Prescription Pattern Of Drugs Research Articles

An observational study on prescription pattern of drugs and psychiatric disorders occurring in elderly patients in a tertiary care hospital

Abstract Background: Elderly age group is the most vulnerable age group for various health-related issues. Psychiatric disorders and their management are quite important, especially in this vulnerable population. With increased availability of newer drugs, rational prescription of drugs is essential. Objectives: The objectives of this study were as follows: (1) To assess the prescription pattern of antipsychotic drugs and other psychiatric drugs prescribed to elderly psychiatry patients, (2) to determine the psychiatric illness occurring among the elderly psychiatric patients, and (3) to estimate the polypharmacy and cost burden of drugs prescribed. Materials and Methods: It was an observational study conducted over a period of 6 months in “Government Hospital for Mental Care.” The prescriptions were collected from the outpatient medical records and were thoroughly analyzed to assess antipsychotics and other psychiatric drugs being prescribed and the disorders frequently came across in the elderly patients who visited the psychiatry outpatient department. Results: Two hundred and fifty prescriptions were analyzed during the study. Male patients outnumbered female patients. The majority of the patients were of age group 50–60 years. Schizophrenia was the most common disorder encountered in the study population followed by psychosis and bipolar. Among the drugs, trihexyphenidyl followed by quetiapine, olanzapine, risperidone, and so on were the most common drugs prescribed. Conclusion: In the current study the prescribing pattern of drugs is as per the norms with rational usage of more efficacious drugs. Polypharmacy is limited. Periodic drug utilization studies help to solve the issues related to polypharmacy and improve the quality of treatment given to the patients.

Antihypertensive drug prescription patterns and their impact on blood pressure outcomes in a tertiary care teaching hospital

Background: The guidelines from the Joint National Committee (JNC-8) emphasize the importance of rapid blood pressure (BP) control to reduce morbidity and mortality. The success of hypertension treatment depends on various factors, with irrational prescription being strongly linked to poor BP control. This study aimed to evaluate the patterns of antihypertensive drug prescriptions among patients in a tertiary care teaching hospital. Methods: A hospital-based observational study was conducted in 2018, including all hypertensive patients on medication. Their prescription patterns were analyzed. Results: The study analyzed prescriptions from 240 hypertensive patients. The mean ages for male and female patients were 56.68±15.32 and 62.29±12.65 years, respectively. Physicians commonly prescribed monotherapy (34.60%) followed by two-drug (18.40%), three-drug (11.80%), and four-drug combinations (3.00%). The most frequent two-drug combination was ACE inhibitors + diuretics (4.40%), followed by angiotensin receptor blockers (ARBs) + diuretics (3.60%) and calcium channel blockers (CCBs) + ACE inhibitors (2.60%). Adherence to JNC 8 guidelines was 19.3% for pre-hypertension, 88.70% for stage 1 hypertension, and 73.29% for stage 2 hypertension. Conclusions: Monotherapies were the most commonly prescribed regimens. Twice-daily dosing and monthly appointments were associated with lower incidences of uncontrolled BP. However, complete adherence to standard guidelines was not observed in all cases, especially in patients with comorbid conditions.

Evaluation of drug prescription patterns in Iran: a scoping review

Evaluation of drug prescription patterns in Iran: a scoping review

Increased risk of depression and anxiety in individuals with Darier disease.

Darier disease patients show increased risk for depression and anxiety which matches well with increased drug prescription patterns of antidepressants and anxiolytics.

Antidepressant prescription patterns and polypharmacy in outpatient psychiatry: a cross-sectional study.

