Evaluation of Drug Utilization Pattern among Geriatric Patients in a District Head Quarters Government Hospital using World Health Organization Indicators (original) (raw)
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Drug utilization studies on geriatric population are an area of research where the data available is very limited and this population is generally neglected. This study was done to assess the usage of essential medicines and to identify the diseases common among this population. It was a cross sectional, unicentric observational drug utilization study with admitted patients in medicine ward as study population. The sample size was 111 patients. The case sheets of the patients were verified after obtaining written informed consent and the drugs prescribed were analyzed. The majority of patients were found to be in the age group of 60 to 70 years (76%).It was noticed that males were more (63%) compared to females. The drugs prescribed were categorized and drugs used for respiratory disorders were used more commonly of which Deriphylline was prescribed for almost half of the patients in this study group. The Average number of drugs per prescription was 9.4±0.31 (SEM). Average drug cost per admission was Rs.981.93±87.49 (SEM). Brand names were used (74%) in preference to generic names. Among the drugs prescribed 78% were from the national list of essential medicines (NLEM) and only 58% were from the WHO Essential Medicines List. This study revealed the chronic nature of diseases affecting the geriatric population with an increased incidence of respiratory diseases and rightly the drug deriphyllin was the most common drug utilized. The pattern of drug prescription also shows a trend towards polypharmacy (> 5 drugs) which has to be viewed with caution given the pharmacokinetic changes in the elderly. These studies can help to promote rational use of drugs.
International Journal of Medicine and Public Health, 2015
A study of the prevalence of potentially inappropriate medication in elderly in a tertiary care teaching hospital in the state of Odisha Introduction: Quality and safety of prescribing in older people remains a global healthcare concern. Inappropriate prescribing in the elderly population is now considered a major public health issue because of its direct association to morbidity, mortality and wastage of health resources. The study was initiated to study the prevalence of potentially inappropriate medications (PIMs) in elderly patients coming to seek health care in a tertiary care teaching hospital in Odisha. Materials and Methods: 2012 AGS Beers Criteria was used to analyse the inappropriateness of the prescriptions in 700 new as well as old patients of either sex who had completed 65 years of age as on 30th September 2013. Data obtained was analyzed with the help of SPSS version 20.0. Multivariate logistic regression was applied to find out the predictors of PIM. Results: 21.86% patients were prescribed at least one potentially inappropriate medication. Most of the drug use was seen in the age group of 65-74 years. Multivariate logistic regression analysis showed that increased number of concurrent medications use (OR: 1.95, CI: 1.19-3.01, P = <0.01) was the predictor of inappropriate medication use as per 2012 AGS Beers Criteria. Age, gender and co-morbidity did not influence the use of inappropriate drugs. Conclusion: Inappropriate prescribing to elderly patients is influenced by the total number of drugs prescribed to an elderly patient. There is a need to improve the prescribing pattern in elderly. This will reduce the occurrence of adverse drug reactions, cost of treatment, and increase compliance in elderly patients.
International Journal of Pharmacy and Pharmaceutical Sciences, 2017
Objective: This study was conducted to generate the data on drug utilization pattern among geriatric inpatients in general medicine department. Methods: The patient's prescriptions and medical record files were randomly selected on the basis of inclusion and exclusion criteria at medicine department of Shri Mahant Indiresh Hospital, Dehradun and the required data for the study were collected in well-designed data collection form and evaluated after the period of 3 mo. Results: Conclusion: Most of the drugs were utilized by male patients and the rate of polypharmacy was high. Among 175 patients, males were predominant and 31.42% patients were in age group of 71-75 y. Cardiovascular diseases (28%) were most common cause of hospitalization followed by, respiratory disorders (20.57%). Hypertension (25.72%) was most commonly diagnosed disease followed by, diabetes mellitus (22.2%) and chronic obstructive pulmonary disease (14.28%). The most common comorbidity was hypertension and diabetes mellitus. More than 3 co-morbidities were found in 79 patients. Cardiovascular drugs (22.17%) was most frequently prescribed drug followed by, gastrointestinal drugs (15.30%). Among individual drugs pantoprazole (A02BC02) was most commonly prescribed drugs. Total of 1581 drugs was prescribed with an average of 9.03 drugs per prescription. Only 9.63% drugs were prescribed by generic name. Antimicrobials were prescribed in 146 prescriptions, among them ceftriaxone (J01DD04) was frequently prescribed.
