Prescription Pattern Of Drugs Research Articles

Trends and patterns of neurotology drug prescriptions on a nationwide insurance database.

ObjectiveTo examine neurotologists' 2013 to 2016 Medicare Part‐D data and evaluate commonly prescribed medications, longitudinal changes in prescribing patterns, presumed associated pathologies, and cost distribution across United States.MethodsComprehensive prescription data of Part‐D‐participating neurotologists was quiered from the 2013 to 2016 Medicare Part‐D database. Outcome variables consisted of the 25 most commonly prescribed + refilled medications, cost distribution per medication, presumed associated pathologies, and standardized prescription cost across United States.ResultsOf the 594 available U.S. neurotologists, 336 (57%) were found in the Medicare Part‐D database. In 2016, total prescription costs were $4 483 268 with an averaged $13 343 ± $18 698 per neurotologist. The three most frequently filled drugs were fluticasone propionate, ciprofloxacin, and triamterene‐hydrochlorothiazide. From 2013 to 2016, the greatest change in prescription pattern was observed with azelastine (+188%), montelukast sodium (+104%), mupirocin (+63%), and mometasone (−91%), whereas the greatest change in relative drug cost distribution was seen in ofloxacin, (+695.7%) neomycin‐polymyxin‐hydrocortisone (+262.1%), and mometasone (−83%). Triamterene‐hydrochlorothiazide, prednisone, montelukast, amoxicillin‐clavulanate, azelastine, spironolactone, and mupirocin had statistically significant increases in average number of prescriptions per physician, whereas ofloxacin and mometasone had significant decreases. Medications presumably treating Eustachian tube dysfunction, Meniere's disease, and vestibular migraine had the greatest percent changes across years. Cost distribution of four drugs increased upwards of 100%. Geographic analysis demonstrated that Southern and Midwest regions had higher standardized prescription costs.ConclusionsThis study is the first to analyze neurotologists' trends in prescribing patterns, regional prescription cost distributions, and commonly treated pathologies. This can lead to better standardization of prescribing patterns and cost in the future.

Prescribing Patterns of Antidiabetic in Patients with Type 2 Diabetes Mellitus at Levy and Chilenje Hospitals in Zambia

Objective: To determine the prescription pattern of anti-diabetics drugs in patients with type 2 diabetes at Levy Mwanawasa General and Chilenje Level 1 Hospitals. Methods: A cross-sectional study was conducted by reviewing the diabetic patients’ prescriptions with diabetic drugs from outpatient department from January to December, 2016. Data generated from this study was analyzed using SPSS version 23. The P value < 0.05 was considered as significant. Descriptive statistics and one way analysis of variance (One way -ANOVA) statistical techniques were used to analyze data. Results: Of the total of 384 patients’ prescriptions, 63% were female and the majority of patients belonged to the age group 51-60 years indicating 28%. 51% of the prescriptions had 2 to 3 antidiabetic drugs written by generic name. Metformin/Daonil combination was highly prescribed with 57%, followed by Metformin as Monotherapy at 19%. Conclusion: This study reported that female patients were significantly more affected with diabetes associated with cardiovascular complications than male patients reviewing 37% for male and 67% female. Most of the patients were on combination therapy of Metformin /Glibenclamide in the frequency TDS/OD. The choice of drug based on demographic data, economic status, associated conditions and complications would give additional insights into prescribing patterns in type 2 diabetes mellitus.

Off-label Drug Prescription Pattern and Related Adverse Drug Reactions in the Medical Intensive Care Unit.

