Prescription Pattern Of Drugs Research Articles

144-LB: Assessment of Drug Prescription Patterns of Patients with Type 2 Diabetes Mellitus in India

Rationale: Drug prescribing studies can suggest modifications in the current prescribing practices, which in turn will reduce the treatment cost, non-compliance and complications. Purpose: To identify the prescription patterns in patients with type 2 diabetes mellitus with respect to the duration of the disease. Methods: Patients with type 2 diabetes mellitus seeking regular care at twelve of the locations in Western India were included in the study. Using MEDEVA (EMR), an integrated research platform, information on medical history, laboratory values and medications was recorded. Data collected from 1st December 2022 to February 25th 2023 was considered for the analysis. Results: Of the 920 patients enrolled in the study, 607 had a duration of diabetes and prescribed medications recorded. Patients with a duration ≤ 5 years are about 53.0%, 5-10 years are 28.8% and >10 years are 18.1%. Biguanides and Sulfonylureas, followed by DPP-4, are the most common drug classes prescribed in patients with ≤ 5 years duration and Insulins in patients with a duration of more than 10 years. Conclusion: This study offers valuable information on the trends in oral antidiabetic medications and insulins in diabetic patients. As the duration of the disease increases insulin is the most prescribed medication. Disclosure V. Chavda: None. B. D. Saboo: None. V. Abhichandani: None. S. Desai: None. V. Patadia: None. B. S. Mori: None. S. Patel: None. A. M. Prajapati: None. M. N. Parekh: None. F. Vora: None. T. Vora: None. D. Hasnani: None.

Monoclonal antibody usage pattern in a tertiary care center: A retrospective study

Abstract Background: Monoclonal antibodies (mAbs) are agents that are clones of homogenous parent B cells used in managing and diagnosing multiple conditions. They are used for individualized therapy for patients due to their high specificity for an antigen/epitope. Much needs to be understood about their utilization patterns in a developing country like India, where accessibility and cost play a major role in patient care. Objectives: The objectives of this study were to evaluate the drug prescribing patterns and indications for use of mAbs and compare their availability, with the essential drug list of the World Health Organization (WHO) and the National list of essential medicines in India (NLEM). Materials and Methods: This is a retrospective cross-sectional study conducted from July to December 2021. Data were collected from 237 patients who have visited the tertiary care center or been admitted and have received mAbs. Demographic data, department of admission, diagnosis on admission, and mAbs used during treatment were recorded and analyzed. Results: Out of the 237 patients, who were eligible for this study, 61.6% of them were males and 38.4% were females. The department of ophthalmology used mAbs most commonly (65.8%). Ranibizumab was the most used mAb in this department and overall. Conclusion: Out of the mAbs being used in the tertiary care center, only rituximab was part of the NLEM (India) essential drug list, and six more drugs were present in the WHO essential drug list. The advent of biosimilars is expected to bring costs down significantly for the patient and have better treatment outcomes.

Prescription Patterns of Anticancer Drugs for Breast Cancer in Oncology Unit at a Tertiary Hospital in Oman: A Retrospective Observational Study

Cancer is a large group of diseases that can begin in practically any organ or tissue of the body and spread to other organs. The latter process is called metastasizing, a leading cause of cancer death. Breast cancer is common cancer in women worldwide. Multiple factors are related to an increased risk of breast cancer, like family history, obesity, processed foods intake, and physical inactivity. This retrospective cross-sectional study was designed to assess the prescription pattern of anticancer drugs in breast cancer patients in the oncology unit at Sultan Qaboos University Hospital (SQUH). Female patients aged ≥ 18 years diagnosed with breast cancer as the first occurring primary cancer type and received at least one treatment, who were admitted from January 2018 to December 2020 at SQUH constituted the sample. A total of 191 patients were included in this study. Most patients received an average of 4.73 anticancer drugs. The most commonly prescribed medication was Anthracycline, Cyclophosphamide, and Docetaxel (AC-D) regimen, used in 33.5% of patients. Cyclophosphamide was the most commonly prescribed drug, followed by Doxorubicin and Docetaxel. The total drug expenditure on anticancer therapy in the whole course of therapies was approximately 1.655 million Omani Riyals (OR). Targeted therapy represented three-quarters of the total spending (75%), Whereas Chemotherapy and Hormonal therapy represented one-quarter, 20% and 5%, respectively. Our study's prescription pattern of anticancer drugs is comparable with previous studies conducted in different countries. Different drug prescription guidelines from one setting to another may contribute to the differences between our study and previous studies. Our findings show how analyzing drug prescription patterns can help institutions manage inventory and use healthcare resources more efficiently.

