Department of Pharmaceutical Sciences, University College of Pharmaceutical Sciences, Kakatiya University, Warangal, Telangana, India.
Department of General Medicine, Kakatiya Medical College, Mahatma Gandhi Memorial Hospital, Warangal, Telangana, India.
Indian J Pharmacol. 2019 Sep-Oct;51(5):323-329. doi: 10.4103/ijp.IJP_743_17. Epub 2019 Nov 26.
Cardiovascular disease (CVD) is the primary cause of death globally despite the advanced health-care facilities. Extensive disparity exists in pharmacotherapy pattern among CVD patients where rational drug use plays a pivotal role in promoting safety and efficacy. The study focused to evaluate drug utilization using the World Health Organization (WHO) prescribing indicators and defined daily dose (DDD) in patients admitted to a teaching/referral hospital in Northern Telangana.
A total of 1120 medical records were analyzed for drug utilization for a period of 7 months. Prescription pattern was assessed using the WHO prescribing indicators and DDD to measure individual drug utilization categorized under anatomical-therapeutic-chemical classification.
Of the total admissions, 58.57% (55.19 ± 15.19 years) were male and 41.43% (56.64 ± 15.28 years) were female where coronary artery disease was the most common cause of admission followed by cardiomyopathy. Among prescribing indicators, percentage of drugs with generic names was least accounted with 26.86% and 18.95% during hospitalization and discharge, respectively. A mean of 11.55 (hospitalization) and 6.55 (discharge) drugs were prescribed per prescription. Antiplatelet (72.86%) and statin (80.62%) use was predominate during complete therapy. The DDD of furosemide (109.33) was found to be high, followed by atorvastatin (64.6), enalapril (58.44), aspirin (58.14) and clopidogrel (53.2).
Polypharmacy and least use of generic name were observed in the study which may affect the rationality. The use of antiplatelets, statins, and angiotensin-converting enzyme-inhibitors was appropriate, but furosemide overuse is of major concern. Therefore, appropriate prescription writing improvises treatment compliance in the patients, which results in rationality.
尽管医疗设施先进,心血管疾病(CVD)仍是全球主要死因。在 CVD 患者的药物治疗模式方面存在广泛差异,其中合理用药在促进安全性和疗效方面起着关键作用。本研究专注于评估在北特伦甘纳邦一所教学/转诊医院住院患者的药物使用情况,使用世界卫生组织(WHO)处方指标和限定日剂量(DDD)进行评估。
分析了为期 7 个月的 1120 例病历以评估药物使用情况。使用 WHO 处方指标和 DDD 评估处方模式,以衡量按解剖治疗化学分类分类的个体药物使用情况。
在总住院人数中,58.57%(55.19 ± 15.19 岁)为男性,41.43%(56.64 ± 15.28 岁)为女性,其中最常见的入院原因是冠状动脉疾病,其次是心肌病。在处方指标中,在住院和出院时,分别有 26.86%和 18.95%的药物使用了通用名。每张处方平均开具 11.55(住院)和 6.55(出院)种药物。在整个治疗过程中,抗血小板(72.86%)和他汀类药物(80.62%)的使用率较高。发现呋塞米(109.33 DDD)的 DDD 较高,其次是阿托伐他汀(64.6 DDD)、依那普利(58.44 DDD)、阿司匹林(58.14 DDD)和氯吡格雷(53.2 DDD)。
本研究中观察到多药治疗和通用名使用率最低,这可能会影响合理性。抗血小板、他汀类药物和血管紧张素转换酶抑制剂的使用是适当的,但过度使用呋塞米是一个主要问题。因此,适当的处方书写可以提高患者的治疗依从性,从而提高合理性。