Drug Utilization In Patients Research Articles

Drug utilization in patients starting haemodialysis with a focus on cardiovascular and antidiabetic medications: an epidemiological study in the Lazio region (Italy), 2016–2020

BackgroundEntering dialysis is a critical moment in patients’ healthcare journey, and little is known about drug therapy around it. A study funded by the Italian Medicines Agency offered the opportunity to leverage data from the Lazio Regional Dialysis and Transplant Registry (RRDTL) and perform an observational study on drug use patterns before and after initiating chronic dialysis.MethodsIndividuals initiating dialysis in 2016–2020 were identified from RRDTL, excluding patients with prior renal transplantation, stopping dialysis early, or dying within 12 months. Use of study drugs, predefined by clinicians, in the two years around the index date was retrieved from the drug claims register and described by semester. For each drug group, proportions of users (min 2 claims in 6 months) by semester, and intensity of treatment in terms of Defined Daily Doses (DDDs) for cardiovascular and antidiabetic agents were compared across semesters, stratifying by sex and age.ResultsIn our cohort of 3,882 patients we observed a general increase in drug use after initiating dialysis, with the mean number rising from 5.5 to 6.2. Cardiovascular agents accounted for the highest proportions, along with proton pump inhibitors and antithrombotics over all semesters. Dialysis-specific therapies showed the most evident increase, in particular anti-anaemics (iron 4-fold, erythropoietins almost 2-fold), anti-parathyroids (6-fold), and chelating agents (4-fold). Use of cardiovascular and antidiabetic drugs was characterised by significant variations in terms of patterns and intensity, with some differences between sexes and age groups.ConclusionsEntering dialysis is associated with increased use of specific drugs and goes along with adaptations of chronic therapies.

RWD137 Real-World Osteoporosis Drug Utilization in Patients with Recurrent Osteoporotic Fracture: A Nationwide Cohort Study in South Korea

RWD137 Real-World Osteoporosis Drug Utilization in Patients with Recurrent Osteoporotic Fracture: A Nationwide Cohort Study in South Korea

Evaluation of Drug Utilization in Patients with Coronary Artery Disease: Prevalence, Predisposing Factors and Prescribing Patterns in Tertiary Care Hospital in Punjab

Evaluation of Drug Utilization in Patients with Coronary Artery Disease: Prevalence, Predisposing Factors and Prescribing Patterns in Tertiary Care Hospital in Punjab

Analysis of Drug Utilization in Patients with Psoriasis: A Real-World Retrospective Study Among the Italian Population.

An Italian real-world retrospective study was conducted in patients with psoriasis (PSO) to evaluate their characteristics, treatment patterns, and biological/targeted synthetic disease-modifying antirheumatic drug (b/tsDMARD) drug utilization. The retrospective analysis was carried out on real-world data collected from administrative databases of selected Italian health-departments; the dataset covered approximately 22% of the Italian population. PSO patients (identified by PSO hospitalization, and/or active exemption code and/or a topical anti-psoriatic medication prescription) were included. In prevalent patients identified during 2017-2018-2019-2020, baseline characteristics and treatment patterns were investigated. Moreover, b/tsDMARD drug utilization (focusing on persistence, monthly dosage, and mean duration between prescriptions) was evaluated in bionaïve patients included during 2015 and 2018. PSO was diagnosed in 241,552 (in 2017), 269,856 (in 2018), 293,905 (in 2019) and 301,639 (in 2020) patients. At the index date, almost 50% of patients had not received systemic medications, and 2% had received biological treatment. Among the b/tsDMARD-treated patients, a decrease in the use of tumour necrosis factor (TNF) inhibitors (60.0-36.4%, from 2017 to 2020) and an increase in the use of interleukin (IL) inhibitors (36.3-50.6%, from 2017 to 2020) were observed. In 2018, the persistence rates of TNF inhibitors and IL inhibitors in bionaïve patients ranged from 60.8-79.7% and 83.3-87.9%, respectively. This real-world study of PSO drug utilization in Italy showed that a significant number of patients were not treated with systemic medications and only 2% of patients were treated with biologics. An increase in the use of IL inhibitors and a decrease in the prescription of TNF inhibitors over years were found. Patients treated with biologics were highly persistent with treatment. These data provide insight into routine clinical practice for PSO patients in Italy, suggesting that the optimization of treatment for PSO still represents an unmet medical need.