ABSTRACTIntroduction: The utilization of prescription drugs as off-label is common. While this practice can be beneficial to some patients, it can raise a safety concern when scientific evidence is lacking; hence, this study was conducted to evaluate the off-label drug consumption and its adverse drug reactions (ADRs) in the medical intensive care unit (ICU).Materials and methods: In the prospective cohort study conducted for a duration of 6 months, data pertaining to ICU patients’ (age ≥18 years) demography, diagnosis, treatment, and laboratory investigation were collected to assess for off-label use as well as the strength of evidence and the occurrence of ADRs by using MICROMEDEX 2017 version (Healthcare Series Thomson Reuter, Greenwood, CO).Results: Of total 3574 drugs prescribed, 1453 (41%) were off-label indications and 65 (1.81%) were off-label dose. On the evaluation of off-label indication use, 1279 (88%) were evidence-based and 174 (12%) were low/no evidence-based medications (EBMs); 59 (91%) were evidence-based and 6 (9%) were low/no EBMs for off-label dose. Most commonly prescribed evidence-based off-label drug belonged to the gastrointestinal class while low/no evidence drugs were mostly of anti-infective class. A total of 383 ADRs were identified and 139 (36.2%) were implicated due to off-label medications, of which ADRs with evidence off-label medications (87.8%) were higher than low/no evidence off-label medication (12.2%) (P < 0.001).Conclusion: Widespread presence of off-label use was observed in medical ICU. Although incidence of ADRs was similar to the FDA-approved use, ongoing monitoring of such practice is needed.How to cite this article: Raut A, Krishna K, Adake U, Sharma AA, Thomas A, Shah J. Off-label Drug Prescription Pattern and Related Adverse Drug Reactions in the Medical Intensive Care Unit. Indian J Crit Care Med 2021;25(8):872–877.

Current status of oral antidiabetic drug prescribing patterns based on the body mass index for Japanese type 2 diabetes mellitus patients and yearly changes in diabetologists' prescribing patterns from 2002 to 2019 (JDDM61).

Aims/IntroductionType 2 diabetes mellitus is caused by a relative imbalance between insulin secretion and sensitivity related to the body mass index (BMI). Seven categories of oral antidiabetic drugs (OADs) are available in Japan. It is important to assess the OAD utilization patterns based on patients’ BMI levels.Materials and methodsOAD prescribing patterns from 2002 to 2019 were analyzed using the data collected in the computerized diabetes care database provided by the Japan Diabetes Clinical Data Management Study Group; OAD utilization patterns in 25,751 OAD‐treated type 2 diabetes mellitus patients registered in 2019 were analyzed after classifying them into five categories of BMI.ResultsComparing OAD usage between 2002 and 2019, sulfonylureas decreased from 44.5 to 23.2%, and biguanides (BGs) increased from 19.3 to 50.3%. Dipeptidyl peptidase‐4 inhibitors (DPP4is) increased to 56.9% in 2019. Sodium–glucose cotransporter 2 inhibitors (SGLT2is) increased to 23.6% in 2019. About 90% of type 2 diabetes mellitus patients had BMI < 30 kg/m2. DPP4is were the most used OADs in 2019. When BMI exceeded 30 kg/m2, use of BGs and sodium–glucose cotransporter 2 inhibitors increased, and use of sulfonylureas and DPP4is decreased. Although DPP4is were the most used OADs for patients with BMI <30 kg/m2, they were the third most prescribed OADs for patients with BMI >35 kg/m2 after BGs and sodium–glucose cotransporter 2 inhibitors .ConclusionsDPP4i usage was as high as that of BG in the analysis of Japanese type 2 diabetes mellitus patients with relatively low BMI. This was considered to be a treatment option appropriate for the pathophysiology in Japanese patients.

Patterns of pharmaceuticals use during the first wave of COVID-19 pandemic in Athens, Greece as revealed by wastewater-based epidemiology

Since 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), impaired public health with considerable morbidity and mortality due to the lack of vaccines and effective treatment. The severe disease mainly harmed adults with predisposing medical comorbidities (such as heart disease, hypertension, chronic lung disease), while it can occur in healthy individuals that may be asymptomatic. Wastewater-based Epidemiology (WBE), a non-invasive, objective, chemical tool was used to monitor and estimate the changes in drug's consumption and prescription patterns under normal conditions (2019) and under COVID-19 pandemic conditions (2020). NSAIDs, antihypertensives, diuretics, antiepileptics, antilipidemics, antibiotics, analgesics, antivirals, anticancer drugs, contrast iodinated drugs, antidiabetics, antiallergic drugs, antiulcers and other pharmaceuticals were studied in wastewater and revealed the application of various treatments during the first wave of the pandemic in Athens, Greece. Data were correlated with COVID-19 infection therapeutical plans. The result of the analysis revealed a remarkable increase for antiviral drugs (170%), hydroxychloroquine (387%), and antibiotics (57%), which were the most applied treatments against COVID-19 during the first wave in Greece. In agreement with related authorities urge, NSAIDs presented decrease (27%) during the first lockdown, while paracetamol demonstrated a remarkable increase (198%). The use levels for Angiotensin II receptor blockers such as valsartan, and co-administrated diuretics, such as hydrochlorothiazide, were reduced during 2020, by 32% and 26% respectively.

