Prescription audit of rheumatoid arthritis patients treated at primary and secondary care level, before reaching a tertiary care centre hospital in Eastern India

Abstract

Background: To analyse the usage pattern of pharmacological agents in the treatment of rheumatoid arthritis in Eastern India at a community level before reaching a specialized rheumatology clinic.Methods: Total 200 patients earlier diagnosed to be RA on treatment were selected and their demographic details, duration of treatment, agents prescribed, adverse drug reactions (ADRs) were analysed.Results: At the end of the study analysis, we observed that HCQ (24.4%) and Sulphasalazine (20.9%) were the commonest disease modifying anti-rheumatoid drug (csDMARD) used, followed by Methotrexate (16.9%). Dual combination csDMARD (33.1%) was preferred. Biological therapy was a rarity (0.5%). Steroids (21.0%) and NSAIDs (22.5%) was commonly used. Complementary and Alternative Medicines (CAM) (44.0%) was used often. Polypharmacy was the trend. Not all patients diagnosed as RA met the 2010 ACR/EULAR classification criteria of RA.Conclusions: In 15% patients, the diagnosis of RA was inappropriate according to the recent classification criteria. csDMARD was preferred either as monotherapy or combination therapy. Use of steroids and NSAID was a common practice. ADR were mild in severity.