Profile of Drug Utilization in Patients with Rare Diseases in Tuscany, Italy: A Population-Based Study

Patients with rare diseases (RDs) generally have delayed diagnosis and misdiagnosis, which lead to inappropriate care or the need to modify treatment during the course of the disease. The medical care of RD patients can be further complicated by the presence of comorbidities. In this population-based study, we evaluated the prevalence, intensity of use, and consumption of drugs prescribed to RD patients residing in Tuscany (Italy) in the years 2008-2018. Data from the Registry of Rare Diseases of Tuscany were integrated with information retrieved from regional pharmaceutical prescription databases. The overall prevalence of drug use in the RD patients was 85.4%. Drugs for the alimentary tract and metabolism and antiinfectives for systemic use showed the highest prevalence of use, while drugs for the nervous system had the highest intensity of use only in the pediatric patients. The adults exhibited a female preponderance in terms of the prevalence of use and drug consumption in almost all the age groups and therapeutic categories. Conversely, a higher prevalence of use was observed in the male children. These results provide relevant insights into drug profiles in RD patients, representing a first step for future analyses to monitor changes in drug utilization in patients with RDs over time.

Drug utilization in patients with SARS-CoV-2 in an intensive care unit

Context: Prescription indication studies allow identifying the problems that arise during the use of the drug. Aims: To evaluate the treatments used in patients diagnosed with SARS-CoV-2 infection hospitalized in critical care service, through a prescription indication study. Methods: A longitudinal observational study of medication use of the indication-prescription type with elements of the therapeutic scheme and practical consequences was carried out. The sample was characterized from the sociodemographic, clinical, and pharmacotherapeutic points of view. The prescription was evaluated through the indicators: indication, therapeutic scheme, treatment individualization, and drug combinations. The detected adverse reactions were classified according to their causality by the Naranjo Algorithm, their severity, their clinical significance, and according to their mechanism by Rawlins and Thompson. Results: In the sample (n = 77), the male gender predominated (79%) between 27-59 years old (64%), alcohol consumer (62%), hypertensive (33%) with long hospital stay (51%). A total of 417 medications were analyzed, being antibiotics (50.6%) the most prescribed. 73.4% of the therapeutic schemes were correct; however, 26.6% had problems with the therapeutic schemes due to incorrect doses, intervals, duration of treatment, and risky interactions. According to Rawlins and Thompson, two probable adverse reactions were detected, mild, non-serious, and type A and B. Conclusions: The results obtained will allow the pharmaceutical professional to create risk matrices that guarantee a timely intervention in the health team to contribute to the rational and safe use of medicines in patients infected with SARS-CoV-2.

Utilization patterns of antihypertensive drugs in the management of hypertension among patients with chronic kidney disease at a tertiary hospital

Background: Objective of the current investigation was to identify the utilization patterns of antihypertensive drugs among hypertensive patients with chronic kidney disease at Sultan Qaboos university hospital.Methods: This is a retrospective study of the utilization patterns of antihypertensive drugs that were prescribed to 181 hypertensive patients with CKD. Patients’ data and drugs’ data were collected from the hospital track care system and analysed.Results: The results show that diuretics were prescribed for 63.53% of the patients followed by β-blockers (61.3%). Drugs were prescribed orally to 90% of the patients. Furosemide was prescribed to 55.8% of patients followed by amlodipine (55.2%). The majority of the patients were on multiple antihypertensive medications (84%). There was no significant difference between drug utilization in patients with albuminuria and those without albuminuria. Among patients with CKD stages two and three, β-blockers were the most common antihypertensive drugs being utilized. Among patients with stage 4 and stage 5, calcium channel blockers and diuretics were the most common antihypertensive drugs being utilized. The prescription of angiotensin II receptor blockers and direct vasodilators showed a significant difference among different stages of CKD.Conclusions: This study showed that diuretics were the most commonly prescribed antihypertensive drugs among the study cohort. The majority of the patients were on multiple antihypertensive medications.