Assessment of Prescribing Patterns and Health-Related Quality of Life in Cerebral Stroke Patients

Background and objectives: Stroke was one of the major public health challenges, not only for neuroscience but the society in general. This study aimed to assess the Prescribing Patterns and Health-Related Quality of Life in Cerebral Stroke patients. Methods: This is a prospective observational study for 6 months where patients diagnosed with cerebral stroke, satisfying the inclusion criteria were recruited and were categorized into Ischemic and hemorrhagic stroke. A standardised data collection was prepared and symptoms, risk factors and the prescription pattern of various drugs used were recorded. Quality of Life assessment was done by the Short Form36 questionnaire and paired t-test was used for determining any significance in the change detected before and after treatment. Results: Out of 150 patients’ stroke was higher in males (63%). The weakness of limbs (32%) constitutes the major complaint. Major risk factors associated were hypertension (30%), diabetes mellitus (18%). Cognitive enhancers (16%), antiplatelets (14%) were the most prescribed class of drugs and in combination aspirin + clopidogrel was highly prescribed. The response score of all scales increased statistically (p-value &lt; 0.0001) indicating improved Quality of life after treatment. Conclusion: Long term studies are further required to evaluate the benefit of combinational therapy over monotherapy and to develop standard guidelines for better management. Integration of the role of a pharmacist in the management of the disease is crucial and improves clinical outcomes of patients.

Prescription pattern of anti-hypertensive drugs in Chitwan Medical College Hospital

Background and Objectives: Hypertension is a crucial health issue globally. Cardiovascular and kidney disease is one of the results of hypertension which remarkably confer to overall mortality. Thus, the aim of this study is to investigate the prescribing pattern of anti-hypertensive drugs to hypertensive patients and also to establish the current trend of prescribing pattern of anti-hypertensive drugs at Chitwan Medical College (CMC).&#x0D; Material and Methods: A descriptive cross-sectional study was conducted among 290 patients to assess the prescribing pattern of anti-hypertensive drugs from hypertensive patients visiting medicine OPD of CMC during study period and fulfilling the inclusion criteria. A standard proforma was used to collect information about patient’s socio-demographic details and anti-hypertensive drugs used for them. Data was collected, compiled and analyzed by using Statistical Package of Social Science (SPSS) version 16.&#x0D; Results: Out of 290 prescriptions, 201 (69.3%) patients received monotherapy while only 89 (30.7%) patients received combination therapy. In monotherapy, calcium channel blockers (CCBs) and Angiotensin receptor blockers (ARBs) were most commonly prescribed, while angiotensin receptor blockers (ARBs) + diuretics were the most commonly prescribed combination therapy.&#x0D; Conclusion: In the present study, it was found that CCBs and ARBs were the most commonly prescribed anti-hypertensive drug in monotherapy.

Pattern of Antihypertensive Drugs Prescribed in a Tertiary Care Hospital in Western India

Hypertension is a leading cause of cardiovascular morbidity and mortality. Although known as disease of old age, younger population is at increasing risk due to various factors including obesityand diabetes. Antihypertensive drug treatment being the only measure to control the raised blood pressure, large number of patients remain untreated or inadequately treated. Prescription pattern studies are needed to optimize and control the drug treatment. Present study was done with the aim to study the prescription pattern of antihypertensive drugs in a tertiary care hospital in western India.Pattern of drugs prescribed whether in combination or as single drug in various comorbidities were the objectives of the study. It was observed that ARB was the most commonly prescribed drug (41.5%) either alone or in combination. Multidrug therapy being the preferred treatment (56%), combination of ARB, CCB and Diuretic was the most common (35.7%). Diabetes mellitus was the most commonly associated comorbidity in hypertensive patients (39%), with ARB and CCB as the preferred antihypertensive drugs used in them. The treatment prescribed seemed to be specific to age, comorbidity and was in accordance with national and international guidelinesincluding the Indian Guidelines on Hypertension.