Association between the type of hypnotic drug and in-hospital fractures in older patients with neurocognitive disorders: A case-control study using a nationwide database.

Hypnotics might increase the risk of falls and fractures in older patients with neurocognitive disorders. Orexin receptor antagonists have recently been approved, but the relationship between the new drugs and fractures remains unclarified. This study aimed to evaluate the association between the type of hypnotic and in-hospital fractures in older patients with neurocognitive disorders using a nationwide inpatient database. Using the Japanese Diagnosis Procedure Combination database, we collected information on inpatients aged ≥65 years with neurocognitive disorders between April 2014 and March 2021. We examined trends in the prescription patterns of benzodiazepine drugs, Z-drugs, orexin receptor antagonists and melatonin receptor agonists. We also carried out a 1:4 matched case-control analysis of in-hospital fractures. The odds ratio of each hypnotic drug was estimated using a generalized estimating equation with adjustment for walking ability, comorbidities, osteoporosis, dialysis, selective serotonin reuptake inhibitor use and anti-dementia drug use. The prescription of benzodiazepine hypnotics decreased and that of orexin receptor antagonists increased. This case-control analysis included 6832 patients with fractures and 23 463 controls. Ultrashort-acting benzodiazepines, short-acting benzodiazepines and Z-drugs were associated with an increased risk of bone fracture (odds ratio [95% confidence interval] 1.38 [1.08-1.77], 1.38 [1.27-1.50], 1.49 [1.37-1.61], respectively). Orexin receptor antagonists were not associated with an increased risk of bone fracture (1.07 [0.95-1.19]). In contrast to other types of hypnotics, orexin receptor antagonists were not associated with in-hospital fractures in older patients with neurocognitive disorders. Geriatr Gerontol Int 2023; 23: 500-505.

Evaluation of prescription pattern of antifungal drugs in the dermatology department of a tertiary care teaching hospital

Background: In general, fungal infections are one of the contributors of disease burden in the community, but irrational use of antifungal drugs can result in unwanted adverse events or antifungal drugs resistance. The present study was designed to analyze the prescription pattern of antifungal drugs prescribed in the dermatology department of a tertiary care teaching hospital. Methods: After getting permission from the ethics committee, this prospective observational cross-sectional study was conducted by analysis of prescriptions of 900 voluntary participant patients over a period of seven months in the dermatology outpatient department of a tertiary care teaching hospital in western India. Prescribed medicines’ parameters were analyzed as per WHO/INRUD prescription indicators. Results: Overall 900 prescriptions were analyzed, and among them around 50% patients were having tinea corporis and tinea cruris, making it the most common fungal infection. The most commonly prescribed antifungals were Clotrimazole (34.59%), followed by Fluconazole (31.61%) and Luliconazole (23.52%). Percentage of drugs prescribed from the WHO model list of essential medicines was 71.22%. Average number of antifungal drugs per prescription was 2.83 ± 0.57%. Conclusions: This study indicates prescribing practices of anti-fungal drugs and supportive medicines at tertiary care hospital that can be further improved by promoting prescribing by generic names. Overall final list of essential medicines at district level, state level and national level may vary as compared to the WHO list for anti-fungal drugs and doctors can consider alternative drugs as per domestic resistant pattern.