Background and aim: Prescription patterns of antidepressants have changed over the years with a shift towards newer antidepressants with better tolerability and safety. Polypharmacy is common in psychiatry settings. The study aimed to evaluate the antidepressant drug prescription pattern and polypharmacy in a psychiatry outpatient setting. Investigations: This prospective observational study was conducted in a psychiatric outpatient clinic. The medication use data of eligible patients were collected. In addition, the rationale of antidepressant medication prescription, the defined daily dosage (DDD), the prescribed daily dose (PDD), and the PDD to DDD ratio were assessed. The assessment of prescription polypharmacy was conducted utilizing the framework provided by the National Association of State Mental Health Program Directors. Results: Data from 131 patients was analyzed. Major depressive disorder (32.8%) was the most common disorder for which antidepressants were prescribed. The majority, 91 (69.4%), received monotherapy. Selective serotonin reuptake inhibitors were the most frequently prescribed drugs in 69 (52.7%). Mirtazapine was the most frequently 32(24.4%) prescribed drug. Escitalopram and mirtazapine were the most commonly prescribed combination therapy (4.6%). Antipsychotic medications (37.4%) were the most widely co-prescribed medications, along with antidepressants. The PDD to DDD ratio was less than 1 for mirtazapine and imipramine; they were ≥1 for others. Psychiatric polypharmacy was documented in 87.1% of prescriptions. The total polypharmacy was not significantly (p>0.05) associated with demographic, illness, and treatment-related variables. Conclusion: Selective serotonin reuptake inhibitors were the most commonly prescribed antidepressants, monotherapy, and combination therapy. A substantial amount of patients received concomitant administration of antidepressants or psychotropic drugs, warranting careful monitoring.

A Study on Prescription Pattern of Drugs in Orthopaedics Inpatient Department of Navodaya Medical College Hospital and Research Centre in Raichur

Background: Periodic evaluation of drug utilization pattern is necessary to promote rational drug use by. In orthopaedics practice, the prescribing pattern needs to be regularly monitored since many of the drugs prescribed carry untoward adverse effects. In this backdrop, the present study was conducted to explore the prescribing pattern in orthopaedics outpatient department (OPD) of Navodaya medical college hospital and research centre in Raichur. Methods: This is a prospective observational study conducted for 3 months, in Navodaya medical college hospital and research centre in Raichur, a 1000 bedded tertiary care rural based, teaching hospital. Total 100 patients were included in this study. Results: Total 1216 drugs were prescribed in 100 prescriptions. Average number of drugs per prescription was 7.34. Average duration of prescription was 9 days. Percentage of drugs prescribed by generic name was 29.7%. Percentage of encounter with an Antibiotic prescribed was 60.23% i.e. out of 100 prescriptions antibiotics were prescribed in 60. Percentage of encounter with an Injection prescribed was 60% which means out of 100 prescriptions, injectables were prescribed in 60. Percentage of drugs prescribed from National Essential Medicine List was 52.63%. Percentage of drugs prescribed from WHO model List was 32.46%. Diclofenac (14.25%) was most commonly prescribed drug. Incidence of polypharmacy was quite high in context of Analgesics. Almost 19% of prescriptions had 3 drugs. Orally prescribed Analgesics were 62.4%, Injectables 34% and Topical 3.6%. Conclusion: The study provides an insight into the prescribing pattern in orthopaedics in-patients. It highlights the importance of emphasizing rational drug prescribing and toward improving awareness of the physicians and medical students to the WHO recommended standards on prescribing indicators.

Evaluation of Pharmacotherapy of Cancer Pain in Patients with Head and Neck Cancer at a Tertiary Care Teaching Hospital

Background Head and Neck Cancers (HNC) account for 5% of all malignant tumours, but 80% of patients experience pain. As per the WHO analgesic ladder, analgesics are a cornerstone for the management of pain in HNC patients. Purpose Our study aims to analyse the prescribing pattern of analgesic drugs in patients with HNC pain. Materials and Methods A prospective, continuous, observational study was conducted among patients with HNC pain. Demographics, detailed history of pain (type, duration, location and Numerical Rating Scale [NRS] score), details of drugs prescribed and any adverse drug reactions (ADRs) were recorded at baseline visit and at first, second and sixth month follow-up. Descriptive statistics were used to analyse the above parameters. The mean reduction in NRS was analysed by the Z test. Results Out of 145 patients, 118 (81.37%) were male and 27 (18.62%) were female. The mean age of patients was 51.89 + 7.07 years. Tramadol (81.37%) followed by morphine (62.75%) were the commonly prescribed analgesics. Amitriptyline (20%) followed by pregabalin (19.31%) were commonly prescribed adjuvant analgesics. A statistically significant reduction in mean NRS was found at each follow-up visit ( p < .05). A total of 50 ADRs were observed. Constipation (38%) and drowsiness (24%) were the most frequently reported ADRs, with morphine and tramadol being the most common suspected causal drugs. Conclusion Tramadol and morphine were frequently prescribed analgesics in patients with HNC pain in accordance with the WHO analgesic ladder. The majority of patients with HNC pain achieved a significant reduction in NRS pain scores at the end of six months.

