DRUG PRESCRIBING PATTERN AND ITS POTENTIAL FETAL HARM AMONG PREGNANT WOMEN IN BISHOFTU GENERAL HOSPITAL, OROMIA REGIONAL STATE, ETHIOPIA (original) (raw)
Related papers
Prescription Pattern of Drugs in Pregnancy: A Review
International Research Journal of Pharmacy, 2015
Authors carried out a systematic review of peer-reviewed literature published from 2005-2014. We incorporated studies assessing individual-level exposures to medicines prescribed during pregnancy. We selected only those studies conducted in India and published in English. Published drug utilization studies reveal about 22% to 69.8% overall use of prescribed drugs during pregnancy excluding vitamins and minerals. On measuring antenatal drug use, the medications with positive evidence of risk (FDA category D) ranged from 4.8% to 24.25%. Iron, folic acid and vitamin supplements were most commonly prescribed drugs globally depending on the need of the patient and their benefit ratio. Overall drug use estimates are examined, use of drugs by therapeutic categories and by potential for fetal risk is considered while updating this review. Several studies consistently reported the usage of drugs with potential risks during pregnancy. Due to such extensive use, it is essential to develop standards for assessing and reporting antenatal exposures to refine any future research in this field. The prescribing practices of Indian physicians are similar to those in developed countries.
Assessment of Prenatal Drug Prescription Pattern at Mbabane Government Hospital
Background: Pregnancy is the time of profound physiological changes in a female's body. Maternal drug use during pregnancy may pose a teratogenicity risk to the fetus. However, the fact that drugs are needed to mitigate the complications during pregnancy cannot be avoided, therefore, this study is designed to assess prenatal drug prescription pattern at Mbabane Government Hospital.
Innovative Publication, 2016
Background: The principal aim of drug utilization research is to facilitate the rational use of drugs in populations. Pregnancy is a special physiological condition. Careful consideration of the benefit to the mother and the risk to the foetus is required while prescribing drugs during pregnancy. Material and Methods: Present study was Prospective, non-interventional & observational study conducted among 711 antenatal women in Obstetrics & Gynaecology Dept. during October 2014 to September 2015. Result: Out of 711 antenatal women majority 328 (46.13%) were in the age group of 22-25 years. Majority 568 (79.89%) of antenatal women were having mild anaemia while 21 (2.95%) were having moderate anaemia and majority of antenatal women were suffering from nausea and vomiting (12.37%) followed by pre-eclampsia (5.90%) and fever (3.79%). Most commonly prescribed drug was ferrous sulphate in 545 encounter followed by calcium, and vitamin B-complex same encounter 543. Total prescribed drug were 2661, from this most commonly prescribed drug class was miscellaneous about 1628 (61.18 %) drugs. Most commonly prescribed Drug in 1 st trimester was folic acid 167 (97.6%) while in 2 nd and 3 rd trimester it was ferrous sulphate 269 (98.89%)and 265 (98.88%) respectively. Average number of drugs prescribed was 3.74. Majority 2395 (90%) of drugs prescribed by generic name. Most of the prescribed drugs were belongs to FDA category A (91.13%). Conclusion: Most commonly prescribed drugs for antenatal women were ferrous sulphate, calcium, and vitamin B-complex by oral route.
Evaluation of Usage of Drugs in Pregnancy at Private Hospitals
Indian Journal of Pharmacy Practice, 2021
Background: Pregnancy represents a special physiological state during which the use of the drug is inevitable due to the risk of teratogenicity with drugs. The evaluation of prescribing drugs in pregnancy is required due to a lack of knowledge about the harmful effects of these drugs in pregnant women and fetuses. Aim: To evaluate prescribing pattern of drugs and the FDA drug risk category in pregnant women at private hospitals. Materials and Methods: The observational prospective and multicenter study were conducted in 386 pregnant women for 6 months. Each prescription was analyzed for demographic variables, medical illness, antimicrobials, risk categories of drugs prescribed, dosage forms, and WHO prescribing indicators. Results: A total of 2507 drugs were reported in the 637 prescriptions of 386 patients. A large proportion of women had anemia during pregnancy (42.9%). Majority of prescriptions prescribed oral dosage forms of drugs (81.53%) and injections (15.59%). The majority of drugs used in this study were from Category A which included anti-anemic, thyroid therapy drugs, vitamins, and minerals, followed by category C which included calcium supplements, muscle relaxants, and antihypertensive medications. No drugs were prescribed from category X. Conclusion: Iron, Calcium, and Folic acid along with Vitamins and Minerals were the most frequently prescribed drugs. In general, the drug use pattern is rational with few exceptions. The majority of drugs were used from category A followed by Category C. Drugs prescribed by their Brand name were higher than prescribed by their Generic name.
