A study of drug utilization in indoor patients of high-risk pregnancy in a tertiary care hospital (original) (raw)
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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.
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.
Prescription drug use in pregnancy
American Journal of Obstetrics and Gynecology, 2004
Objective: The purpose of this study was to provide information on the prevalence of the use of prescription drugs among pregnant women in the United States. Study design: A retrospective study was conducted with the use of the automated databases of 8 health maintenance organizations that are involved in the Health Maintenance Research Network Center for Education and Research on Therapeutics. Women who delivered of an infant in a hospital from January 1, 1996, through December 31, 2000, were identified. Prescription drug use according to therapeutic class and the United States Food and Drug Administration risk classification system was evaluated, with the assumption of a gestational duration of 270 days, with three 90-day trimesters of pregnancy, and with a 90-day period before pregnancy. Nonprescription drug use was not assessed. Results: During the period 1996 through 2000, 152,531 deliveries were identified that met the criteria for study. For 98,182 deliveries (64%), a drug other than a vitamin or mineral supplement was prescribed in the 270 days before delivery: 3595 women (2.4%) received a drug from category A; 76,292 women (50.0%) received a drug from category B; 57,604 women (37.8%) received a drug from category C; 7333 women (4.8%) received a drug from category D, and 6976 women (4.6%) received a drug from category X of the United States Food and Drug Administration risk classification system. Overall, 5157 women (3.4%) received a category D drug, and 1653 women
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.
2020
Objective: To carry out prescription analysis and assign risk category as per USFDA (United States Food and Drug Administration) to prescribed drug during pregnancy in a tertiary health care center at Raipur, Chhattisgarh.Method:This cross-sectional study was carried out over the period of 2 months in obstetric OPD (outpatient department) at tertiary health care center Raipur. Pregnant woman of any trimester was recruited from ANC (antenatal clinic) after obtaining informed written consent. Important information collected was demography, gravida, parity, trimester of pregnancy, reason for visit to clinic, history of any chronic illness, names of drugs prescribed with their doses and frequency of administration. Prescription analysis was carried out and USFDA risk category had been assigned to each of the drug.Results:Total 340 drugs were prescribed for 75 patients.And 51.43% pregnant women were from 3rd trimester of pregnancy. Most of pregnant women(92.86%) reported to OPD for regul...
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.
African Health Sciences
Background: Despite the lack of adequate studies on the safety of drugs in pregnancy, surprisingly, available evidence shows that pregnant women still take large number of drugs. Objectives: The study aim was to determine drug utilization pattern and predictors of number of medications used by pregnant women. Methods: This was a cross-sectional survey of 369 pregnant women attending a secondary health facility. Data were collect- ed using interviewer-administered questionnaire. Descriptive and inferential statistics using the Chi-Square test were carried out with level of significance set at p<0.05. Results: Three hundred and sixty-nine women were interviewed. Their mean age was 27.7 years (SD± 4.78) and the mean number of pregnancies was 2.46 (SD± 1.34). On average, 2.62 medications were taken, with the lowest being 1 and the highest being 12 different medications during the course of pregnancy. Those who were on more than 2 medications were more likely to be older than 30 years...
Indian Journal of Pharmacy Practice, 2015
Background: Pregnancy is a special physiological condition where the treatment needs a special concern. Moreover, pharmacotherapy during pregnancy is very challenging since only a few medicines have been specifically tested for safety. Objective: The aim of this study was to evaluate the utilization pattern and the teratogenicity risk of the drugs prescribed to pregnant women in Fiche Hospital, Ethiopia. Methods: A retrospective study was conducted by reviewing medical case files of 323 pregnant women, encountered with at least one drug, out of 1876 pregnant women attending antenatal clinic from February 09/2013 to March 09/2014. The prescription pattern was assessed from perspectives of World Health Organization (WHO) core drug use indicators, and the United States Food and Drug Administration (FDA) fetal harm classification. Results: Among 1876 pregnant women who visited ANC clinic, a total of 323 women received 456 medications. The age of the patients was within the range of 16-49 years and the majority of them (77.22%) were within the age group of 20-35 years. The majority of pregnant women (80.47%) visited antenatal care (ANC) during their first trimester gestation. Out of the total drugs prescribed, category A drugs comprised 20.83%, category B (26.34%), category C (24.34%), category C/D (9.65%), category D (9.43%) and category X (1.09%). Percentage of encounter with antibiotics and injectable drugs were 31.8% and 19.30%, respectively. Conclusion: Approximately half of the pregnant women utilized drugs from FDA category C, D and X which are thought to cause fetal harm; therefore, the use of these drugs should be minimized.
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.
Predictors of the use of medications before and during pregnancy
International Journal of Clinical Pharmacy, 2013
Background Drug use in pregnancy is often reason of concern for mothers and their physicians. However, only few studies investigated predictors of drug use in pregnancy. Objectives To examine maternal characteristics as predictors of medication use in the 6 months before pregnancy and during the first 6 months of pregnancy. To examine whether prescription and over-the-counter (OTC) medication use in the 6 months before pregnancy had an impact on medication use in pregnancy. Setting Six maternity care units and five community pharmacies. Method Data were collected using a specially designed self-reported questionnaire during the period March 2009-March 2010. Logistic regression was used to identify factors associated with medication use. Main outcome measure Adjusted odds ratios (aOR) and 95 % confidence intervals (CI) were used as association measures.