Pharmacoepidemiological profile and polypharmacy indicators in elderly outpatients
Brazilian Journal of Pharmaceutical Sciences, 2013
This cross-sectional study was carried out with 1000 elderly outpatients assisted by a Basic Health District Unit (UBDS) from the Brazilian Public Health System (SUS) in the municipality of Ribeirão Preto. We analyzed the clinical, socioeconomic and pharmacoepidemiological profile of the elderly patients in order to identify factors associated with polypharmacy amongst this population. We used a truncated negative binomial model to examine the association of polypharmacy with the independent variables of the study. The software SAS was used for the statistical analysis and the significance level adopted was 0.05. The most prevalent drugs were those for the cardiovascular system (83.4%). There was a mean use of seven drugs per patient and 47.9% of the interviewees used ≥7 drugs. The variables that showed association with polypharmacy (P value < 0.01) were female gender, age >75 years, self-medication, number of health problems, number of medical appointments, presence of adverse drug events, use of over-the-counter drugs, use of psychotropic drugs, lack of physical exercise and use of sweeteners. The exposition to all these factors justified the high prevalence of polypharmacy amongst the interviewees. These results showed the need to adopt clinical intervention and educational and managerial measures to analyze and promote rationality in the use of drugs amongst the elderly users of SUS.
Asian Journal of Pharmaceutical and Clinical Research, 2020
The current study aims to evaluate prescribing pattern and potentially inappropriate medicine (PIM) among elderly patients in a tertiary care hospital of western Nepal. Methods: A prospective cross-sectional study was conducted in the outpatient department of Manipal Teaching Hospital of Western Nepal. The World Health Organization prescribing indicators and Beers' 2015 updated criteria were assessed to analyze the result. Results: The mean±standard deviation of the age was 73.47±6.42 years and the majority of patients were in the age group 65-74 (58.81%). Male preponderance (male: female=1.20:1) was found. The value of prescribing indicator includes the average number of drug per prescription (4.91), percentage of generic name prescription (3.40%), percentage of antimicrobials prescribed (19.40%), percentage of injections prescribed (2.70%), and percentage of the drug from essential drug list of Nepal (42.22%). At least one PIM was prescribed to 87 (21.6%) patients. Non-cyclooxygenaseselective nonsteroidal anti-inflammatory drugs (44%) and anticholinergics (18%) were the most frequently prescribed PIMs. Conclusions: Polypharmacy, PIMs, and potential drug-drug interaction were prevalent in this study. It is recommended that all the doctors, pharmacists, other concerned health-care professionals, patients, policymakers, and all other stakeholders must be aware of these situations and a multidisciplinary approach must be developed for the promotion of rational use of drugs.
Drug, Healthcare and Patient Safety, 2019
Background: Rational drug use is a critical component in patient care, particularly among the elderly who often have multiple medical problems. The aim of this study was to assess the pattern of medication use among the elderly visiting primary health care facilities. Methods: A retrospective cross-sectional study was conducted at 25 primary health care facilities in Karawang District, Indonesia, and patients aged ≥60 years visiting the facilities from January to December 2014 were included. A systematic random sampling technique was used to select the study samples. Each prescription was assessed using the WHO prescribing indicators. Results: A total of 10,118 prescriptions with 31,927 drugs were assessed. The average number of drugs prescribed was 3.15 (range: 1-7). Drugs prescribed by generic name comprised 98.09% (n=31,318) of the total number of drugs. Medical appointments wherein an antibiotic was prescribed constituted 23.45% (n=2373) of the total number of prescriptions. No injections were prescribed in this study setting. Drugs prescribed from the essential drug list comprised 83.07% (n=26,522). Paracetamol (13.44%), vitamin B complex (8.05%), and aluminum-magnesium hydroxide (7%) were the most frequently prescribed drugs, whereas amoxicillin (44.03%), chloramphenicol (13.10%), and ciprofloxacin (12.00%) were the most frequently prescribed antibiotics. Conclusion: Our findings highlight that polypharmacy and prescription of essential drugs remain subjects of concern in geriatric health care. Regular medication review and promoting the use of the essential drug list among health care professionals are encouraged in primary care settings.
