Drug Utilization Evaluation Research Articles

Assessment of Drug Utilisation Evaluation of Cephalosporins in A Tertiary Care Hospital

Drug Use Analysis (DUR) or Drug Use Assessment (DUE) is known as an important quality management method for evaluating and improving substance use and patient care. It is an ongoing, systematic method to examine the pattern of drug administration in a number of clinical environments, with recommendations or defined criteria to facilitate the acceptable and efficient use of drugs. The DUE can be organized for evaluation and to improve the method of prescribing or dispensing the medication according to acceptable indications, dosage, drug reactions, therapeutic efficacy and cost-effectiveness. The aim of this study to evaluate the drug utilization pattern of cephalosporins. A retrospective study was performed for a period of 2 months among the hospitalized patients who received cephalosporins for different indications in which 100 patients were enrolled. Inappropriate use of drug therapy has been found in phase 1 (pre- intervention) and interventions have been conducted to rationalize the appropriate use of drugs in terms of indication, dose, dose length, individualized dosage modification, which has been strengthened in phase 2 by providing effective guidance on the application of DUE and interventions.

Drug Utilization Evaluation of Antibiotics in Intensive Care Units of a Referral Teaching Hospital

Background: Drug Utilization Evaluation (DUE) studies are designed to assess drug usage appropriateness. This study aimed to evaluate the drug utilization of antibiotics in the intensive care units (ICUs) of a referral teaching hospital. Methods: Patients hospitalized in ICU who received antibiotics were enrolled in this crosssectional study. Patients’ medical charts were reviewed and data including indication of antibiotics, dosing, dose adjustment, and culture sensitivity test were recorded in a predesigned data collection form. Related guidelines and references were used for judgement about the correctness of these parameters. Results: Among 182 evaluated antibiotic prescriptions, 75.8% of the cases were prescribed empirically that for 31.88% of them microbial culture and sensitivity test were requested. Indication was appropriate in 51.6%. Fifteen patients needed antibiotic dose adjustment that was performed just for 4 patients. Doses of antibiotics were correct in 58.5% of cases. Meropenem (15.9%), Metronidazole (15.9%), and vancomycin (11.5%) were the most frequently prescribed antibiotics. Conclusion: Use of antibiotics in ICUs of our hospital is associated with high rate of errors especially in the aspects of medical indication and dosage. J

Drug Utilization Evaluation of Medications Used by Hypertensive Patients in Hospitals in Nigeria

Drug utilization studies in developing countries is evolving. Rising medication cost for hypertensive patients is a major cause of noncompliance to therapy. The study was a cross-sectional drug utilization review involving outpatients in two purposively selected hospitals (secondary and tertiary) in Abeokuta, Southwestern Nigeria. Data and relevant information were obtained from the patients’ medical records domiciled in the outpatients’ hospital records department. Descriptive and inferential statistics were used at p < 0.05. Total medication cost to patients was USD$48,575; out of which antihypertensive medications accounted for 46% (USD$21,588) in two referral hospitals. Ramipril was the most prescribed in both hospitals. Generic drugs were cheaper than their branded alternatives. Study outcomes are beneficial for managing costs for hypertensive patients.

Evaluation of Drug Utilization of Parenteral And Inhaled Corticosteroids

Evaluation of Drug Utilization of Parenteral And Inhaled Corticosteroids

Drug Utilization Evaluation of High Alert Medications in Intensive Care Units of Tertiary Care Teaching Hospital

Introduction: The utilization of HAMs is crucial in emergency and intensive care departments, as they can cause a significant amount of damage to the patient and health care members if we could not follow the standard treatment guidelines. Drug utilization evaluation/review involves a comprehensive review of the patient’s prescription and medication data before, during, and after dispensing to ensure appropriate medication decision making and positive patient outcomes. Objective: This study was taken up given finding the utilization patterns and rectifying the issues with the usage of high alert medications (HAMs) and improving their utilization. Methodology: A cross-sectional study was conducted for 6 months at a south Indian tertiary care hospital. Treatment guidelines were prepared to compare the actual drug use. Data were collected both retrospectively and prospectively by patients and care taker’s interview, medication chart review, and discussion with prescribers and applied WHO DUE indicators to evaluate utilization patterns. Results: Of 362 cases, 57.73 % were males/ and the majority geriatrics. Among all HAMs Insulin is frequently prescribed (34.5 %) and the costly drug is Enoxaparin. Generic names were used in writing prescriptions and parenteral formulations were mostly used. Around 9 ADRs were identified and managed, and a total of 133 moderate to severe Drug-Drug Interactions were found, of them, only 2 were actual. Conclusion: With this study, we conclude that the use of HAMs was found to be appropriate as per the guidelines as we observed very few DRPs with the study drugs. Keywords: HAM, DRP’s, DUE, ICU, DDD