A STUDY OF DRUG UTILIZATION IN PATIENTS OF CARCINOMA BREAST RECEIVING SYSTEMIC CHEMOTHERAPY IN TERTIARY CARE HOSPITALS

Objective: The objective of the study is to study drug utilization in patients with breast carcinoma receiving systemic chemotherapy in government as well as private set-up.
 Methods: This was a record-based, retrospective-prospective study, analyzing the prescription pattern of drugs used for systemic chemotherapy in patients diagnosed with carcinoma breast at government teaching hospital (GTH) and private trust hospital (PTH) for 1 year in 600 patients. Patient’s demographic, clinical, and therapeutic data were collected from the files and personal interviews and analyzed in Microsoft Excel.
 Results: Diagnosis of breast carcinoma was highest in age bracket of 40–49 years (32.33% GTH and 32.67% PTH), and the most common presenting symptom was painless lump (76.33% GTH and 83% PTH). In GTH, most frequently prescribed regimen was 4AC → 4T → RT (17.33%). In PTH, most commonly prescribed regimen was 6FEC → RT (19.33%). Highest prescribed drugs were A (32.8%), C (29.12%), and F (20.24%) in GTH and A (32.26%), F (31.68%), and E (16.45%) in PTH. Average number of drugs prescribed per prescription was 12.55 and 11.37; percentage of chemotherapeutic agents prescribed by generic name was 100 and 95.02, and from the WHO essential drug list (2015) was 96.43 and 82.77 in GTH and PTH, respectively (A= Cyclophosphamide, C= Doxorubicin, T=Taxanes [Paclitaxel/Docetaxel], F=5-fluorouracil, E=Epirubicin, RT=Radiotherapy, → followed by, the number indicates chemotherapy cycle).
 Conclusion: The study results can help in generating local data regarding drug use pattern of the systemic chemotherapeutic agents in breast cancer patients and promote rational drug use.

Consumption of antidiabetic medicines in Portugal: results of a temporal data analysis of a thirteen\u2010year study (2005\u20132017)

BackgroundStudies of drug utilization in patients with diabetes, a chronic disease that can be treated with a wide range of available medicines, have attracted substantial social and clinical interest.ObjectiveTo characterize antidiabetic medicine consumption between 2005 and 2017, to evaluate the trends of these medicines in mainland Portugal, and to compare district consumption. An additional objective was to perform a statistical analysis on drug consumption in different regions of Portugal.MethodsA descriptive, longitudinal observational study; the setting was mainland Portugal ( excluding Azores and Madeira).Each medicine has a respective defined daily dose (DDD). The sum of the DDD, provides the annual consumption in terms of the DDD for each district each year. When calculating the annual average for the resident district population and the number of days in a year, the denominator is expressed as 1000 inhabitants per day (TID).Main outcome measure: The DDD/TID for mainland Portugal (for all districts) between 2005 and 2017 for antidiabetic medicines.Information was obtained from the official database of prescription medicine invoices with reimbursement in mainland Portugal.ResultsIn mainland Portugal, the antidiabetic medicine consumption was 49.3 DDD/TID in 2005 and 88.2 DDD/TID in 2017. The consumption of insulins and their analogs increased from 10.8% to 17.4% compared to the total consumption of antidiabetic medicines.In 2017, the level of biguanide consumption was 23.1 DDD/TID, that of sulphonylurea consumption was 15.8 DDD/TID, that of DPP-4 inhibitor consumption was 6.8 DDD/TID, and that of SGLT2 inhibitor consumption was 3.0 DDD/TID. The oral consumption of fixed-dose combinations reached 21.4 DDD/TID.After employing a geographical division between north and south and between coastal and inland regions, the consumption of several different drugs showed statistically significant differences.ConclusionsWhen comparing 2017 with 2005, the panorama was quite different, with higher levels of consumption of antidiabetic medicines, insulins and their analogs, noninsulin medicines, long-acting and fast-acting insulins and their analogs, metformin, DPP-4 inhibitors and, mainly, metformin combined with a DPP-4 inhibitor. The SGLT2 inhibitors achieved a representative consumption.Different consumption patterns may be related to sociodemographic factors or to clinical practices.