Prepandemic psychotropic drug status in Portugal: a nationwide pharmacoepidemiological profile

The prescription of psychotropic drugs has been rising in Europe over the last decade. This study provides a comprehensive profile of prepandemic consumption patterns of antidepressant, antipsychotic, and anxiolytic drugs in Portugal considering full nationwide psychotropic drug prescription and dispensing records (2016–2019) against several criteria, including active ingredient, sociodemographics, medical specialty, and incurred costs. An increase of 29.6% and 34.7% in the consumption of antipsychotics and antidepressants between 2016 and 2019 is highlighted, accompanied by an increase of 37M Eur in total expenditure (> 20M Eur in public copay) for these classes of drugs. Disparities in sociodemographic and geographical incidence are identified. Amongst other pivotal results, 64% of psychotropic drug prescriptions are undertaken by general practitioners, while only 21% undertaken by neurological and psychiatric specialties. Nationwide patterns of psychotropic drug prescription further reveal notable trends and determinants, establishing a reference point for cross-regional studies and being currently assessed at a national level to establish psychosocial initiatives and guidelines for medical practice and training.

Use of metformin and insulin among pregnant women with gestation diabetes in the United Kingdom: A population-based cohort study.

The contemporary prescription patterns of antidiabetic drugs following guideline changes recommending metformin as first-line gestational diabetes (GDM) pharmacotherapy is underexplored. We aimed to examined use of metformin and insulin during pregnancy among women with GDM over 20 years in the United Kingdom. We conducted a population-based cohort study using linked data from the Clinical Practice Research Datalink, its pregnancy register and Hospital Episode Statistics from 1998 to 2017. We included pregnancies of women without prior diabetes history who received GDM diagnosis or initiated an antidiabetic drug after 20 weeks gestation. Patient-level and practice-level characteristics were compared between metformin initiators and insulin initiators. We described trends of initiating metformin as first-line treatment and described time to initiation of rescue insulin overall, and by body mass index among metformin initiators. Our cohort included 5633 pregnancies from 5393 women with GDM, of whom 38.9% initiated pharmacotherapy (41% insulin, 59% metformin). Metformin prescriptions (as opposed to insulin) increased substantially, from <5% of pregnancies before 2007 to 42.5% in 2008. Over 85% of pregnancies that were prescribed pharmacotherapy were prescribed metformin as first-line treatment in 2015. Among metformin initiators, 16% initiated rescue insulin, typically occurring within 40 days of metformin initiation. Choice of GDM pharmacotherapy varied by characteristics, including smoking, obesity, race/ethnicity and general practice regions. Metformin was the most prescribed medication for GDM, with large increases over the past 2 decades. The increasing use of oral-antidiabetic drugs during pregnancy, consistent with other regions, highlights the need for future studies examining effectiveness and safety of antidiabetic drug use during pregnancy.

Study to Analyse Prescription Pattern of Antihypertensive Drugs Used in Preeclampsia Patients at a Secondary Care Hospital: A Prospective Observational Study

Study to Analyse Prescription Pattern of Antihypertensive Drugs Used in Preeclampsia Patients at a Secondary Care Hospital: A Prospective Observational Study