Drug Utilization Evaluation of Pantoprazole in Inpatients of Tertiary Care Hospital

Drug Utilization Evaluation of Pantoprazole in Inpatients of Tertiary Care Hospital

Drug utilization evaluation of psychotropic drugs in the psychiatry in-patient department of Tertiary care hospital

Objectives: To study the prescription pattern of psychotropic drugs in different psychiatric disorder. Methodology: The prospective observational study was conducted in 100 psychiatric in-patients at a tertiary care hospital in Bangalore. Study was conducted on gaining approval from the institutional human ethical committee. All patients who meet the study criteria were enrolled in to the study after taking the informed consent from the patients or their legal representatives. The demographic, clinical and medications data were documented into a specially designed case report form. All the data was analyzed using descriptive statistics. Results and Discussion: In 100 study subjects 194 different psychotropic drugs were prescribed. Among 194 psychotropic drugs 38.14% were sedatives and hypnotics, 36.08% were antipsychotics, 18.55% were antidepressants and 7.21% were mood stabilizer. Conclusion: This study found that schizophrenia was the most common illness in psychiatric patients. Male patients were more prone to psychiatric disorders than female. Most of the study populations were non-alcoholic and non-smokers. Sedatives and hypnotics of benzodiazepine class were found to be the most commonly used drugs followed by antipsychotics, anti-depressants and mood stabilizers in the studied population. Future studies to evaluate the drug utilization evaluation of psychotropic drugs in large patient populations are much needed to promote patient safety and increase the quality of psychiatric patients.

Drug Utilization Evaluation Study and Dose Adjustment in Patients with Kidney Disease in Tertiary Care Hospital

INTRODUCTION: Kidney disease is becoming a worldwide public health problem with an increase in incidence and prevalence, poor outcomes and high cost. Rational prescription is necessary in kidney disease patients. These patients are at higher risk of developing drug related problems since they need complex therapeutic regimens that include comorbid conditions like diabetes mellitus, hypertension, coronary artery disease and infection that require frequent monitoring and dosage adjustment. Inappropriate use of medications can increase adverse drug effects, which can be reflected by excessive length of hospital stays, excessive health care utilization and cost. OBJECTIVES: The objective of the study was to assess, evaluate and analyze the prescribing pattern of drugs in kidney disease and their dose adjustments in medicine and emergency department of tertiary care teaching hospital. METHODOLOGY: The study was conducted for a period of 6 months. Ethical clearance was obtained from Institutional Ethical Committee of S C S College of Pharmacy, Harapanahalli. Collected data was analyzed to identify the current prescribing trend and dosage regimen in the management of renal failure patients and to know whether the prescribing rationality was obtained in Medicine and Emergency unit in hospital by using KDIGO guidelines. RESULTS: A total of 140 patients were enrolled in the study according to the inclusion criteria in which 104 were males and 36 were females. 134 CKD cases and 6 AKI cases were found. In the study, 105 (75%) patients were hypertensive, 62 (44.28%) patients were anemic, 54 (38.57%) patients were diabetic and dyslipidemia was associated with 21 (15%) patients. 87 patients were on hemodialysis. On the basis of ATC classification of drugs, cardiovascular system (35.7%) class of drugs was the commonly prescribed followed by drugs for alimentary tract and metabolism (25.97%), anti-infective (10.11%) and blood and blood forming agents (7.97%). Out of 1028 studied drugs, only 105 (10.21%) required dose adjustment where 76 (72.38%) were adjusted and 29 (27.61%) were not adjusted. CONCLUSION: This study illustrates the need for proper dose adjustment and drug utilization pattern in patients with renal failure. Appropriate dosing of antibiotics as well as other drugs, including narrow therapeutic drugs play a vital role in preventing dose related adverse reactions and toxicities. This study will provide an outline for management strategies and will influence the decision making process in clinical practice.