Worldwide antipsychotic drug search intensities: pharmacoepidemological estimations based on Google Trends data

Prescription patterns of antipsychotic drugs (APDs) are typically sourced from country-specific data. In this study, a digital pharmacoepidemiological approach was used to investigate APD preferences globally. Publicly available data on worldwide web search intensities in Google for 19 typical and 22 atypical APDs were temporally and spatially normalized and correlated with reported prescription data. The results demonstrated an increasing global preference for atypical over typical APDs since 2007, with quetiapine, olanzapine, risperidone, and aripiprazole showing the largest search intensities in 2020. Cross-sectional analysis of 122 countries in 2020 showed pronounced differences in atypical/typical APD preferences that correlated with gross domestic product per capita. In conclusion, the investigation provides temporal and spatial assessments of global APD preferences and shows a trend towards atypical APDs, although with a relative preference for typical APDs in low-income countries. Similar data-sourcing methodologies allow for prospective studies of other prescription drugs.

Evaluation of Drug Use Patterns in Intensive Care Unit of Tertiary Care Hospital: A Descriptive Cross-Sectional Study

Background: Prescription of rational drugs is needed to save critically ill patients. This study was conducted to assess the prescription patterns of drugs in the intensive care unit.&#x0D; Materials and Methods: A descriptive cross-sectional study among patients admitted in intensive care unit from March 2020 to February 2021 after approval from the Institutional Review Committee (ref no. 344 /2019). Demographic profile, prescription patterns, the average number of drugs used, route of administration, and duration of hospitalization were recorded based on the pre-structured questionnaires. Convenient sampling was chosen. Data were analyzed by SPSS, version 20.&#x0D; Results: Prescription patterns of 225 were analyzed. The mean age was 55.60 ± 20.16 years with a male predominance of 131(58.2%). Cardiac disorders 57(25.3%) were the most common admitting diagnosis followed by pulmonary, neurological, and kidney disorders. The average length of hospital stay was 4.14 days (range 1-38 days). A total of 887 drugs were prescribed. The mean number of drugs prescribed per patient was 7.71 ± 1.92. Parenteral drugs accounted for 81.39%. Antibiotics were prescribed to all patients. Intravenous fluids were given to 62.2% of patients, blood and blood products to 21.33%. Thromboprophylaxis was used in 15 (6.7%) patients. Seven hundred twenty-two (81.39%) drugs were injectables, 129(14.54%) were used by the oral or nasogastric route and 36 (4.05%) were inhaled drugs.&#x0D; Conclusion: Newer generations antibiotics were the most commonly prescribed drugs. Pantoprazole, Metoclopramide, and Hydrocortisone were the top three most commonly prescribed individual drugs. There was marked underuse of thromboprophylaxis, analgesics, and sedatives.

PRESCRIPTION PATTERN OF PSYCHOTROPIC DRUGS IN A PSYCHIATRY OPD OF A TERTIARY CARE HOSPITAL – A CROSS SECTIONAL STUDY.