DRUG PRESCRIBING PATTERN OF VARIOUS ANTIFUNGAL DRUGS FOR DERMATOPHYTOSIS IN A TERTIARY HEALTHCARE AND TEACHING HOSPITAL

Objective: To analyze the pattern of drug prescription and the rationality of pharmacotherapy used in dermatophytosis. Methods: A prospective observational study was conducted from January 2021 to June 2022 in the Department of Skin and Venereal Diseases. Prescriptions included all newly diagnosed patients with cutaneous fungal infections of both genders who attended Dermatology OPD. Factors considered were sociodemographic parameters, clinical manifestations, combination and monotherapy along with prescribed topical and systemic agents, and details of prescribing indicators. Results: A total of 362 dermatophytosis cases were observed, which included 230 males and 132 females. Patients in the age group of 13-40 y (65.47%) have shown the dominance of dermatophytosis infection with a high prevalence among the student category, which accounts for 177. Tinea corporis (40.85%) was the prominent clinical manifestation of dermatophytosis infection. Among single topical agents, the most commonly prescribed drug is Clotrimazole (15.19%), and among topical combinations, sertaconazole and ketoconazole (29.28%). Itraconazole (48.75%) is the most commonly used oral formulation, followed by the itraconazole and terbinafine combination (22.56%). While imidazoles were the maximally prescribed topical antifungals according to the therapeutic class. Conclusion: Tinea corporis is the prominent clinical manifestation and the majority of prescriptions were for a combination of three agents mainly oral itraconazole with topical sertaconazole, and ketoconazole.

STUDY ON DRUG PRESCRIPTION PATTERNS AMONG DENGUE PATIENTS IN A TERTIARY CARE HOSPITAL, TUMKUR

Background: Dengue fever causes a signicant economic and social burden on the population worldwide. When standard management guidelines are not practiced it leads to economic burden on patients. The present study aims to assess the drug prescription pattern for dengue patients admitted in a tertiary care teaching hospital. A prospective study Material and Methods: was conductedamong 100 dengue patients undergoing treatment in the Department of General Medicine of Medical college in Tumakuru, Karnataka over a period of one year from November 2018 to October 2019. Details of drugs prescribed was documented and analysed. Results: The mean age of patients was 34.25 ± 14.69 years with minimum and maximum age of 14 and 68 years respectively. 56% of patients were male and 44% female.The average number of drugs prescribed per patients in the present study was 3.7 ± 1.05 drugs. A total of 110 antimicrobial were used with 24% and 41% receiving two and one antimicrobial agents respectively for treating dengue patients. All patients were given i.v. uids and antipyretrics. Cari papaya extract was given to 48% of cases. Steroids were needed only among 3% of dengue cases while platelet transfusion was done for 29 patients with mean requirement of 6.79 ± 2.4 units of platelet. Si Conclusion: gnicant proportion of patients received antibiotics and other drugs with no proven benets in dengue management, increasing the cost of treatment and unnecessary side-effects. There is a need to conduct training programme among treating physician on the use of recommended drugs as per standards.

A Case Control Study on Risk Factors and Drug Prescription Patterns in Glaucoma at a tertiary eye care center in a city of Western India

Introduction: Glaucoma is an idiopathic, progressive optic disc neuropathy complicating into irreversible blindness if untreated. Early diagnosis by screening cases from high-risk populations has a pivotal role in managing this major public health problem with high treatment expenditures. Objectives: To identify the various ocular and non ocular risk factors of glaucoma and to identify the drug prescription pattern among glaucoma patients. Method: This was an observational, case-control study including 165 adult Glaucoma patients on treatment as cases and 165 age and sex-matched healthy individuals as controls, all of which were randomly selected from the patients visiting a tertiary eye care center. Various risk factors, drug prescription pattern and symptoms of the patients were recorded and analyzed.Results: A total of 165 adult Glaucoma patients and age and gender matched 165 controls were enrolled. Majority of the patients (41.21%) complained of blurring of vision at the time of study. The Odds ratios for Family history, Hypertension, Diabetes Mellitus, Migraine, Sleep apnea and Smoking showed strong association as risk factors for Glaucoma and the differences between the two groups were statistically significant (p value &lt; 0.05). The mean number of drugs per prescription ± SD was 1.88 ± 0.79. Fixed drug formulations were prescribed in 42.4% patients. All the drugs were prescribed by their brand names and majority of them were in the form of eye drops. Conclusion: Primary Open Angle Glaucoma (POAG) was the most common subtype in the study. Age, Family history, Myopia, Hypertension, Diabetes Mellitus, Sleep Apnea, Migraine, Corticosteroid usage and Smoking emerged as putative risk factors. In consistence with present guidelines, Prostaglandin analogs were the most prescribed antiglaucoma drugs. The considerable proportion of asymptomatic cases (23%) suggests the need for periodic eye examinations to detect glaucomatous changes at an early stage.