Drug utilization evaluation of olanzapine and assessment of adverse drug reactions associated in psychotic patients in a Tertiary Care Hospital

Objectives: To review the drug utilization and evaluation pattern of olanzapine and assessment of adverse drug reaction associated in psychotic patients in a tertiary care hospital. Methodology: A prospective Observational study was conducted in Department of Psychiatry, MVJ Medical College and Research Hospital, Bangalore, South India. Study was conducted for 6 months in In-patients who are diagnosed as suffering from psychosis which includes schizophrenia, delusional disorders, schizo-affective disorders, acute and transient psychosis and BPAD as per ICD 10 criteria. The utilization pattern of olanzapine therapy were assessed using case record forms with overall demographic data information was collected and ADR is assessed using standard scales. Result: Among 108 patients enrolled into the study 68 patients were under olanzapine therapy and rest were under other antipsychotics. A total of 68 patients olanzapine therapy patients out of which 51%were females and 49% were males. Majority of the patients belong to the age group of 28-37years and 18–27 years and 66% patients were married. Schizophrenia was found to be the common type of psychotic disorders with 63%. Even among the various psychotic disorders there was a slight female predominance. The hospitalization period was 12.43±8.4days. Majority of the patients had normal body mass index. Out of 68 patients 16 patients had switch over from olanzapine to other second-generation antipsychotics. Conclusion: This study has assessed for prescribing pattern of olanzapine in psychotic patients using a specially modified case reporting form. Olanzapine is most commonly prescribed antipsychotic compared to other antipsychotics for the treatment of paranoid schizophrenia and also in certain cases of bipolar affective disorder with mania or mixed episodes. Maximum patients were having paranoid schizophrenia.

Drug utilization evaluation of aminoglycosides, gentamicin and amikacin: A retrospective study in pediatric patients at secondary care public hospital

Drug utilization evaluation of aminoglycosides, gentamicin and amikacin: A retrospective study in pediatric patients at secondary care public hospital

Drug Utilization Evaluation On Antidiabetic, Thyroid And Antithyroid Drugs

Aim: To evaluate the drug utilization of antidiabetic, thyroid and antithyroid drugs at an endocrinology speciality hospital among the ambulatory patients. Method: This was a prospective observational study conducted for a period of 6 months. Patients who were diagnosed with either diabetes mellitus (both type-I &amp; type-II) or thyroid disorders and receiving their respective pharmacological therapy irrespective of age and gender were included in this study. Pregnant, lactating women and patients with endocrine problems other than diabetes mellitus and thyroid disorders were excluded from this study. Results: The total number of cases collected and analyzed during a period of 6 months was 246 in which 139 (56.5%) were diabetes mellitus and 107 (43.5%) were thyroid disorders. Among the parenteral hypoglycaemic agents, long acting-insulin glargine and intermediate acting + short acting- NPH + regular insulin were prescribed in almost similar frequency. In case of mono therapy, teneligliptin was the most commonly prescribed medication and this was the unique finding in this study which signified that the trend in prescribing pattern is changing and updating from time to time. In dual combination therapy Glimepiride + Metformin and in triple combination Glimepiride + Metformin + Voglibose combinations were the most commonly prescribed medication. In hypothyroidism, supplementation with levothyroxine was the only treatment alternative as it is related to the underactive thyroid, secreting insufficient amount of hormone. Irrespective of many classes of drugs available in treating hyperthyroidism carbimazole was the most frequently prescribed drug in this study. Conclusion: It was observed that some changes in the prescribing pattern of antidiabetic drugs that signified the trend in drug utilization pattern. Clinical pharmacists should play a key role in observing and identifying the trends in prescribing patterns by performing the drug utilization evaluation studies thereby providing a better pharmaceutical care in collaboration with the other health care professionals.