PND78 Real-World Burden of Comorbidities Along with Drug Utilization in United States Patients with Essential Tremors

To evaluate and compare mental health conditions and drug utilization in patients diagnosed with and without Essential Tremors (ET), using claims data from Truven Health Analytics MarketScan database. Using the Truven Health Analytics MarketScan® Commercial, and Medicare Supplemental databases (1/1/17-12/31/18), adult patients with ET (>22 years old) were identified. Newly diagnosed patients did not have a diagnosis for the 3 years prior to incident date. ET drug utilization in this population was used to identify type and frequency of initial prescription, as well as proportion of patients with ET who did not initiate treatment at diagnosis. The proportion of patients with mental health conditions was also identified and compared between cohorts of patients with and without ET in the commercial and Medicare Supplement setting. 68% of the newly diagnosed patients received 1 of the 5 drugs of interest (31% Propranolol, 15% Primidone, 14% Gabapentin). 32% of patients did not fill claims for any prescriptions within 24 months post ET diagnosis. 31.7% of ET patients with commercial coverage also received a diagnosis of depression during the 24 months post first ET claim, compared to 11.0% in the non ET cohort. (27.6% vs. 14.2% in a Medicare Supplement population). 39.3% of ET patients with commercial coverage received a diagnosis of anxiety in the same period, compared to 14.8% in the non-ET cohort. (34.1% vs. 14.4% in a Medicare Supplement population). The findings in this study suggest that a considerable number of ET patients do not initiate any treatment up to 24 months post the first claim of ET. Furthermore, the findings on depression and anxiety align with those described in the literature as common comorbidities for patients with ET.

1426-P: Utilization of Glucose-Lowering Drugs in Patients with T2DM and Established CVD in the U.S.

Background: People with T2DM have increased risks of CV morbidity and mortality. Glucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i) have been shown to reduce risks of CV events, but the degree to which they are used in clinical practice remains unknown. Our objectives were to describe glucose-lowering drug utilization in U.S. patients with T2DM and established CVD (eCVD) in 2014-18. Methods: Annual drug use by adults (≥ 18 years) with T2DM and eCVD (during the same 12-months) was determined from the MarketScan claims database. Results: We identified 345,340 (2014) to 227,418 (half year 2018) patients with T2DM and eCVD; hypertension and ischemic heart disease were the most prevalent eCVDs. About 55-60% of patients used any type of glucose lowering drug. Although the use of GLP-1 RA and SGLT2i increased 6.2 and 9.5 percentage points respectively across 2014-18, the use of dipeptidyl peptidase-4 inhibitors (DPP-4i) decreased by 3.7 points and use of other glucose lowering drugs decreased by 10.8 points. Patients who used GLP-1 RA and SGLT2i were 8 years younger than users of DPP-4i or other glucose lowering drugs. SGLT2i users had the lowest prevalence of chronic heart failure and chronic kidney disease. Conclusion: Despite recent increases, GLP 1-RA and SGLT2i are significantly underused among patients with T2DM and eCVD in the MarketScan claims database. Disclosure M.L. Ganz: None. A.V. Ustyugova: Employee; Self; Boehringer Ingelheim International GmbH. N. Sawalhi-Leckenby: None. S. de Souza: None. R. Gao: None. D. Homsy: None. E. Gunnarsson: None. L. Zhang: None. N. Desai: None.

Utilization of biologic disease-modifying anti-rheumatic drugs in patients with rheumatoid arthritis and cancer.

Biologic disease-modifying anti-rheumatic drugs (bDMARDs) interfere with the immune system and could theoretically increase risk of malignancies. However, recent evidence has not substantiated such concerns and physicians are less reluctant in treating patients with underlying cancer with such bDMARDs. We aimed to understand the current utilization patterns of bDMARDs for the treatment of rheumatoid arthritis (RA) in cancer patients. We performed a retrospective cohort study of patients with prevalent RA and cancer initially seen at MD Anderson Cancer Center between 2002 and 2014. A cohort of cancer patients was identified from the tumor registry, and patients with RA were identified through ICD-9 codes, followed by review of electronic medical records. We included patients 18years and older, with a cancer diagnosis, and a diagnosis of RA by a rheumatologist. Patients were followed until 2016. We identified 431 patients with RA and cancer that met our inclusion criteria. Overall, 111 (26%) received bDMARDs after their cancer diagnosis; of these, 60 (54%) had received bDMARDs prior to their cancer diagnosis and continued to receive this therapy following their diagnosis. Thirteen (22%) switched to a different bDMARD, and the rest continued to receive the same agent after their cancer diagnosis. Of all patients on a bDMARD, 91 (82%) received tumor necrosis factor inhibitors (TNFi). The treatment landscape of patients with a history of cancer and RA is changing. Future studies evaluating the safety of bDMARDs in patients with a recent history of cancer or with active cancer are needed. Part of the data of this project was presented as a poster at the 2016 American College of Rheumatology annual meeting. Zamora NV, Siddhanamatha H, Barbo A, Tayar J, Lin H, Suarez-Almazor M. Utilization of Biologic Therapy in Patients with Rheumatoid Arthritis and Cancer [abstract].Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/utilization-of-biologic-therapy-in-patients-with-rheumatoid-arthritis-and-cancer/. Accessed September 30, 2019. Key Points • One in four patients with RA and concomitant cancer received bDMARDs, including TNFi, after their cancer diagnosis, at our institution. • Half of the patients with RA and cancer who received bDMARDs had initiated therapy prior to the cancer diagnosis, continuing thereafter.