A Study on Drug Prescribing Patterns in Vitiligo Patients of Andhra Pradesh in a Tertiary Care Teaching Hospital.

Vitiligo is a dermatological condition characterized by the appearance of white spots or patches on the skin due to the loss of skin pigment called melanocytes. The estimated prevalence of vitiligo is about 0.5-2% of the world population, but in India, the prevalence rate varies from 2 to 8%, depending on the region. This study aimed to assess drug prescribing patterns in vitiligo patients. A prospective cross-sectional study was carried out in the Dermatology Department of Government General Hospital, Andhra Pradesh, India, from December 2019 to 2020. Patients aged ≥18 years, both genders, and diagnosed and receiving treatment for vitiligo were included in the study. All medicines prescribed to the patients were collected on the predesigned case report form. Ethical approval for this study was taken from the Institutional Ethics Committee of Rajiv Gandhi Institute of Medical Science (RIMS). The collected data were analyzed by using SPSS version 18. The most commonly prescribed class of drugs was corticosteroids (42.9%), followed by calcineurin inhibitors (13.4%), vitamins (14.6%), basic fibroblast growth factor (BFGF) (9.5%), moisturizers (6.9%), antihistamines (6.5%), and minerals (6.2%). Among corticosteroids, betamethasone was the most commonly prescribed drug, followed by clobetasol propionate. Topical drugs were prescribed more often than orally. The prescription pattern in vitiligo patients is as per the guidelines and recommendations. However, further studies using multiple centers are recommended to verify our findings.

A cross sectional study on prescription patterns of antipsychotic drugs among adults with psychiatric illness in a tertiary care hospital

Importance: Antipsychotic drugs are typically used to treat schizophrenia but they are also helpful for other psychotic symptoms, including manic states with psychotic symptoms including hallucinations, delusions. Objective: To study the prescribing patterns of antipsychotic drugs among people with psychiatric illness & to study the prescribing factors comparison between elderly and Adolescent’s patients. Design and Settings: This is a prospective, comparative, cross sectional and observational study conducted on 100 patients in IP and OP psychiatry Department at Prathima Institute of Medical Sciences. In this study, we compared 1st generation antipsychotics with 2nd in prospective of their safety and effectiveness. Study Period: 6 months (Sep 2022- Feb 2023). Participants: Study population: 100.Study Criteria; Inclusion criteria includes: Adults of age 18-55 years, Geriatrics above 60years. Exclusion criteria includes: Paediatrics, Pregnant women. Main outcome and measure: 2nd generations antipsychotics are more commonly prescribed as it has more effectiveness and less side effects. Results: In our study population out of 100 patients, majority of the patients were from the age group of 30-35 years (20%), 25-30 years (17%). Among 100 patients, the most common symptoms were anger (30%), fearfulness (31%), decreased sleep (57%). Majority of the patients have been diagnosed with schizophrenia (26%), mixed anxiety and depressive disorder (26%). Atypical drugs were more commonly prescribed (risperidone 64%, olanzapine 14% and quetiapine 14%) than typical drugs (haloperidol 25%, chlorpromazine 2%). Conclusion and Relevance: we have observed that there is a greater need for patient education regarding psychiatric illness in order to have better patient outcomes, and providing knowledge regarding medication adherence. In this study, among typical and atypical antipsychotics the later are more commonly prescribed compared to former as it has more effectiveness and less side effects.