Characteristics of prescribing activity within primary care in Scotland 2013-2022 of general practitioners, nurse, pharmacist and allied health prescribers: A retrospective cross-sectional study.

Independent prescribing by nurses, pharmacists and allied health professionals is diversifying into a variety of healthcare settings as pressures mount on existing resources. Primary care was an early adopter of prescribing by non-medical professionals with resulting improvements in accessibility and flexibility of services but also noted barriers. Exploring existing prescribing activity within primary care can support future initiatives that are cognisant of the needs of this specific population and targeted in the use of finite resources. To explore the characteristics of prescribing activity of common drugs dispensed by community pharmacies in Scotland by prescribing groups of general practitioners, nurses, pharmacist and allied health professionals. Specifically, to compare overall drug prescribing frequency by prescriber group and identify emergent prescribing patterns of individual drugs. A cross-sectional study. The data from Public Health Scotland on frequency of the ten most common drugs prescribed and dispensed from community pharmacies between 2013 and 2022 by prescriber group were examined, applying descriptive statistics using secondary data analysis. Prescribing activity in non-medical prescribing groups accounted for 2%-3% of overall prescribing activity in primary care. There is a growing interprofessional approach to prescribing in chronic disease. Proton pump inhibitors were the most commonly prescribed medication overall with a 4-fold increase in nurse prescribing. The decline in prescribing frequency caused by COVID 19 restrictions has since returned to pre-pandemic levels. There is a growing contribution of nurse independent prescriber activity within primary care although still a relatively small proportion compared to medical practitioners. The pattern of increased prescribing of medications for long term and chronic conditions such as proton pump inhibitors by all prescribers is suggestive of multi-disciplinary professionals supporting increased patient demand. This study provides a baseline to evaluate current service provision in further research and enable professional, service and policy development.

The longitudinal patterns of psychotropic drug prescriptions for subpopulations of community-dwelling older people with dementia: electronic health records based retrospective study

BackgroundStudies focusing on patterns of psychotropic drug prescriptions (PDPs) for subpopulations of community-dwelling older people with dementia are lacking.ObjectiveThe aim of this study was to identify the longitudinal patterns of PDPs in subpopulations.MethodsThis retrospective study used electronic health records from general practitioners (GPs) in the Netherlands. People (N = 1278) firstly diagnosed with dementia between 2013 and 2015, aged 65 years or older, were selected and categorized into four subpopulations: community-dwelling (CD) group throughout follow-up, ultimately admitted to nursing homes (NH) group, ultimately died (DIE) group, and ultimately deregistered for unclear reasons (DeR) group. Generalised estimating equations were used to estimate the patterns of psychotropic drug prescriptions, after the diagnosis of dementia for a five-year follow-up, and 0–3 months before institutionalisation or death.ResultsOver the five-year follow-up, antipsychotic prescriptions increased steadily in CD (OR = 1.07 [1.04–1.10]), NH (OR = 1.10 [1.04–1.15]), and DIE (OR = 1.05 [1.02–1.08]) groups. Similarly, prescriptions of antidepressants also showed upward trends in CD (OR = 1.04 [1.02–1.06]), NH (OR = 1.10 [1.02–1.18]), and DIE (OR = 1.04 [1.00–1.08]) groups. The other psychotropic drugs did not show clear changes over time in most of the subpopulations. In the three months before institutionalisation, antipsychotic prescriptions increased (OR = 2.12 [1.26–3.57]) in the NH group compared to prior periods. Likewise, before death, prescriptions of antipsychotics (OR = 1.74 [1.28–2.38]) and hypnotics and sedatives (OR = 2.11 [1.54–2.90]) increased in the DIE group, while anti-dementia drug prescriptions decreased (OR = 0.42 [0.26–0.69]).ConclusionsAfter community-dwelling older people are diagnosed with dementia, all subpopulations’ prescriptions of antipsychotics and antidepressants increase continuously during the follow-up. While we cannot judge whether these prescriptions are appropriate, GPs might consider a more reluctant use of psychotropic drugs and use alternative psychosocial interventions. Additionally, antipsychotic prescriptions rise considerably shortly before institutionalisation or death, which might reflect that older people experience more neuropsychiatric symptoms during this period.

