Drug Utilization and Prescribing Pattern of Glaucoma in a Tertiary Care Hospital of Dehradun

Abstract

Glaucoma is a condition in which distinctive changes occur in the optic nerve and visual field. In glaucoma intraocular pressure (IOP) is raised that compresses and damages the optic nerve. As the optic nerve is damaged, it fails to carry the visual information to the brain which induce clinically progressive loss of peripheral visual field and ultimately loss of vision. AIMS AND OBJECTIVES: To Evaluate the drug utilization and prescribing pattern of drugs used for treatment of glaucoma, to analyze current prescribing trends in anti-glaucoma drugs, to perform a drug utilization study, to identify drugs per prescription, category wise identification of drugs prescribed, mono therapy vs combination therapy. MATERIALS AND METHODS: The present study was a prospective, observational study carried out in 105 patients at Shri Mahant Indiresh Hospital, Dehradun, Uttarakhand, India. RESULTS: Out of total 105 patients, 68 were males (64.76%) and 37 were females (35.24%). The most common age group was 46-60 years. Patients were mostly affected by primary open angle glaucoma (95.23%) then angle closer glaucoma (4.76%). Total 184 drugs were prescribed in the treatment of glaucoma. Average number of drugs per prescription was 1.75. Combination therapy was prescribed in 51.43% patients & most common used combination therapy was combination of Brimonidine+ timolol (81.48%) followed by Bimatoprost+ timolol (18.52%). Monotherapy was used in 48.57% patients in which drug dorzolamide (22.31%) was prescribed mostly which is belongs to the category of carbonic anhydrase inhibitors followed by timolol (19.23%) (β- blockers) which was second line choice of drug. Generic drugs were mostly prescribed in 77 patients (73.33%) followed by 28 patients (26.66%) were brand names. CONCLUSION: The prescription analysis of glaucoma patients concluded that monotherapy with dorzolamide was the first line choice for glaucoma therapy and timolol was found to be the second line choice. Timolol+ brimonidine was the mostly prescribed combination of drug. It also showed that all drugs were prescribed in their generic name instead of brand name.

A Drug Utilization Study of Anti-glaucoma Drugs in a Tertiary Care Hospital

“…These findings were similar to the Bayesian metaanalysis by Rudnicka et al [10] and the study by Allison et al [11]. The average number of drugs per prescription was 1.75 (95% CI: 1.04-2.47), which concords with the findings of some previous studies [7,[13][14][15]. Most participants (61%) had received combination therapy, which might have contributed to a more significant IOP reduction by different mechanisms.…”

“…Though various drug utilization studies have been conducted regarding anti-glaucoma drugs in India [3][4][5][6][7], only a few have done detailed analyses [8,9]. Age and gender-based variations regarding the epidemiology of glaucoma have prevailed for decades.…”

Evaluation of antiglaucoma drug treatment awareness and patient-reported medication adherence: Determinants of glaucoma management

“…There are few studies about POAG prescription patterns in western India;[ 24 25 26 ] hence, we conducted the study wherein the average number of drugs was 2.53. In a study done by Advani et al ., in western India, the average number of antiglaucoma drugs per prescription was 1.36,[ 27 ] and 54% of drugs were prescribed with their generic name.…”