PSU19 Drug Utilization Evaluation in a General Surgery Department of a Tertiary Healthcare Hospital

PSU19 Drug Utilization Evaluation in a General Surgery Department of a Tertiary Healthcare Hospital

Drug Use Evaluation of Crystalline Penicillin in Pediatrics Ward of Dessie Referral Hospital, North East Ethiopia: A Hospital Based Cross Sectional Study

Background: Antibiotic resistance is a worldwide issue due to rise of antibiotic consumption and wide variation in antibiotic prescribing practices. Crystalline penicillin is the most highly consumed antibiotics by hospitalized pediatrics patients in Dessie Referral Hospital and its utilization pattern is not known in the study area. The objective is to assess the appropriateness of crystalline penicillin use in pediatrics ward of Dessie Referral Hospital, Northeast Ethiopia. Methods: A hospital based cross-sectional study was used for evaluating medication records of hospitalized pediatric patients who received crystalline penicillin from October to December 2018. Results: A total of 262 hospitalized pediatrics patient records were included in the study. All the 262 (100%) cases were consistent with guidelines for contraindication and drug interaction to use the drug. Crystalline penicillin use was consistent with guideline recommendations in 93.8%, 92.8%, 89.6%, 66.7% and 39.4% of the cases with regard to, indication, outcome, frequency, dose and duration of treatment, respectively. The observed value of all drug utilization evaluation parameters except drug interaction and contraindication showed statistically significant difference from the set threshold in nonparametric binomial test. Conclusion: The result of the current study especially with regard to dose and duration is much below the recommended threshold and needs scheduled trainings and necessary interventions to tackle the problem.

Liposomal Bupivacaine Infiltration Versus Bupivacaine Hydrochloride for the Management of Unilateral Total Knee Arthroplasty in Geriatric Patients at a 287-Bed Community Hospital.

Introduction: Geriatric patients receiving total knee arthroplasty (TKA) are found to have similar postoperative complications, functional scores, and perioperative mortality, as compared to younger patients. Conversely, geriatric patients often have longer lengths of stay. Periarticular injection (PAI) of liposomal bupivacaine (LB) as part of the multimodal pain management strategy is thought to improve recovery, however, mixed comparative efficacy data exists for its use in TKA.2-5. Methods: A retrospective, chart review was conducted at a 287-bed community teaching hospital. Orthopedic surgical patients who received an infiltration with liposomal bupivacaine versus bupivacaine HCl for unilateral TKA were compared. Patients identified in the electronic medical record by Diagnosis Related Group (DRG) 470-major joint replacement or reattachment of lower extremity without major complication or comorbidity codes were utilized. Patients who meet the following criteria were included: age 65 and older who underwent a TKA between 8/1/2018 to 7/31/2019 were discharged to home. Patients who have contraindications or hypersensitivity to bupivacaine formulations or a history of opioid dependence were excluded. The primary outcome is to identify whether patients who received an infiltration with liposomal bupivacaine had a lower total opioid consumption during their hospital stay. Results: A total of 114 patients who had a DRG 470 code and were above the age of 65 years were studied. There was no statistically significant difference in mean total opioid consumption (oral morphine equivalents) between the bupivacaine HCl (n = 25) and liposomal groups (n = 85) respectively, 93.76 versus 83.72 mg; P = .569. In addition, patients in both groups had similar lengths of hospital stay, 2.5 versus 3 days; P = .529 and mean pain scores until discharge 3.7 versus 4.34 on VAS; P = .305. Conclusion: The results of this drug utilization evaluation do not support a strong clinical advantage with local infiltration of liposomal bupivacaine over bupivacaine HCl in geriatric patients undergoing primary TKA surgery at this institution. There was not a statistically significant difference in mean total opioid consumption between the 2 groups. Additionally, the use of non-opioid analgesics, mean pain scores, and hospital lengths of stay were similar in both groups.