Background: The expanding and challenging eld of psychopharmacology is constantly seeking new and improved drugs to treat psychiatric disorders. Psychotropic drugs utilization in actual clinical practice, effectiveness and safety in the real-life situation needs continuous study. Therefore, the study was undertaken to analyze the prescription pattern of psychotropic drugs. Methods: A Cross sectional study was conducted in the psychiatry out-patient department of a tertiary care hospital for 4 months. Diagnosis was made according to ICD-10 criteria. Prescription pattern was analyzed using World Health Organization (WHO) drug indicators. Results: Psychotropic drugs constituted 74.85% of the prescribed medication. Average number of the psychotropic drugs per prescription was 2.53. Percentage of prescriptions with injectable drugs accounted for 5.13%. 59.28% of the drugs were prescribed by generic names, while the rest were branded. 28% of prescriptions contained psychotropic FDCs (Fixed dose th combination). 78.65% of the drugs were from the WHO's 18 List of Essential Medicines. Among the total psychotropic drugs prescribed, antipsychotics (43.87%) were the most commonly prescribed class of drugs followed by antidepressants (23.32%), anxiolytics (22.13%) and the mood stabilizers (9.88%) were the least. Conclusions: Prescription pattern of the psychotropic drugs were in accordance to the recommendations of various treatment guidelines. Antipsychotics were the most commonly prescribed psychotropic drugs.

A Long-Term Incidence of Heart Failure and Predictors Following Newly Developed Acute Myocardial Infarction: A 10 Years Retrospective Cohort Study with Korean National Health Insurance Data.

: BackgroundHeart failure (HF) is the major mechanism of mortality in acute myocardial infarction (AMI) during early or intermediate post-AMI period. But heart failure is one of the most common long-term complications of AMI. Applied the retrospective cohort study design with nation representative population data, this study traced the incidence of late-onset heart failure since 1 year after newly developed acute myocardial infarction and assessed its risk factors. Methods and Results: Using the Korea National Health Insurance database, 18,328 newly developed AMI patients aged 40 years or older and first hospitalized in 2010 for 3 days or more, were set up as baseline cohort (12,403). The incidence rate of AMI per 100,000 persons was 79.8 overall, and 49.6 for women and 112.3 for men. A total of 2010 (1073 men, 937 women) were newly developed with HF during 6 years following post AMI. Cumulative incidences of HF per 1000 AMI patients for a year at each time period were 37.4 in initial hospitalization, 32.3 in 1 year after discharge, and 8.9 in 1–6 years. The overall and age-specific incidence rates of HF were higher in women than men. For late-onset HF, female, medical aid, pre-existing hypertension, severity of AMI, duration of hospital stay during index admission, reperfusion treatment, and drug prescription pattern including diuretics, affected the occurrence of late-onset HF. Conclusion: With respect to late-onset HF following AMI, appropriate management including hypertension and medical aid program in addition to quality improvement of AMI treatment are required to reduce the risk of late-onset heart failure.

Prescription patterns of antiseizure drugs in tuberous sclerosis complex (TSC)-associated epilepsy: a multicenter cohort study from Germany and review of the literature

ABSTRACT Objective Seizures are a primary and early disease manifestation of Tuberous Sclerosis Complex (TSC). We aimed to describe the age-stratified patterns of antiseizure drug (ASD) treatments among children, adolescents, and adults with TSC in Germany. Additionally, we reviewed real-world and clinical study evidence regarding ASD utilization in patients with TSC. Methods We evaluated the pattern of routine ASD use and everolimus prescriptions based on a 2019 multicenter survey of 268 individuals with TSC-associated epilepsy. We contextualized the results with a structured review of real-world and clinical study evidence. Results TSC-associated epilepsy treatment comprises a wide variety of ASDs. In this German sample, the majority of patients were treated with polytherapy, and lamotrigine (34.7%), valproate (32.8%), oxcarbazepine (28.7%), vigabatrin (19.0%), and levetiracetam (17.9%) were identified as the most-commonly used ASDs. In addition, everolimus was used by 32.5% of patients. In adherence to current TSC guidelines, the disease-modifying ASD vigabatrin was widely used in children (58% below the age of 5 years), whereas treatment in adults did not necessarily reflect guideline preference for (partial) GABAergic ASDs. Conclusions The selection of ASDs for patients with TSC-associated epilepsy follows well-evaluated recommendations, including the guidelines regarding vigabatrin use in children. Several characteristics, such as the comparatively high frequency of valproate use and polytherapy, reflect the severity of TSC-associated epilepsy.