Medications use among pregnant women in Ethiopia: A cross sectional study
Despite lack of scientific evidence about the safety of some medications, the reported use of medications during pregnancies has increased. This may lead to adverse reproductive outcomes, due to potential risk to the mother and the fetus. In contexts of most developing countries including Ethiopia, it is difficult to elucidate medications use prevalence during pregnancy and their relative contributions to birth defects for several reasons. Institutionbased cross sectional study was conducted in Tertiary care hospital Ethiopia. Current medication use data were collected by reviewing patients' charts in the antenatal care follow up clinic, chronic care (internal medicine) as well as psychiatry clinic and by interviewing pregnant women using semi-structured questionnaire. Medications were classified using the United States Food and Drug Administration pregnancy risk classification system. A total of 339 women were included in the study; of which 187 (55.2%) had used at least one prescription and 162(52.2%) had used over the counter medications during pregnancy. The majority of the medications were antibiotics (42.5%) and analgesics (40.1%). 57(16.8%) and 24(7.1%) of medications were prescribed from category D and X respectively. Out of 187 (55.2%) prescription medications used, 51 (15.0%) were obtained without prescribers order. Majority (70.8%) of the women did not have awareness regarding risks associated with self medication. Prescription medications use was 0.08 times less among women with a co-morbidities (AOR 0.08(.05, 0.13), p=0.001) and 2.5 times higher among women from rural areas (AOR 2.53 (1.15, 5.56); P=0.02). Compared to employed women, over the counter medications use were 1.9 times more among house wife women (AOR1.87 (1.12, 3.09), p= 0.02) and about thrice higher among merchant women (AOR 2.88(1.10, 7.55), p= 0.03). Likewise, presence of medical problems was found to have 60% protective against OTC medications use (AOR 0.40 (.26, 0.64), p=0.01). The overall medications use during pregnancy was found to be high. Medications use without prescribers order was common and potentially harmful medications (category-D and X) use appeared to be higher in all trimesters. The findings of this study argue in favor of prescribing some potentially harmful medications which could have been avoided during pregnancy. Majority of the women lacked awareness about the potential risks associated with medications use in pregnancy without prescribers order.
Drug Utilization Pattern during Pregnancy in a Government Maternity Hospital -A Prospective Study
IOSR Journals , 2019
There are limited studies involving general medication use in pregnancy from the developing countries and most studies reviewed were from developed countries. Descriptive drug utilization research is intended to profile the population's use of medicines in order to identify areas deserving of further study or where interventions to address the irrational use of medicines may be appropriate. The importance of conducting descriptive drug utilization studies in high-risk populations such as pregnant women, children, and the elderly is widely recognized. Careful consideration of the benefit to the mother and the risk to the fetus is required while prescribing drugs duringpregnancy. In the present study 1000 pregnant women attending antenatal outpatient department of Modern Government Maternity Hospital, Petlaburg, Hyderabad were interviewed by questionnaire method to determine the drug utilization pattern during pregnancy. Iron, calcium, B complex and folic acid were the most frequently prescribed drugs. It was observed that majority of the prescribed drugs were from category A, the safest category during pregnancy, followed by category C. Antiepileptic drugs-Phenytoin And Efavirenz were the only drugs of category D. Co-morbid conditions like PIH, hypothyroidism, gestational diabetes mellitus, T.B, HIV were properly attended.
Asian Journal of Pharmaceutical and Clinical Research Journal, 2022
Objective: The aim of the study was to study and evaluate the pattern of drug use in pregnant women attending the antenatal clinic of obstetrics and gynaecology department at a tertiary care hospital. Methods: A prospective observational study was conducted at the Department of Gynecology and Obstetrics in M.G.M. Medical College and Hospital, Kishanganj, Bihar. The study included 368 pregnant women who consented and provided written informed consent for participation in this study during the study period from January 2020 to November 2021. Results: Time for seeking the first antenatal check-up was majorly in 1st trimester (48.10%), followed by 35.60% in the 2nd and 16.30% in the 3rd trimester. A total of 3054 drugs were prescribed in all three trimesters from all organ systems. The majority belonged to blood and bone-forming agents, followed by antimicrobials and gastrointestinal drugs. Analyzing the prescribing trend grossly depicts that the drug prescribing showed a gradual increase from 18 to 2nd trimester, followed by a slow drop in 3rd trimester. During the entire study period, there were 177 prescriptions for 1st trimester, 306 prescriptions for 2nd trimester, and 366 prescriptions for 3rd trimester. Conclusion: Our study site revealed a greater tendency to prescribe by generic name rather than by brand name in our hospital, which is a good sign as it reduces the economic burden on the patients. In other previous studies, it was less. Prescribing percentage of antibiotics in all trimesters was on the high rise, while the percentage of encounters with injection was within acceptable ranges. The majority of prescribing corroborated with national drug policy and was in concurrence with the national drug formulary and NLEM 2015, which reflects the essence of rational prescribing of pregnancy drugs in our set-up.