Evaluating Prescription Pattern and Effectiveness of Antihypertensive Drugs in Non-Operated Aortic Dissection Patients

Aortic dissection (AD) is a life-threatening disease. However, the effectiveness of different strategies of antihypertensive therapies in non-operated AD patients is still unclear. Patients were classified into five groups (groups 0-4) based on the number of classes of antihypertensive drugs, including β-blockers, renin-angiotensin system (RAS) agents (angiotensin-converting enzyme inhibitors (ACEIs), angiotensin II receptor blockers (ARBs), and the renin-inhibitors), calcium channel blockers (CCBs), and other antihypertensive drugs, were prescribed within 90 days after discharge. The primary endpoint was a composite outcome of re-hospitalization associated with AD, referral for aortic surgery, and all-cause death. A total of 3932 non-operated AD patients were included in our study. The most prescribed antihypertensive drugs were CCBs, followed by β-blockers and ARBs. Within group 1, compared to other antihypertensive drugs, patients using RAS agents (aHR, 0.58; p = 0.005) had a significantly lower risk of occurrence of the outcome. Within group 2, the risk of composite outcomes was lower in patients using β-blockers + CCBs (aHR, 0.60; p = 0.004) or CCBs + RAS agents (aHR, 0.60; p = 0.006) than in those using RAS agents + others. For non-operated AD patients, RAS agents, β-blockers, or CCBs should be given in a different strategy of combinations to reduce the hazard of AD-related complications compared to other agents.

The use of Chinese herbal medicines throughout the pregnancy life course and their safety profiles: a population-based cohort study

Chinese herbal medicines (CHM) have been long used among pregnant populations in China. However, despite the high susceptibility of this population to drug exposure, it continued to remain unclear about how often they were used, to what extent they were used at different pregnancy stages, and whether their use was based on sound safety profiles particularly when used in combination with pharmaceutical drugs. The aim of this descriptive cohort study was to systematically investigate the use of CHM throughout the pregnancy and their safety profiles. We developed a large medication use cohort by linking a population-based pregnancy registry and a population-based pharmacy database, which documented all prescriptions both at outpatients and inpatients from conception to 7 days after delivery, including pharmaceutical drugs and processed CHM formula that were approved by regulatory authority and prepared under the guidance of national quality standards. We investigated the prevalence of CHM formula use, prescription pattern and combination use of pharmaceutical drugs throughout the pregnancy life course. Multivariable log-binomial regression was conducted to assess temporal trend, and further explore the potential characteristics associated with the CHM use. Two authors independently conducted a qualitative systematic review of patientpackageinserts (PPI) of top 100 CHM formula use to identify their safety profiles. Our study included 199,710 pregnancies; of those, 65.71% (131,235/199,710) were administered with CHM formula, including 26.13% during pregnancy (corresponding to 14.00%, 8.91% and 8.26% in the first, second, and third trimesters), and 55.63% at post-delivery. The peak uses of CHM occurred between the 5th and 10th weeks. The use of CHM significantly increased over the years (63.28% in 2014 to 69.59% in 2018, adjusted relative risk [aRR]: 1.11, 95% CI: 1.10-1.13), which was particularly great during pregnancy (18.47% to 32.46%, 1.84, 95% CI: 1.77-1.90). Our study observed 291,836 prescriptions involving 469 CHM formula, and the 100 mostly used CHM accounted for 98.28% of the total prescriptions. Of those, a third (33.39%) were dispensed at outpatient visits; 6.79% were external use and 0.29% were injections. However, CHM were very often prescribed in combination with pharmaceutical drugs (overall 94.96%), involving 1,175 pharmaceutical drugs with 1,667,459 prescriptions. A median of 10 (IQR: 5-18) pharmaceutical drugs was prescribed in combination with CHM per pregnancy. The systematic review of drug patient package inserts found that the 100 most frequently prescribed CHM contained a total of 240 herb constituents (median 4.5); 7% were explicitly indicated for pregnancy or postpartum conditions; 43.00% were reported with efficacy or safety data from randomized controlled trials. Information was lacking about whether the medication has any reproductive toxicity, is excreted in human milk or may cross the placenta. The use of CHM was prevalent throughout the pregnancy and increased over years. The CHM use peaked at the first trimester and was very often used in combination with pharmaceutical drugs. However, their safety profiles were mostly unclear or incomplete, warranting a strong need for post-approval surveillance for CHM use during pregnancy life course.