Analysis of prescription pattern and adverse drug reactions of drugs used in Urinary Tract Infection in reproductive age group (15-44 years) women in a Tertiary Care Hospital in Central India: An observational retrospective study

Background Urinary tract infection is considered a common bacterial infection. Nowadays there is an increase in the irrational and inappropriate use of drugs. Adverse drug reactions have been reported to be a main cause of morbidity, hospital admission, and sometimes death. For this, it is very important to do the analysis of prescriptions and to see the adverse drug reactions due to the prescribed drugs. Objective 1. To determine the prescribing pattern of drugs used in urinary tract infections of the reproductive age group (15-44). 2. To identify adverse reactions due to drugs used for UTI of reproductive age group (15-44). 3. To observe the pattern of combination therapy for urinary tract patients of reproductive age group. 4. To analyze the Fixed Drug Combination. Methods It is a retrospective observational study. Data will be collected from 175 prescription papers. Data will be collected from the medical record section. The study will include prescriptions of UTI for Females of the reproductive age group (15-44 years).

Expert opinion on the prescription practice of topical calamine lotion for chronic urticaria and other dermatologic conditions in Indian clinical settings

Background: Calamine is suggested as a potentially effective treatment for skin exudation, itching, and rashes. However, there aren't many thorough analyses of the drug prescription patterns for treating urticaria in the Indian literature. This study aimed to gather expert opinions on the prescription practice of topical calamine lotion for chronic urticaria and other dermatologic conditions in Indian clinical settings. Methods: The cross-sectional questionnaire-based survey, comprising 25 questions, gathered data regarding the prescription practice of topical calamine lotion for the management of chronic urticaria and other dermatological conditions. Results: Of the 467 participants, 62% indicated that they would prescribe topical calamine lotion for pruritus management. About 39% of the participants preferred the cream formulation of the calamine lotion for treating diaper dermatitis in 11-25% of patients. About 76% of the respondents stated that they would recommend an oral antihistamine along with topical calamine lotion to treat chronic urticaria. For the treatment of pruritus, 44% of the participants preferred menthol in addition to calamine. Sixty-eight per cent of the respondents stated that approximately 5% of those with chronic urticaria need to be treated with calamine and tetrahydrocurcumin. Most specialists (69.38%) preferred using calamine lotion on 5-10% of patients with itchy skin conditions during pregnancy. Conclusions: Experts recommend the topical calamine lotion for managing various skin conditions including pruritus and chronic urticaria. Specialists recommended it as a safe option for managing itchy skin conditions during pregnancy.

Effect of brand reputation on drug prescribing pattern in India

Effect of brand reputation on drug prescribing pattern in India

The Impact of reference pricing on prescribing patterns, costs, and health services utilization of proton pump inhibitors: A quasi-experimental study in British Columbia, Canada

IntroductionThe Reference Drug Program (RDP) was established to steer patients toward equally safe and cost-effective medication under British Columbia's public drug coverage. Each RDP class covers at least one reference drug, and non-reference drugs are reimbursed up to the cost of the reference drug. In 2016, the RDP updated to include proton pump inhibitors (PPIs). This study evaluated the impact on drug expenditures, prescription patterns, and health services utilization. MethodsWe identified a cohort of individuals covered by Fair Pharmacare who used PPIs, and a control group of H2 Blockers users. We used interrupted time series analysis on administrative data from June 2014 to December 2019 on the following outcomes: new users, day supply, expenditures, drug costs, reference drug use, and physician visits and costs. ResultsThe RDP had little impact on overall PPI use patterns. We did not observe any changes in reference drug uptake, new users, physician visits, cost-savings, or significant changes to days supplied post-policy. Cost expenditure results were likely biased due to co-occurring changes to drug prices. ConclusionInclusion of PPIs to the RDP saw no cost-savings for the provincial drug program and had little impact on prescribing patterns. Overall, our findings are consistent with existing evidence that the RDP is safe for similar therapeutic alternatives, but the impact on PPI costs remains unclear.

To Study the Prescription Pattern of Antihypertensive Drugs in Teerthanker Mahaveer Hospital Moradabad (U.P.)