A Prospective Observational Studies on Drug Utilization Evaluation and Rational Use of Corticosteroids in Tertiary Care Hospital

Background: Corticosteroids are widely prescribed Drugs in Hospitals, forming a part of standard treatment of modern medicine for a wide range of diseases, associated with inflammation and immune activation. Apart from beneficial effects they also produce number of adverse effects. In the present study, Prospective Observational studies on DUE (Drug utilization evaluation) and rationality of Corticosteroids has been Performed.&#x0D; Objectives: To Investigate the Drug utilization evaluation, Prescription pattern and Rationality of corticosteroids in various department of tertiary care teaching hospital.&#x0D; Methodology: A prospective observational study was conducted on 100 patients receiving corticosteroids in the various departments of Osmania general Hospital, Hyderabad. Patients prescribed corticosteroids therapy was included in the study. Exclusion of those patients with age less than 18, psychiatric disease, pregnant women and patients not willing to sign on consent form.&#x0D; Result: This study included 100 Patients out of which 68 were Male and 32 were female. In Age wise distribution, 15 Patients prescribed with corticosteroid in age group 18-28 years, 20 patients in 29- 38 years, 12 in 32-48 years, 16 in 49-58 years, 22 in 59-68 years, 11 in 69-78 years and 4 in above 80 years. This data showed that commonly male populations are more prone to diseases. As per the demographic data our finding shows that Budesonide was the most frequent prescribed corticosteroid (31.75%) followed by Hydrocortisone (26.19%), Dexamethasone (15.08%), Prednisolone 13.49%, Betamethasone (7.94%), Methyl prednisolone (5.56%).&#x0D; Out of 100 prescriptions total 10 ADRs and 25 Drug interactions were detected in this study. The majority of drug interactions were minor 24 followed by major 1.&#x0D; Conclusion: The Prescription pattern of corticosteroids was found to be rational as there is no Major drug interaction. Commonly geriatric population was more prone to diseases, for which steroids were used. Hence close observation is required to ensure safety, effectiveness and well-balanced therapeutic management with corticosteroids, both patients and prescribers should be more aware of the appropriate dose, dosage regimen, Drug - Drug interactions, ADRs and overall guidelines for corticosteroids prescribing.&#x0D; Keywords: Corticosteroids, Drug utilization evaluation, Prescription pattern.

Drug Utilization Pattern and Prescription Auditing of Antiepileptic Drugs and its Adverse Effects in Private Hospital

Background: Epilepsy is a common medical condition characterized by repeated seizures due to a disorder of the brain cells. The data was limited regarding the prescribing pattern and side effects of various antiepileptic drugs in private hospitals. The objective of the present study was to evaluate the prescribing pattern of Antiepileptic drugs in the management of various types of epileptic seizures over a period of twelve months. Methods: A prospective observational study was conducted among epileptic patients on follow up at neurology department of Life line hospital, Azamgarh. During the twelve months study period, epileptic patients who were prescribed with AED’s (antiepileptic drugs) were included in this study. Data were collected through the Patients case files. Results: Our study revealed male predominance over female. In 18-30(35.66%) age group, Patients were more prone to epilepsy. Total 145(48.33%) patients were diagnosed with generalized seizure. Headache (27.55%) was most commonly observed ADRs. Total 959 (94.57%) number of drugs were prescribed with brand name. Valproic acid (15.18%) was most commonly prescribed drugs for treatment of epilepsy for treatment of epilepsy which included 154 encounters. Avg. cost for 6 months of epileptic treatment was 64752.02. Average cost per prescription was Rs. 1553.50. Conclusion: This study highlights the need of drug utilization evaluation as it will help in analysing on-going health care practices, so that lacunae in the system can be identified and Proper strategies can be planned to rectify them. In recent times, there has been done an immense effort to ensure and implement rational drug use.

A study on drug utilization evaluation of antibiotics in tertiary care hospital

Studies like Drug utilization evaluation have an essential role in finding a prescription pattern of drugs prescribed in hospital for the rational use of antibiotics. An observational study conducted in a tertiary care hospital for six months among 200 patients. The study was conducted to assess prescribing pattern, the average cost of antibiotics prescribed. Also, the ten most commonly prescribed antibiotic’/ 100bed- days and ATC were calculated. Most commonly prescribed antibiotic was , followed by /. The average cost was Rs. 2742.5±25135.19 for the prescribed antibiotics. Pharmacists and physicians play a significant role in decreasing patient problems and the problems related to antibiotics by creating awareness programs related standard prescribing guidelines in the hospital, which results in a reduction of the antibiotic resistance. it is essential to carry out a drug utilization review to study the rational use of antibiotics.