Prescription pattern of non-steroidal anti-inflammatory drugs among patients admitted with fever in a tertiary hospital

Background: WHO estimates that more than half of all medicines are prescribed, dispensed or sold inappropriately. Nonsteroidal anti-inflammatory drugs are a group of drugs that are commonly prescribed for the treatment of fever associated with pain and inflammation. The objective was to assess the prescribing pattern of NSAIDs in fever patients. Along with this, we looked at the clinical indications for prescribing and the pattern of prescribing with respect to use of generic or trade names. Methods: This observational study was conducted in a tertiary care teaching hospital in Malappuram district of Kerala, India by extracting data of inpatients retrospectively from medical records for a six-month period. The reported prevalence of NSAID use in previous study was 20%, with a relative precision of 18% the sample size required was 500. The data was analyzed and expressed as absolute numbers and/or percentages. Results: Out of these 500 patients, Dengue fever was the most common diagnosis (86.6%) followed by Typhoid (2.8%) and Leptospirosis (2.4%). Among these, 392 (78.4%) received any of the NSAIDs. The most commonly prescribed drug was Paracetamol (77.04%). Among to the prescriptions, 91.7% were prescribed with generic names. As concomitant medications, antibiotics were prescribed at 21.2% cases, gastro protective agents were prescribed to 24.23% and vitamins were prescribed in 72.6% cases. Conclusions: This study has shown that the prescribing, usage and preferences of NSAIDs practiced rationally. No over use, under use or misuse of drugs was noticed.

Antimicrobial drug utilization pattern in a tertiary level intensive care unit in Northern India: Antimicrobial Stewardship Programme need of the hour

