Pharmacoepidemiology of drugs in glaucoma patients with comorbidities like hypertension and diabetes mellitus type 2 in Pakistan

Abstract

Purpose: To evaluate the prescription pattern and utilization of drugs used by glaucoma patients with comorbidities including hypertension and diabetes mellitus type 2. Methods: This study was conducted at Al-Shifa trust eye hospital, Rawalpindi Pakistan from April 2021 to October 2021. Data regarding patient demographics, disease profile, medications & side effects were recorded. Percent utilization of total ophthalmic, antiglaucoma, antihypertensive, and antidiabetic drugs was calculated. Comparative utilization of antiglaucoma drugs in hypertensive and diabetic patients and in pre and post-visit to glaucoma specialists was also calculated. Results: Out of 876 glaucoma patients, majority had primary open-angle glaucoma, 58.3 were males, >50 belonged to the 50-70 years age group, and 27 and 18.8 were hypertensive and diabetic respectively. In the majority of cases, 1 or 2 eye drugs were prescribed and mostly in the topical dosage form. Fixed dose combinations (33.39) mainly were prescribed in all groups and Dorzolamide + Timolol was given in almost 80 of the time. Prostaglandin analogs (29.09) were 2nd most prescribed drugs. Beta-blockers were the least prescribed in all groups. Burning of the eyes was the most common side effect of ophthalmic drugs (28). Systemic beta-blockers were most commonly utilized by hypertensive patients while sulfonylureas by diabetic patients. No prominent change was noted in pre- and post-visit utilization of antiglaucoma drugs except brinzolamide. Conclusion: This study highlights the need for rational prescribing of antiglaucoma drugs in multimorbid patients and the importance of creating awareness of pharmacological actions, drug interactions, and side effects among physicians.