Journal of Bioanalysis & Biomedicine, 2017
Background: Population ageing is a result of high life expectancy and declining fertility. Medication use in older people is a particular public health concern since the older population has a higher prevalence of multiple drug use referred to as 'poly-pharmacy'. This study aimed to determine poly-pharmacy and the contributing factors among elderly patients at Shashemene Referral Hospital. Materials and methods: A Health facility based prospective cross sectional study was conducted. Elders of 65 and above years old were enrolled. Data was analyzed by SPSS version 16.0 software. Logistic regression analysis was used to assess association of variables with poly-pharmacy. Statistical significance was conducted at p-value<0.05. Results: The total number of population enrolled in the study was 116 elders (60 yrs old and above). Among this, 59.5% were males. The primary diagnosis of most patients was infection (50% (n=58)) and followed by cardiovascular disorders (18.1% (n=21)). The widely used drug group was antimicrobials (58.7%), followed by cardiovascular (25%) and GIT drugs (13.8%). Almost half, (48.3%), of population were taking 1-2 drugs. The maximum total number of drug per patient was seven drugs of the same or different classes. Poly-pharmacy was observed among almost one-third (32.75%) of study subjects with highest prevalence among younger elders (65yrs-69 yrs old). The polypharmacy that has been seen in elderly in highest prevalence was appropriate poly-pharmacy, 79%. Co-morbidity (AOR=7.427) and occupation, employee, (AOR=8.840) were the contributing factors of poly-pharmacy. Conclusion and recommendations: In this study, a total of 116 elderly patients, 69 males and 47 females, were involved. The primary diagnosis of most patients was infection. Co-morbidity has been seen in over one-third of the study subjects. The widely used drug group was antimicrobials, followed by cardiovascular. The study also shows that poly-pharmacy was prevalent in almost one third of the elderly patients in SRH. The multivariate logistic regression showed that co-morbidity and occupation, employee, were the factors independently associated with poly-pharmacy. The health care system should improve the prescribing process among elderly patients.
2013
Drug utilization studies on geriatric population ar e an area of research where the data available is v ery limited and this population is generally neglected. This study was done to assess the usage of essential medicines and to identify the diseases common among this population. It was a cross sectional, unicentric observational drug uti lization study with admitted patients in medicine ward as study po pulation. The sample size was 111 patients. The cas e sheets of the patients were verified after obtaining written informed consent and the drugs prescribed were anal yzed. The majority of patients were found to be in the age gr oup of 60 to 70 years (76%).It was noticed that ma les were more (63%) compared to females. The drugs prescribed were categorized and drugs used for respiratory disord ers were used more commonly of which Deriphylline was prescribed for almost half of the patients in this study group. The Average number of drugs per prescription was 9.4±0.31 (SEM). Average ...
Pharmacoepidemiology and the ?Impact Factor?
European Journal of Clinical Pharmacology, 2005
The field of ''Pharmacoepidemiology/Drug Utilization'' research has been analysed by studying published research articles under the medical subject headings (MeSH terms) ''Pharmacoepidemiology'', ''Drug Utilization'' and ''Drug Utilization Review''. There were 1822 articles published, and stored in Medline, during the 32-month period between 1 January 2001 and 31 August 2003; these papers might represent a field of research, due to the similarity of MeSH terms used for coding and the set of journals in which the articles were published. A total of 457 articles, representing 25% of all articles in the field, were published in 14 different journals, and 50% of all articles (948) were collected in only 64 different journals. The two main journals publishing research in ''Pharmacoepidemiology/ Drug Utilization'' are Pharmacoepidemiol Drug Saf and the Eur J Clin Pharmacol. These two publications are the official journals of the three main societies in the field and are at least partially focused on this subject, with 45.7% of all articles in Pharmacoepidemiol Drug Saf and 11.1% of all articles in Eur J Clin Pharmacol included under the studied MeSH terms; other journals only occasionally publish papers in this line of research. These two journals are the leaders in pharmacoepidemiology and drug utilization research, having impact factors (IFs) in 2002/2003 above (1.955/1.972 for EJCP) and a bit below (1.092/1.257 for PDS) the middle of the ranking of publications, according to the IF, in the ''Pharmacology and Pharmacy'' list of the Science Citation Index (SCI).
Indian Journal of Pharmacy Practice, 2019
Background: Globally, the population of elderly is gradually rising. Co-morbidities and polypharmacy are the prime reasons for the inappropriate use of medications. Objective: A prospective, observational study was conducted in a South Indian tertiary care teaching hospital to assess the medication prescribing pattern in elderly patients and also to evaluate the inappropriateness of medications using Beer's criteria. Materials and Methods: Institutional ethics committee has approved the study. Written informed consent was taken from all the enrolled elderly patients meeting the inclusion criteria. Necessary demographic, clinical, laboratory and therapeutic information was collected and recorded in a suitably designed data collection form and the same was evaluated for prescribing pattern and inappropriateness using Beer's criteria. Results: A total of 104 patients aged above 60 years were enrolled into the study. Among them 64 patients (61.53%) were males and 40 (38.46%) were females. Among these patients 61 (58.65%) patients were in the age group of 60-65 years, 25 (24.03%) were in 66-70 years, 12 (11.53%) were in 71-75 years, 6 (5.76%) were >75 years. Common cause for hospital admission was hypertension and diabetes. As per Beer's criteria, 91.3% prescriptions given to the study patients were found inappropriate. Antibiotics and Pantoprazole were the most commonly prescribed drugs. The study findings suggest that use of poly pharmacy is high and majority medications prescribed were found inappropriate as per the Beer's criteria. Conclusion: Presence of clinical pharmacist would optimize the drug therapy and minimize the drug related problems and negative therapeutic outcomes in elderly patients.