Background: Antimicrobial drugs are the most frequently prescribed drugs in hospital settings with intensive care unit (ICU) patients showing the highest consumption of these drugs. Antimicrobial overuse and misuse is attributed to antimicrobial resistance (AMR). AMR in coming years will emerge as a global pandemic, maiming the modern health-care system. High consumption of antimicrobial drugs is one of leading factors contributing to AMR. Aims and Objectives: This study aimed at evaluating the prescription pattern of antimicrobial drugs in ICU and estimates the burden of inappropriate antimicrobial drug utilization in ICU settings of a tertiary level teaching hospital. Materials and Methods: The current study was conducted on 100 patients over a period of 6 months, admitted in surgical ICU (SICU), and neuro SICU (NICU) of a tertiary level hospital in Jammu and Kashmir, India. Study patients were identified through daily review of pharmacy records and antimicrobial drugs prescribed for the initial 5 days of ICU admission were documented in a well-designed questionnaire consisting all the necessary information regarding antibiotic therapy. Results: Out of the 100 enrolled study subjects, 98% received an empiric therapy. Majority of the patients were given a combination antimicrobial therapy during the initial 5 days of ICU admission. The most common antibiotic prescribed as monotherapy was ceftriaxone during the initial 2 days of ICU stay followed by piperacillin-tazobactam and meropenem in the next 3 days. Amikacin was the most frequently prescribed antibiotic in combination therapy during first 2 days followed by vancomycin in the consecutive days. A total of 27 antimicrobial drugs belonging to 15 classes were prescribed to the study participants during the initial 5 days of ICU admission. Conclusion: The study reports a very high consumption of antimicrobial drugs in ICUs with maximum of antimicrobial therapies prescribed empirically. A robust action plan, consisting of proper protocol for prescribing empiric antimicrobials, regular monitoring of antibiotic consumption in ICUs with a system of prospective audit, and feedback and timely interventions are a keystone of good antibiotic stewardship and should be the focus in ICU and NICU.

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes.

To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI-Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription.

Prescription pattern in ischemic heart disease inpatients at B. P. Koirala Institute of Health Sciences: a cross sectional study

Background: Drug utilization pattern studies seek to screen, evaluate and suggest appropriate modifications in prescription practices. It would help to make patient care rational and cost effective. Objective was to analyze the drug prescribing pattern for treatment of ischemic heart disease (IHD). Methods: A prospective cross-sectional observational study was conducted in patients of IHD admitted in intensive coronary care unit and medicine ward for the period of six months. Data were collected in preformed case record form. The data were analyzed for drug use indicators, demographic parameters, morbidities, pattern of drug use using Microsoft excel 2010. Results: A total of 145 patients were enrolled out of that 89 (61.38%) were males. The mean age was 60.01±12.71 years and majority (26.89%) belonged to age group of 61-70 years. A total of 1208 drugs were prescribed in 145 patients. Most frequently prescribed drugs were antiplatelet group of drugs 100% encounters, followed by hypo-lipidemics (98.62%). Average number of drugs per encounter was 8.33 and percentage of drugs prescribed by generic name was 5.04%. Conclusions: IHD was more common in males than females. The most commonly prescribed drug classes were anti-platelet drugs followed by hypolipidemic agents.

Analysis of prescription status of antihypertensive drugs in Chinese patients with hypertension based on real-world study

Background Globally, the prevalence of hypertension and the accompanying burden of cardiovascular disease are increasing. Through drug utilization research, we can understand the prescription status of hypertension patients and promote rational drug use. The purpose of this retrospective study was to describe the current prescription pattern of antihypertensive drugs in Chinese patients and determine the compliance level of treatment guidelines. Materials and methods Around 11.1 million patients who received a prescription for antihypertensive therapy between January 2021 to December 2021 were obtained from a database of Hangzhou Kang Sheng Health Consulting CO., Ltd. Results The mean age of hypertensive patients was 54.75 ± 12.98 years. About 6.7 million (60.30%) were males. About 46.07% of patients had comorbidities. The most common classes of antihypertensive medications used were calcium channel blockers (CCBs) and angiotensin II receptor blockers (ARBs). Around 78.33% of participants were on monotherapy. Diuretics + ARBs and Diuretics + CCBs + ARBs were the most commonly prescribed pattern in two-drug combination therapy and three-drug combination therapy, respectively. Conclusions CCBs and ARBs were the two most frequently prescribed for patients with hypertension. The prescription pattern of antihypertensive medications in the study largely complied with recommended Chinese hypertension guidelines. Key messages Cardiovascular disease is the most common complication of hypertension. Calcium channel blockers (CCBs) and angiotensin II receptor blockers (ARBs) are the two most commonly used drugs for hypertension patients in China. The proportion of combination prescription pattern in Chinese hypertensive patients is low.