Prescribing Pattern of Drugs in Department of Obstetrics and Gynecology at A Tertiary Care Teaching Hospital, Bangalore, India

Objective: To assess the drug prescription pattern in the department of obstetrics and gynecology At A Tertiary Care Teaching Hospital, Bangalore, India. Methodology: A prospective observational study on Drug Utilization pattern was done in the department of Obstetrics and Gynecology of a 950 bedded tertiary care teaching hospital in Bangalore for 6 months. All patients were admitted to the Department of Obstetrics and Gynecology. Patients satisfying Inclusion criteria were enrolled after obtaining Informed Consent. Patient data entered into Case Report Form (CRF). Medication orders were observed for Prescription patterns. WHO Prescription indicators will be used to study the number of drugs per encounter, percentage of drugs prescribed by generic name, percentage of encounters with an antibiotic, percentage of encounters with an injection, percentage of drugs prescribed. Result: A total of 120 cases were collected. A total of 1004 drugs were prescribed which included 244 (24.30%) minerals and vitamin supplements, 219 (21.81%) Antibiotics, 146 (14.55%) Gastric acid Secretion Inhibitors, 108(10.75%) Analgesics, 35 (3.49%) Antihypertensive drugs, 22 (2.19%)Antifungal drugs, 32 (3.19%) Anti-diabetic drugs, 32 (3.19%) Anti-spasmodic, 41 (4.08%) Antiemetic drugs, 12 (1.19%) Corticosteroids, 16 (1.59%) Anticonvulsant drugs, 97 (9.66%) in the category of “Others”: Anti sceptics, Topical agents, Oxytocic, Antihyperlipidemic drugs, Oral contraceptives, etc. Percentage of Drugs used in different categories were, In our study majority of drugs from Category A (45.405), Category B (35.63%), Category C (16.67%), Category D (2.30%). the average number of drugs per prescription in this study (8.36) is higher than the standard set by WHO (1.6-1.8), percentage of patients prescribed with Injectables is 39.70% this is also high when compared with the range of the standard set by WHO. Conclusion: The results of our study highlight several areas that need improvement, most importantly there is Polypharmacy was practiced as the average number of drugs (8.36) per prescription when compared with a standard set by WHO. Another area that is Percentage of drugs prescribed by Generic name is also low which also need to improve. Iron, Calcium, and Folic acid were the most frequently prescribed drugs. Overall drug use pattern is rational with few exceptions which were mentioned above. The majority of the drugs were prescribed from the Essential Medicine List and the majority of drugs were prescribed as per FDA Category A the Safest Category during pregnancy. Keywords: prescription pattern, Obstetrics, Gynecology

Drug prescribing pattern of antifungal drugs for local fungal infections in a tertiary care hospital: MAMC, Agroha

Background: Drug utilization research or studies are the powerful exploratory tools to ascertain the role of drugs in the society which refers to the marketing, distribution, prescription and use of drugs with special emphasis on the medical, social and economic consequences. Periodic prescription audit in form of drug utilization study is a way to improve the quality of prescription and promote rational prescribing.Methods: This was a prospective and an observational study. Prescriptions included all newly diagnosed patients with cutaneous fungal infection of both sexes who attended dermatology OPD. Factors considered were sociodemographic parameters and WHO prescribing indicators.Results: 1000 prescriptions were analysed of patients between 18 to 65 years of age with cutaneous fungal infections. The average number of drugs per encounter was 3.68. The percentage of drugs prescribed by generic name was 50.33% and the percentage of drugs prescribed from NLEM was 20.93%.Conclusions: This study indicates that prescribing practices of drugs in tertiary care hospital can be improved by promoting generic name drug prescribing, prescribing drugs from NLEM and by reducing polypharmacy.