Objective of the study: To assess prescribing pattern of antihypertensive drugs use and adherence to various clinical guidelines in the Hospital. Materials and methods: A prospective observational study was carried out for a period of six months in the IPD and OPD tertiary care hospital. Prescriptions were analyzed during the study period. All the patients of age ≥ 20 (20-70 age) years with or without comorbidities, including males and females, who were diagnosed with hypertension as per JNC 8, ESH/ESC, NICE, STG, IHG, and receiving antihypertensive drugs were included. Discussion: The results of our study suggested that out of the total number of hypertensive patients (202) males were 54.45% witch females were 45.55%. Therefore, there was immensely need of proper awareness about the hypertension and its etiologies among the population especially of younger generation. In this scenario, clinical pharmacist could do a lot more for the patients and overall society because of their expertise in Pharmaceutical Care. Conclusion: Calcium channel blockers, Diuretics, ARB as monotherapy and ARB with CCB as combination therapy were the choices for the treatment of Hypertensive patients as a single drug and combination drug therapy. As per the JNC 8 & ESC/ESH guidelines majority of the prescription patterns were achieved and found optimal at the study site.

Adverse Drug Reactions and Prescription Patterns of Antiretroviral Drugs: A Longitudinal Observational Study From a Tertiary Care Hospital in Western India.

Background In 2018, the World Health Organisation (WHO) released interim guidelines, advising a change of regimens to dolutegravir-based first- and second-line antiretroviral therapy (ART), based on which, in 2021, the National Aids Control Organisation (NACO) updated its guidelines to include the tenofovir+ lamivudine + dolutegravir (TLD) regimen as a first line of therapy for all people living with HIV (PLHIV) and second- and third-line regimens to dolutegravir-based regimens. Considering this change of regimen, the adverse drug reaction (ADR) profiling and longitudinal prescription pattern of antiretroviral and concomitant medications in adult patients at the ART centre of a tertiary care hospital were assessed in this study. Methods Ninety-seven PLHIV out of all the patients who attended the ART centre from September 2021 to July 2022 were enrolled and followed up for six months. The ADRs that occurred during this period were collected along with details of prescription patterns and analyzed by descriptive statistics. Causality assessment for ADR was done using the World Health Organisation-Uppsala Monitoring Centre (WHO-UMC) scale. Results Seventy-eight percent (n=76 out of 97) of patients experienced at least one ADR, and 128 ADRs were seen in 97 patients. The most common ADRs were increased alkaline phosphatase (39.0%, n=128), dyslipidaemia (12.5%, n=128), and nephrotoxicity (10.1%, n=128). The drug most suspected of causing ADRs was dolutegravir (27.5%, n=342). The most common therapeutic regimen was TLD (71.2%, n=97). The most prescribed drug was lamivudine (30.6%, n=1183). The most prescribed concomitant medication was cotrimoxazole (15%, n=312). Conclusions Dolutegravir-based regimens have been implemented for PLHIV in a phased-out manner from previous non-dolutegravir-based ART regimens, which is in line with the recent NACO guidelines. However, it has also led to an increase in dolutegravir-associated ADRs like increased alkaline phosphatase, dyslipidaemia, and nephrotoxicity. Continuous monitoring of prescriptions and ADRs can add to our knowledge regarding their use and ADRs.

Treatment of bone metastases from solid tumors with bone-modifying agents: a web survey of Italian oncologists investigating patterns of practice drug prescription and prevention of side effects