Assessment of Antibiotic Utilization Pattern In Hospital Settings

Drug utilization evaluation is an effective tool for detecting the possible drug related problems and in enhance the clinical use of drugs in public and its impact on the health care system. This tool is adapted by pharmacists to assess appropriate use of medication. DUE usually focus on drugs with more side-effects, high cost or complex dosing regimens. It is important for almost all drugs especially for antibiotics because of its increased utilizationin hospitals and community settings. In prior to starting antimicrobial therapy, the prescriber should consider the type of infection, characteristics of the antibiotic, its category of use, spectrum of activity, cost- effectiveness and duration of therapy. The evolution of multidrug resistance and the emergence of multidrug- resistant microbes are on the rise which can be reduced by increasing the habits of appropriate antibiotic prescribing for the successful outcome of the therapy. Prescribing an antibiotic by understanding the significance of antimicrobial stewardship and following an appropriate guideline may lead to appropriate selection of an antibiotic. Hence, antibiotic utilization studies can help in improving the practice of rational use of antibiotics thereby improving patient safety, which in turn helps in reducing antimicrobial resistance, drug related problems and risk of mortality and morbidity.

A review on steps involved in drug utilization review

Drug Utilization is also known as Drug Utilization Review, is an arrangement of persistent, orderly, criteria based medication assessment that guarantees the proper usage of drugs. Drug use/ utilization evaluation and medication utilization evaluations are the same as drug utilization review. It is a technique for acquiring data to recognize the problems related to the usage of drugs and if appropriately created, it also gives a method for revising the issue and in this way, it becomes a factor in reasonable drug usage. Evaluation of use can survey the real procedure of medication administration or dispensing of proper medication and furthermore the results of treatment. Drug utilization review services include corrective actions, prescriber reviews and further evaluations as a quality assurance mechanism. This article reviews the drug utilization pattern and evaluation of the process of drug utilization. The evaluation pattern can be classified into several categories such as prospective, concurrent and retrospective. The drug utilization evaluation process is a continuous cycle and its maximum effect is attained when it is conducted as a cycle rather than conducting in steps. This evidence-based approach with utilization of the medication is intended to depend on the best accessible clinical evidence to create explicit rules for a particular illness or utilization of a particular medication.

Drug Utilization Evaluation in Dermatology Department: A Study in the Ambulatory Care Settings

The main aim of the study is to evaluate the prescribing pattern of drugs prescribed in the ambulatory patients attending the dermatology department. This was a prospective observational study conducted for a period of 6 months. Patients who were receiving treatment in the dermatological outpatient department and willing to participate were included in the study and patients in the inpatient dermatology department and also with other co morbid conditions were excluded from the study. A total of 306 cases were collected and among them, about 112 (36.6%) were males and 194 (63.4%) were females. During the study period, majority of the patients were in the age group of 21-30 years (41.2%). The most commonly prescribed classes were found to be Antibacterial drugs 312 (22.1%) followed by Antifungal drugs 258 (18.3%) and Anti-histamines 206 (14.6%). Among the antibacterial, Antibacterial soaps (35.3%) were more commonly prescribed followed by the antibiotics Mupirocin (12.8%) and Clindamycin (11.9%). In case of Antifungals, Ketoconazole (25.2%) was most commonly prescribed drug followed by Fluconazole (14%) and Clotrimazole (14%). Among the Antihistamine drug class, Levocetrizine (76.2%) was most commonly prescribed followed by Hydroxyzine (12.2%). The drug Prednisolone (26.4%) was most commonly prescribed among Corticosteroids, followed by Mometasone furoate (23.6%) and Hydroquinone (13.1%). Periodic evaluation of the prescribing pattern of the drugs can improve the quality of prescriptions. It is the responsibility of the clinical pharmacist to perform the drug utilization studies in order to know the drug prescribing patterns and also to know the prevalent disease conditions at a particular point of time. Clinical pharmacist should create awareness regarding the personal and community hygiene which would result in the prevention of dermatological diseases.