Assessing bleeding rates, related clinical impact and factor utilization in German hemophilia B patients treated with extended half-life rIX-FP compared to prior drug therapy

Objective: An extended half-life factor IX (FIX) fusion protein linking recombinant FIX with recombinant human albumin (rIX-FP), indicated for the treatment of hemophilia B, was approved by the European Medicines Agency in May 2016. We aimed to compare clinical outcomes and drug utilization in patients who switched from prior FIX therapies to rIX-FP.Methods: Anonymized patient chart data were collected from German institutions treating patients with hemophilia B. Patients were included if they had been treated with rIX-FP for ≥8 weeks at the time of data collection. Bleeding rates and FIX consumption were compared between rIX-FP and patients’ prior FIX products.Results: Data were obtained for 81 male patients treated with rIX-FP, including 59 who received prophylaxis with both their prior drug and rIX-FP (prophylaxis-to-prophylaxis group). Mean factor consumption in this group was 44.2 IU/kg/wk for rIX-FP compared with 82.3 IU/kg/wk for all prior FIX products. In addition, intra-patient analysis of factor consumption showed lower consumption of rIX-FP compared with prior FIX in 56 of 59 patients. Among the patients for whom bleed data were available (n = 42), annualized bleeding rate decreased from a mean (standard deviation) of 2.6 ± 2.9 on prior product to 0.3 ± 0.6 on rIX-FP. The proportion of patients with zero bleeds increased from 24% with prior therapy to 81% with rIX-FP.Conclusion: rIX-FP was associated with substantial reductions in bleeding rates and consumption of FIX compared with standard half-life products that require more frequent administration.

Drug utilization pattern in Schizophrenia

Background: Pharmacotherapy is the mainstay of treatment in schizophrenia. The economic impact of this illness is wide ranging, long lasting and huge. The emergence of newer antipsychotics has changed the prescribing pattern. Purpose of this study is to determine the prescription pattern of antipsychotic drugs and to analyse the drug utilization in patients with schizophrenia based on WHO prescribing indicators.Methods: A descriptive study was conducted for a period of 1-year duration at inpatient Department of Psychiatry of a Government Medical College in Kerala, India among 230 schizophrenic patients. The case sheets of patients meeting inclusion criteria were scrutinised to find out the antipsychotic prescription pattern and drug utilization was analysed using WHO prescribing indicators. Analysis was done using descriptive statistics.Results: Newer antipsychotics (55.2%) were prescribed slightly more in preference to older antipsychotic (44.8%) drugs. Out of the newer drugs prescribed olanzapine (20.9%) was prescribed the most followed by risperidone (18%). Haloperidol (22.9%) was the most frequently prescribed older antipsychotic. Majority (71.3%) of the patients were given more than one antipsychotics during the hospital stay. Trihexyphenidyl (27.9%) was the most frequently co-prescribed drug with antipsychotics. Average number of drugs per encounter was 4.19, 73.4% of the drugs were prescribed in their generic name, 50.4% of the encounters were with an injection prescribed. 44.4%of the drugs were prescribed from the EDL (WHO-19th edition). Average drug cost per encounter was Rs.45.43. Percentage of drug cost spent on injections was 8.44%.Conclusions: Newer antipsychotics were more prescribed for schizophrenia of which olanzapine was the commonest. Newer antipsychotics are preferred because of their propensity to cause less side effects and more efficacy. Study of pattern of drug utilization is useful for measuring the economic impact of drug use among patients thereby facilitating rational prescribing.