PurposeOptimal use of bone-modifying agents (BMAs) in patients with bone metastases from solid tumors is uncertain in some aspects: the drug choice; the planned treatment duration and long-term therapy; the prevention and management of possible side effects, including renal toxicity, hypocalcaemia, and medication-related osteonecrosis of the jaw (MRONJ).MethodsItalian oncologists were invited to fulfil a 24-question web survey about prescription of BMAs for bone metastases of breast cancer, prostate cancer, and other solid tumors. Prevention and management of side effects were also investigated.ResultsAnswers of 191 oncologists were collected. BMAs are usually prescribed at the time of diagnosis of bone metastases by 87.0% (breast cancer) and 76.1% (solid tumors except breast and prostate cancers) of oncologists; the decision is more articulated for prostate cancer (endocrine-sensitive versus castration-resistant). The creatinine level (32.3%), the availability of patient venous access (15.8%), and the type of primary neoplasm (13.6%) are the most reported factors involved in choice between bisphosphonates and denosumab. Zoledronic acid every 3 months was considered as a valid alternative to monthly administration by 94% of Italian oncologists. Oncologists reported a good confidence with measures aimed to prevent MRONJ, whereas uncertainness about prevention and management of hypocalcemia was registered.ConclusionItalian oncologists showed a high attitude in prescribing bisphosphonates or denosumab at the time of diagnosis of bone metastases, with a large application of preventive measures of side effects. Further studies are needed to investigate some controversial aspects, such as optimal drug treatment duration and long-term drug schedules.

Retrospective analysis of real-world prescribing data for managing cisplatin-based chemotherapy-induced nausea and vomiting in China.

The current utilization of neurokinin-1 receptor antagonists (NK1RAs) and the impact of updated guidelines on prescription patterns of antiemetic drugs among Chinese patients receiving highly emetogenic chemotherapy (HEC) remain undetermined. This study aims to analyze the present situation of Chinese cancer patients using antiemetic drugs and assess the appropriateness of antiemetic regimens. Prescription data were collected between January 2015 and December 2020 from cancer patients receiving cisplatin-based chemotherapy at 76 hospitals in six major cities in China. Trends in the use of antiemetic drugs, prescribing patterns and adherence to antiemetic guidelines were assessed. Among the 108,611 patients included in this study, 6 classes and 17 antiemetic drugs were identified as monotherapy or combination therapy in 93,872 patients (86.4%), whereas 14,739 patients (13.6%) were administered no antiemetic treatment. 5-hydroxytryptamine 3 receptor antagonists (5-HT3RAs) and glucocorticoids were the two most frequently used classes of antiemetics, followed by metoclopramide. NK1RAs were underused across the six cities, only 9332 (8.6%) and 1655 (1.5%) cisplatin-based treatments were prescribed aprepitant and fosaprepitant, respectively. Prescriptions of olanzapine and lorazepam were very low throughout the study period. In prescribing patterns of antiemetic drugs, dual combination regimens were the most common (40.0%), followed by triple combination therapy and monotherapy (25.8% and 15.1%, respectively). Overall, the adherence to antiemetic guidelines for patients undergoing cisplatin-based regimens was only 8.1% due to inadequate prescription of antiemetic drugs. Finally, our study also revealed that 5-HT3RAs and glucocorticoids were overprescribed in 8.8% and 1.6% of patients, respectively. The current study reveals suboptimal utilization of recommended antiemetic drugs for managing cisplatin-based HEC-induced nausea and vomiting in China. Improving the management of CINV is crucial, and these findings provide valuable insights into optimizing antiemetic drug practices.

The effect of prescription patterns on the performance of the pharmacy department of a Regional Referral Hospital, Uganda.

Poor drug prescription patterns (PP) result in irrational medicine use, avoidable stock outs and drug expiries. This study primarily assessed the effects of PP on the performance of the pharmacy department (PD) of Mbarara Regional Referral Hospital (MRRH) Uganda. This was a mixed method cross-sectional study conducted in the outpatient department (OPD) of MRRH, questionnaires were administered to 86 prescribers and 300 patient prescriptions were reviewed. Ethical clearance was granted and informed consent of patients. Data were analysed, presented in the form of graphs, tables. The overall prescription fill rate was 60.5%, being higher among dental officers and lower among those who did not adhere to generic prescribing and EML. Medical officers made most prescriptions at 69.3%. Prescriptions with four (47.1%) and six (17.5%) medicines respectively were made by clinical officers. Of the 300 prescriptions, 76% adhered to the Essential Medicines List (EML), 62% used generic name including 87.3% from dental officers and 52.9% by clinical officersThe overall prescription fill rate was 60.5%, being higher among dental officers and lower among those who did not adhere to generic prescribing and EML. Medical officers made most prescriptions at 69.3%. Prescriptions with four (47.1%) and six (17.5%) medicines respectively were made by clinical officers. Of the 300 prescriptions, 76% adhered to the Essential Medicines List (EML), 62% used generic name including 87.3% from dental officers and 52.9% by clinical officers. Prescription pattern affected the performance of the PD of MRRH, calling for its continued monitoring to ensure that guidelines are upheld, EML and UCG are availed and utilized.

