A Comparative drug utilization study of depression patients between tertiary care teaching hospital and private practitioners of Dehradun city, Uttarakhand

Abstract

the least number of drugs to obtain the best possible effect in the shortest period and at a reasonable cost 2 . Irrational prescribing and disparity between the prescription and the consumption of medicines may offset the benefits. The recent proliferation of new ABSTRACT Background: Drug utilization studies are beneficial in clinical practice for rational prescribing, as there is continuous proliferation of new drugs and the increasing recognition of their delayed adverse effects. Depression is an important global public health problem thus making such studies a must for minimizing the medication errors. Aim and objectives: Present study audits the prescribing pattern of psychiatric private practitioners (PPs) vs psychiatric practitioners of tertiary care teaching hospital (TCTH) at Dehradun, Uttarakhand. Materials and methods: A total of 371 prescriptions were analysed, 196 were collected from PPs and 175 from TCTH at Dehradun. They were analysed using WHO drug use indicators and National List of Essential Medicines (NLEM-2013). Results: Anxiolytics 150(25.25%) were most commonly prescribed by the PPs followed by antidepressants 120(20.20%) and antipsychotics 111(18.48%), whereas antidepressants 105 (27.78%) was the major drug group prescribed by TCTH followed by anxiolytics 102(26.98%) and antipsychotics 37(9.79%). Tricyclic antidepressants(TCAs) were most frequently prescribed antidepressants followed by selective serotonin reuptake inhibitors(SSRIs) at TCTH whereas SSRIs were the major antidepressants prescribed by PPs. Anxiolytics and anticholinergics co-prescription with antidepressants and antipsychotics respectively, was a common observation among PPs and TCTH. Analysis of prescription revealed average number of drugs prescribed per prescription in teaching hospital is 2.16 vs 3.03 among the private practitioners. 18.25% Fixed drug combinations(FDCs) were prescribed by TCTH while 0% were prescribed by PPs. 55.39% and 55.56% drugs were prescribed from the NLEM-2013 by the PPs and the TCTH respectively. Conclusion: There were lesser number of drugs prescribed per prescription and more frequent use of drug combinations at TCTH while no drug combinations and greater number of drugs per prescription were prescribed by PPs. Newer class of drugs were more frequently prescribed by PPs.