THE RATIONALITY OF DRUG PRESCRIPTIONS AT THE GYNAECOLOGY DEPARTMENT IN A TERTIARY CARE TEACHING HOSPITAL IN KELANTAN

The aim of this study is to assess the rational prescribing pattern of drugs for pregnant women using World Health Organization (WHO)/International Network for Rational Use of Drugs (INRUD) core drug prescribing indicators. A one-year retrospective research design from (October 2016–September 2017) was used to review pregnant women prescriptions from their medical records at Hospital Universiti Sains Malaysia (HUSM). A structured data collection form using WHO/INRUD document on prescribing indicators was used. Data was sorted and categorised according to the US Food and Drug Administration (USFDA) pregnancy classification systems and Anatomical Therapeutic Classification (ATC). Then, data was compared with the references values of WHO/INRUD. Descriptive analysis were performed using SPSS version 20. A total of 741 medical files met the study inclusion criteria. The average number of prescribed drugs per prescription and the percentage of prescribed drugs from hospital formulary list and health ministry list were within the acceptable range listed by WHO. Whereas, the percentage of pregnant women with antibiotics and injection drugs were lower than normal values 17.67% and 8.23%, respectively. Percentage of prescribed drugs from categories C and D were 13.8% and 2.8%, respectively. Whereas 24.8% of prescribed drugs were from unclassified risk category. On the other hand, multivitamins preparations were the highest category of prescriptions 17.7%. Injections and number of antibiotics per encounter were lower than the recommended range listed by WHO. However, a great caution and careful prescribing behaviour of physicians were noticed at gynaecology/obstetric departments and most of the prescribed medications were rational and safe during pregnancy.

Contemporary trends in antiepileptic drug treatment among women of childbearing age with epilepsy in the United States: 2004–2015

ObjectiveCertain antiepileptic drugs are associated with an increased risk for major congenital malformations (MCM). However, little is known regarding recent patterns of antiepileptic drug (ASM) prescriptions to women of childbearing age with epilepsy (WCE) in the United States. MethodsData from the Medical Expenditure Panel Survey was analyzed between the years 2004–2015 to determine trends in national antiepileptic drug prescriptions for WCE. Analysis of associations between demographic covariates and prescription of ASMs with MCM rate > 5% (topiramate, valproate, or phenobarbital) was performed with logistic regression. ResultsThere was a weighted total of 395,292 WCE. 29.1% (23.2%–35.8%) of WCE were prescribed an AED with MCM rate > 5%. The odds of a LEV prescription significantly increased in the 2010–2012 (OR 2.91, 95% CI 1.09–7.79) and 2013–2015 (OR 5.06, 95% CI 2.02–12.67) intervals compared to 2004–2006. Conversely, the odds of PB prescriptions significantly decreased in 2010–2012 (OR 0.13, 95% CI 0.02–0.83) and 2013–2015 (OR 0.13, 95% CI 0.02–0.93) compared to 2004–2006. WCE between the ages of 25–34 (OR = 2.67, 95% CI = 1.32–5.41) and 35–44 years (OR = 2.59, 95% CI = 1.23–5.45), had lower odds of being prescribed ASMs with MCM rate > 5% compared to those between the ages of 15–24 years. SignificanceBetween 2004 and 2015, the prescriptions of ASMs given to WCE has changed. Regardless, nearly one third were prescribed potentially teratogenic medications despite available and affordable safer alternatives. Identifying factors associated with the prescription of teratogenic drugs to WCE is critical so that it may be further limited in the future.

DRUG PRESCRIBING PATTERN AND COST-EFFECTIVENESS ANALYSIS OF ORAL ANTIDIABETIC DRUGS IN PATIENTS WITH TYPE-2 DIABETES MELLITUS: REAL-WORLD DATA FROM INDIAN POPULATION.