A Prospective Observational Study on the Prescription Pattern of Anticancer Drugs and Adverse Reactions of Chemotherapy in Patients with Breast Cancer

Background: Every hospital should conduct a periodic study of prescription patterns as a potential tool for determining the function of pharmaceuticals in society. Objective: The study’s primary goals were to evaluate prescription patterns and frequent adverse reactions in individuals undergoing breast cancer chemotherapy. Materials and methods: At the American Oncology Institute in Guntur, a prospective observational study was carried out. The breast cancer patients who met the inclusion criteria underwent a six-month period of purposive sampling in a daycare centre. Information about the patient’s demographics, recommended medications, and adverse responses was gathered using a standard data collection form. Results: The study included 230 patients with breast cancer who, according to the study, were found to be in the 50–60year age range. Of the 230 patients, 117 had left breast cancer and 113 had right breast cancer; 226 of the patients were female and 4 were male. The most frequently used chemotherapeutic agent was cyclophosphamide (26%), which was followed by docetaxel (19%) and Adriamycin (14%). Adriamycin + Cyclophosphamide was the most frequently suggested regimen, followed by Docetaxel + Carboplatin + Trastuzumab. The most often reported ADR was nausea, which was followed by alopecia, fatigue, vomiting, and skin rashes. Conclusion: The medication most frequently prescribed was cyclophosphamide. ADR incidence was highest when cyclophosphamide and Adriamycin were used. Despite receiving prophylactic antiemetic medication, the majority of patients experienced nausea and vomiting. This suggests that more steps should be taken to prevent emesis, as these adverse drug reactions (ADRs) associated with antineoplastic medicines are typically avoidable. Keywords: breast cancer, prescription medications, anti-cancer drugs, breast cancer therapy, adverse effects.

Sedative drug prescription patterns in Danish adults from 2002 through 2021. A register-based cohort study

ObjectivePharmacological treatment strategies for insomnia seem to vary, and there is lack of knowledge about how sedative drugs are used in a real-world setting. We investigated changes in sedative drug prescription patterns in Danish adults who initiated treatment between 2002 and 2016. MethodsAll adults with a first-time purchase of a sedative drug registered in the Danish National Prescription Register from 2002 through 2016 were followed for five years between 2002 and 2021 for subsequent prescriptions of sedative drugs, death, or emigration. Sedative drugs were classified into anxiolytic benzodiazepines (N05BA), hypnotic benzodiazepines (N05CD), Z-drugs (N05CF), melatonin (N05CH01), promethazine (R06AD), and low-dose quetiapine (N05AH04). Analyses were stratified on time: 2002–2006, 2007–2011, and 2012–2016. ResultsA total of 842,880 individuals purchased their first sedative drug between 2002 and 2016. Most of them (40.0%) initiated treatment between 2002 and 2006, whereas 29.2% initiated treatment in 2012–2016. In 2002–2006, anxiolytic benzodiazepines (46.4%), Z-drugs (42.8%), and hypnotic benzodiazepines (5.4%) were the most common first treatment. This pattern changed over time with a gradual increase in the use of melatonin, promethazine, and low-dose quetiapine, which in 2011–2016 accounted for 27% of all first treatments. During the five years from first prescription, around 27% shifted to a different sedative drug. This percentage increased slightly over time, but over time the first shift to another drug class was most often to a Z-drug or anxiolytic benzodiazepine. Few individuals (5.8%) had more than one shift and the third choice seemed randomly distributed across all other drug classes. ConclusionSedative drug prescriptions are distributed on different drug classes, with Z-drugs and anxiolytic benzodiazepines as the most frequent first treatment, and second choice in case of shift.