Drug can have harmful effect on the fetus at any time during pregnancy. It is important to bear this in mind when prescribing for a woman of child bearing age or for men trying to father child. During the first trimester drug may produce congential malformation (teratogenesis), and the period of greater risk is from the third to eleventh week of pregnancy. During the second and the third trimesters drugs may affect the growth and functional development of the fetus or have toxic effect on the fetal tissues and drug given shortly before term or during labor may have adverse effect on labor or-on the neonate after delivery. The main objective of this study was to assess drug utilization in pregnancy among pregnant women at University of Gondar teaching hospital. A retrospective study of drug utilization in pregnancy from ANC cards was conducted from February 15- March 15, 2012 at University of Gondar teaching hospital, North West Ethiopia to assess drug utilization during pregnancy in the hospital by using structured format for collection of data. A total of 400 women were included in the study; of which 96.75% were prescribed an average of 1.82 drugs during pregnancy. The most frequently drug during pregnancy were anti- anemic preparation, antibacterial followed by GIT drugs. Nearly 0.3% of the pregnant women were prescribed with drugs from category D and X of the US-FDA risk classification. Most of pregnant women were exposed to drugs, including those with potential harm to the fetus. Health care providers should thus weigh the therapeutic benefits of drug, to the mother against its potential risk to the developing fetus before prescribing.
BMC pregnancy and …, 2008
Background: The rationale for use of drugs during pregnancy requires a careful assessment as in addition to the mother, the health and life of her unborn child is also at stake. Information on the use of drugs during pregnancy is not available in Pakistan. The aim of this study was to evaluate the patterns of drug prescriptions to pregnant women in tertiary care hospitals of Pakistan. Methods: This was a cross-sectional study conducted at five tertiary care hospitals of Pakistan. Copies of outpatient medicinal prescriptions given to pregnant patients attending the antenatal clinics were collected. The drugs were classified according to the pharmacological class and their teratogenic potential. Results: All the pregnant women attending the antenatal clinics received a prescription containing at least one drug. A total of 3769 distinct prescriptions given to different women were collected. Majority of the women who received the prescriptions belonged to third trimester (55.4%) followed by second (33.6%) and first trimester (11.0%). On an average, each prescription contained 1.66 ± 0.14 drugs. The obstetricians at Civil Hospital, Karachi and Chandka Medical College Hospital, Larkana showed a tendency of prescribing lesser number of drugs compared to those in other hospitals. Antianemic drugs including iron preparations and vitamin and mineral supplements (79.4%) were the most frequently prescribed drugs followed by analgesics (6.2%) and anti-bacterials (2.2%). 739 women (19.6%) received prescriptions containing drugs other than vitamin or mineral supplements. Only 1275 (21.6%) of all the prescribed drugs (n = 6100) were outside this vitamin/mineral supplement class. Out of these 1275 drugs, 29 (2.3%) drugs were prescribed which are considered to be teratogenic. Misoprostol was the most frequently prescribed (n = 6) among the teratogenic drugs followed by carbimazole (n = 5) and methotrexate (n = 5). Twenty nine pregnant women (0.8% of all the women studied) were prescribed these teratogenic drugs. Conclusion: Less than one percent of the pregnant women attending tertiary care hospitals in Pakistan are prescribed teratogenic drugs. The prescribing practices of Pakistani physicians are similar to those in western countries.
African Journal of Pharmaceutical Research & Development , 2019
Drugs prescribed in pregnancy may diffuse across the placenta to the foetus thereby posing risk of teratogenicity. The rational use of drugs in pregnancy is paramount. The general objective of the study was to assess the pattern of drug utilization in pregnant women who attended antenatal outpatient department in Federal Teaching Hospital, Abakaliki, Ebonyi State (FETHA). A validated proforma was used to retrospectively retrieve information on drugs prescribed from 1st January 2013 to 31st December 2017 using the World Health Organization/International Network for the Rational Use of Drugs (WHO/INRUD) core prescribing indicators. Data were analyzed with descriptive statistics using the IBM SPSS version 25. Ethical approval was obtained from the Research and Ethics Committee of Federal Teaching Hospital, Abakaliki, Ebonyi State (FETHA) prior to conducting the study. A total of 1036 prescriptions were utilized, drawn from 415 patient folders. The mean age of the subjects was 30.66 ± 5.17. Most of the patients had tertiary education (82.6%) and were civil servants (46.6%). Patients' obstetrics history showed that about a fifth (20.2%) were primigravid and a tenth (9.9%), in their first trimester. Abdominal/muscle pains (7.9%), upper respiratory tract infections (7.7%) and malaria (7.3%) occurred most frequently. Haematinics (45.3%) were the most prescribed drugs while amoxicillin was the most frequently prescribed antibiotic (36.0%). The average number of drugs per encounter was 4.2. The percentage of encounters with an antibiotic and an injection prescribed were 12.9% and 0.96% respectively. Only 40.5% of the drugs were prescribed by their generic names. The average number of drugs per encounter was above the WHO/INRUD reference value. The percentage of drugs prescribed by generic name and from the essential drugs list or hospital formulary were less than 100%. Antibiotics and injections were not frequently prescribed. More efforts are needed to encourage rational prescribing, prescribing by generic name and the availability of drugs in the essential drugs list.