A prospective study of drug utilization in patients undergoing cataract surgery

A prospective study of drug utilization in patients undergoing cataract surgery

A prospective study of drug utilization in patients attending ophthalmology outpatient department at KBN teaching and general hospital of Gulbarga, India

Background: Drug utilization studies are an important part of rational use of drugs. Assessment of drug use pattern especially in developing countries is becoming increasingly necessary to promote the rational use of drugs. This study was planned to prospectively assess the drug utilization pattern in Ophthalmology outpatient department at KBN teaching and General hospital.Methods: After approval from Ethics Committee, the prescriptions of 1000 outpatients were analyzed using a predesigned form to record information from the OPD prescriptions. Mentioned WHO drug use indicators and additional indices were analyzed: Average number of drugs per prescription, number of encounters with antibiotics, percentage of encounters with injections, percentage of drugs prescribed by their generic names, percentage of drugs prescribed from the National Essential Drug List (NEDL), etc.Results: Prescription analysis showed that the average number of drugs per prescription was 2.6. The drugs were prescribed in the several forms, predominant dosage form been topical eye drops (69.58%) followed by tablets (11.98%), ointments (10.17%) and capsules (6.6%). The ‘dosage form’ was indicated for all of the drugs prescribed, the ‘frequency’ of drug administration was present in 96.5% of the drugs, and the duration of treatment for 82% of the drugs prescribed. Topical Antimicrobial agents were the most commonly prescribed drugs. followed by anti-inflammatory and anti-allergic, lubricants, anti-glaucoma drugs, etc. Percentage of drugs prescribed by generic name and from NEDL was 7.98% and 55 % respectively.Conclusions: The prescription writing errors were less, however, there was very low generic prescribing and inadequate information about the duration of therapy in many prescriptions. Generic prescribing can be improved. Duration of therapy should be mentioned in all prescriptions. It is essential that appropriate guidelines on the use of topical antimicrobials are required to ensure rational prescribing.

THU-126 - Drug utilization in patients with liver cirrhosis in ambulatory care

Background and Aims: Patients with liver cirrhosis are at risk to develop adverse events because of altered pharmacokinetics and pharmacodynamics. Some drugs have known safety risks in patients with cirrhosis, such as NSAIDs and benzodiazepines. There is not much known about drug use in these patients in ambulatory care, where drug use might be more risky because of less monitoring. Therefore,we aim to explore which drugs patients with liver cirrhosis use in ambulatory care. Method: In this retrospective longitudinal cohort study, data from an out-patient pharmacy database were combined with hospitalization data (PHARMO Database Network). Patients with a clinical diagnosis of cirrhosis (ICD-9 code 571.2 or 571.5) between January 1998 and December 2015were included in the study. The index datewas the first day of discharge from hospital with the diagnosis of cirrhosis. Data on drug dispensions were analyzed during the total follow-up of a patient. Results: In total 5,618 patients (59%males)were included with amean age at the index date of 60.7 ± 12.5 years. Patients were followed for a median of 3 years (interquartile range (IQR) 3) after the index date. In 179 patients (3.2%) follow-up ended because of a liver transplantation. During the total follow-up, 102,297 drugs were prescribed. General practitioners prescribed 61.5% of these drugs, specialists 36.4% and the prescriber was unknown in 2.2%. Patients used a median of 6.8 unique drugs per person per year (IQR 8.4). Drugs for acid related disorders (mainly proton pump inhibitors) were the most frequently used therapeutic group (70.9% of patients) followed by diuretics (63.5%) and antibacterials for systemic use (61.9%). For individual drugs, spironolactone (48.7%), furosemide (44.0%) and pantoprazole (34.9%) where used most often. Temazepam (23.2%), diclofenac (22.2%) and paracetamol (21.3%) were the most frequently used drugs for non-liver related co-morbidities. Looking at the group of benzodiazepines and NSAIDs; they were used by respectively 46.2% and 37.1% of patients during the total follow-up. Conclusion: Patientswith cirrhosis frequently use drugs in ambulatory care. A substantial proportion of patients used drugs with known safety risks in cirrhosis, such as NSAIDs and benzodiazepines. Attention is needed for both specialists and general practitioners when prescribing drugs to these fragile patients to prevent adverse events.