Objectives: The objective of the study was to evaluate the drug prescribing pattern and pharmacoeconomics of oral diabetic medications in patients of type 2 diabetes mellitus visiting the medicine OPD of HAH Centenary Hospital, Jamia Hamdard, New Delhi.&#x0D; Methods: Observational study conducts on 100 T2DM patients to assess their demographics and individual details such as disease history, BMI, and economic status along with the drug utilization assessment and cost-effectiveness analysis of prescribed drugs.&#x0D; Results: Among 100 patients, 40 (40%) were male, and 60 (60%) were female, indicating that T2DM is slightly more prevalent in females. The mean age of the subjects included in the study is 51.46 years. Of the total number of patients, 64 were under oral antidiabetic drugs, and remaining were pregnant females under insulin. The majority of the subjects, 69.4%, were on multiple drug therapy and remaining treated with monotherapy. Metformin 500 mg (32.81%) was the most prescribed oral antidiabetic drug followed by glimepiride 4 mg (15.62%) and 12.5% for glimepiride 2 mg + metformin 500 mg, sitagliptin + metformin 50/500, and vildagliptin 50 + metformin 850, respectively. The maximum mean reduction of FBG was seen with glimepiride 4 mg (34.69 mg/dl) and lowest with metformin 500 mg (24.05 mg/dl). The cost per unit (1 mg/dl) reduction in FBG (ACER) was highest with sitagliptin 50 mg (INR 63.14) and lowest with glimepiride 1 mg + metformin 500 mg (INR 9.95).&#x0D; Conclusion: Most type 2 diabetic patients in this setting were treated with multiple oral antidiabetic therapies. Metformin and sitagliptin were the most common choice as monotherapy agents. CEA concludes that the cost associated with diabetes is enormous and varies greatly. The combination therapy of glimepiride 2 mg + metformin 500 mg was the most cost effective.

Prescribing patterns in breast cancer survivors: A Korean National Health Insurance Service cohort study.

Breast cancer survivors often manifest comorbidities that require medication management. This study aimed to investigate the prescription patterns of drugs prescribed frequently among breast cancer survivors and to provide data to monitor adverse effects using other covariates in these patients. We analyzed a Korean national sample cohort database. The diagnosis of breast cancer, survival, survival duration, and frequency of drug prescription were first defined and extracted. We then analyzed the frequency of drug prescription in breast cancer by survival duration. Factors associated with drug prescribing patterns were analyzed using logistic regression analysis. Among 2,410 breast cancer survivors, anti-hormonal agents, gastrointestinal drugs, calcium, and anxiolytics were most frequently prescribed. Gastrointestinal disturbance and depression are most commonly observed among breast cancer survivors. Survivors who were 3 to < 5 years post treatment were frequently prescribed calcium. In addition to gastrointestinal drugs, anxiolytics were frequently prescribed among survivors manifesting comorbidities. In addition to anti-hormone agents, which were frequently prescribed to breast cancer patients, gastrointestinal drugs were the second most frequently prescribed, and anxiolytics were often co-prescribed. Calcium was also frequently co-prescribed in patients requiring anti-depressants. In the Korean National Cohort, gastrointestinal drugs, calcium, and anxiolytics were frequently prescribed to older patients, suggesting that older patients diagnosed with cancer experience a wide array of toxicities requiring supportive care.

Prospective Study of Antibiotics Utilization in Multi-speciality hospitals in Narasaraopet at Guntur District, Andhra Pradesh

Drug use is a complex process uncertainties in diagnosis, treatment and medication adherence contribute to wide variations in the way drugs are used for any given conditions. In any country, a large number of sociocultural factors also contribute to the way drugs are used. In India, this include national drug policy, illiteracy, poverty, use of multiple health care systems, drug advertising and promotion, same of prescription drugs without prescription, competition in the medical and pharmaceutical marketplace and limited availability of and unbiased drug information. The complexity of drug use means that optimal benefits of drug therapy in patient care may not be achieved because of under use, over use or misuse of drugs. One method to evaluate and improved drug use is conducting drug use evaluation studies. Method: This study was prospective observational study in multi-specialty hospitals in Narasaraopet at Guntur district Andhra Pradesh Results: The study was conducted from August 2018 to Dec 2019 in various multi-specialty hospitals in Narasaraopet at Guntur district Andhra Pradesh. Total three departments we collected data Pediatrics, orthopedic, gynecology A total of 435 patients were participated in the current study out of 153 (35%) were males and 282 (65%) were females. In this study most common group antibiotics is cephalosporin’s 152 (34.9%) out of 435 of which mostly cefitriaxone are most commonly prescribed 70 (46%) Conclusion: Study provides the information about the prospective study of antibiotics utilization in multi-specialty hospital. It has helped to identify irrational prescribing patterns of drugs in various departments like pediatrics, gynaecology orthopedic.