PGI30 Assessment of Prescription Use and Patterns of Drug Related Problems in Patients with Peptic Ulcer Disease in Southern India.

Abstract

The aim of the study is to assess the usage of drugs in the management of peptic ulcer and to identify the association of drug-related problems(DRPs). A prospective observational study was conducted over a period of nine months in the department of gastroenterology among both in-patients and out-patients. Patients diagnosed endoscopically with Peptic Ulcer Disease (PUD) were enrolled in the study after obtaining inform consent form. Descriptive statistics were applied to this study. A total of 180 patients were included in the study with 108 (60%) out-patients and 72 (40%) in-patients. Clarithromycin based triple therapy [n= 104 (57.77%)] with Esomeprazole based Helicobacter Pylori (HP) kit [n=90 (86.53%)], Pantoprazole based HP kit [n=14 (13.46%)] were started as fixed drug–dose combination therapy and monotherapy in 45% of the patients. The average maintenance treatment with proton pump inhibitors lasted for 42.12 ± 5.94 days. In-patients with complicated Peptic Ulcer Disease were administered with proton pump inhibitor (PPIs) 80mg bolus followed by PPI infusion 8mg/hr. for a period of 19.5±6.69 hours. A total of 138 (76.66%) participants encountered at least one drug-drug interactions(DDIs) and drug interactions accounted for 71.64% of overall drug related problems. Among 235 DDI’s, minor interactions were 149 (63.40%), the interactions to be monitor closely were 74 (31.49%) and serious interactions were 12 (5.10%). Overall, 10 (3.08%) experienced adverse drug reaction (ADR) as a DRP. Among 108 (60%) ambulatory patients, 10 (9.25%) experienced ADR. The H-pylori kit is popular clarithromycin-based therapy used in H-pylori eradication. Proton pump inhibitor was the most common therapy used in combination or alone, and use of esomeprazole was safe and compliant with the American College of Gastroenterology guidelines. In-patients the prophylactic use of antibiotics was seen due to complicated ulcers. DRPs encountered was DDIs followed by sub-therapeutic dose and failure to receive maintainance dose of PPI.