Evaluation and Assessment of Drug Utilization in Patients of Urinary Tract Infections

Urinary Tract Infections (UTIs) are among the typical bacterial infections occurring in both genders but considered a key public health issue causing morbidity, especially in women population. The present study was aimed to assess the drug utilization evaluation in patients of urinary tract infections from different hospitals and clinics. The study was carried out on both in-patients as well as out-patients, which were currently being following the treatment of urinary tract infections. All the necessary and relevant information were collected from outpatient department cards, treatment charts, laboratory data reports, patient history records and verbal communication with patients. Demographic analysis revealed that among a total of 110 patients, female patients were more in number than male patients. Age wise distribution showed that majority of UTIs patients (56.36%) were between 21–40 years of age. All patients were prescribed with antibiotics. Other drugs like analgesics, anti-emetics, antacids, smooth muscle relaxants, etc. were prescribed according to the complaints of the patients. Most commonly prescribed antibiotics were nitrofurantoin (63.63%) and amikacin (51.81%). The average number of drugs per patients reflected that patients with more than 5 drugs prescribed may result in polypharmacy. Rational use of drugs should be enhanced by the use of appropriate drugs while polypharmacy should be discouraged so as to reduce the risk of drug interactions. Appropriate treatment and sanitation is very important for the management of the disease and follow up is necessary to minimize the consequences of UTIs.

Trend data for administration of medications in patients with acute cerebrovascular accidents and its sequelae

AbstractThe trends in drug utilization in patients with acute cerebrovascular accidents (ACVA) and its sequelae were investigated in the Neurological Department of Lviv Regional Hospital, Ukraine, in 2007 and 2015. From the 10 anatomical groups of the Anatomical Therapeutic Chemical (ATC) classification system, in 2007, 181 medications were prescribed for treatment of ACVA and concomitant diseases, compared to 198 medications in 2015. The medications of Group C (Cardiovascular system) were of the maximal proportion in both analyzed periods (28.1% in 2007 and 29.8% in 2015). Moreover, the largest proportion of the prescribed medications of the 3rd level groups of the ATC classification system were of group В01А - “Antithrombotic agents” (7.2% in 2007 and 6.6% in 2015). Furthermore, three medications (Magnesium sulfate, L-lysini aescinas and Potassium chloride) were prescribed for 50% and more patients in both analyzed periods, while the prescriptions of other medications were characterized by high variability. АТС/DDD analysis also revealed the tendency toward an increase in prescription and drug utilization of the main medication groups, and that these were used for nonspecific and specific therapy for ACVA, as well as for secondary prevention (antihypertensives, anticoagulants, antiplatelet agents and statins). Totally, the drug utilization of these medication groups was 38.5% in 2007 and 58.0%, respectively, in 2015, compared to the overall number of DDDs. The results of our study suggest the existence of a positive tendency in prescriptions, and of compliance with the current principles of treatment, in patients with ACVA, in Ukraine.

A retrospective study on drug utilization in patients with acute exacerbation of bronchial asthma in adults at tertiary teaching hospital in Bidar

Background: Drug utilization plays a role in helping the health care system to understand, interpret and improve the drug use and continuous quality improvement. It plays an essential part of pharmaco Epidemiological studies.Methods: 100 prescriptions from patients with established diagnosis of acute exacerbation of Bronchial asthma were assessed from the Department of Pulmonary Medicine and the data gathered was analysed using MS Excel.Results: Majority of the prescriptions irrespective of severity received inhalation β2 agonist (formoterol) as a bronchodilator. Nebulization route was given for managing the acute exacerbations followed by inhalation route. Hydrocortisone was prescribed to all patients for managing acute Exacerbations. Montelukast was used an adjuvant therapy. Most of them were prescribed combination therapy. Theophylline was prescribed among all the methylxanthines.Conclusions: β2 agonists Combinations and corticosteroids are the most commonly prescribed combination drugs for asthma followed by methylxanthines. The most commonly prescribed asthmatic Medication in combination therapy was inhaled salbutamol with ipratropium followed by intravenous Hydrocortisone and oral Montelukast. The most commonly prescribed methylxanthine was intravenous Theophylline. Nebulization was preferred route to tackle the acute exacerbation of asthmatic symptoms.