern of drugs in patients of cardiovascular emergencies at a tertiary care hospital of Western Maharashtra. Int J Res Med Sci. 2016;4:556-61.
Hannan A, Sinha S, Jamadar P. Drug utilisation study of cardiac emergency patients in a tertiary care hospital. J. Evolution Med Dent Sci. 2017;6(27):2217-24.
Rathod PS, Patil PT, Lohar RP, Patil AW. Prescription pattern in indoor patients of cardiovascular diseases: a descriptive study in a tertiary care hospital attached to a government medical college. Int J Basic Clin Pharmacol. 2016;5:491-5.
Al-Junid SM, Ezat WP, Surianti S. Prescribing patterns and drug cost among cardiovascular patients in Hospital Universiti Kebangsaan Malaysia. Med J Malaysia. 2007;62:59-65.
Shankar R, Partha P, Shenoy N. Prescribing patterns of drugs among patients admitted with cardiovascular disorders in the internal medicine ward prescribing patterns in inpatients. The Internet J Internal Med. 2000;3(1):1-5.
Christian R, Rana D, Malhotra S, Patel V. Evaluation of rationality in prescribing, adherence to treatment guidelines, and direct cost of treatment in intensive cardiac care unit: A prospective observational study. Indian J Crit Care Med. 2014;18(5):278-84.
Barot PA, Malhotra SD, Rana DA, Patel VJ, Patel KP. Drug utilization in emergency medicine department at a tertiary care teaching hospital: A prospective study. J Basic Clin Pharma. 2013;4:78-81.
Choudhary P, Agrawal JM, Malhotra SD, Patel VJ. Drug utilization pattern in acute coronary syndrome at tertiary care hospital: a prospective cross-sectional observational study. Int J Basic Clin Pharmacol. 2016;5:513-6.
Steinman M, Chren M, Landefeld C. What’s in a Name? Use of Brand versus Generic Drug Names in United States Outpatient Practice. J Gen Intern Med. 2007;22(5):645-8.
National List of Essential Medicines (NLEM) 2015 -India. Apps.who.int. 2017. Available at: http://apps.who.int/medicinedocs/en/d/Js23088en. Accessed on 24 September 2017.
Wallis KA, Andrews A, Henderson M. Swimming against the tide: primary care physicians’ views on deprescribing in everyday practice. Ann Fam Med. 2017;15(4):341–6.
American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2015;63(11):2227-46.
O'Mahony D, O'Sullivan D, Byrne S, O'Connor M, Ryan C, Gallagher P. STOPP/START criteria for potentially inappropriate prescribing in older people: version 2. Age and Ageing. 2014;44(2):213-8.