Drug Utilization Evaluation and Assessment of Economic Burden of Anticoagulants in a Tertiary Care Hospital in South India

Abstract

Anticoagulants used for many indications, both prophylaxis and therapeutic treatment, are associated with high risk, hence drug utilization evaluation is essential. Objective: The objectives of the study were to evaluate the drug utilization of anticoagulants, assessment of anticoagulant cost in the prescription, identify and assess drug interactions with the use of anticoagulants. Method: This is a 6 months, prospective cross sectional study, evaluating 263 patients for their prescriptions containing anticoagulants in a tertiary care hospital in south India. Results: During the study period, among anticoagulants prescribed, Heparin is found most commonly prescribed for treatment as well as prophylaxis mainly in the cardiology and neurology wards. Acenocoumarol was the second most prescribed anticoagulant followed by Dalteparin Warfarin and Rivaroxaban. Intravenous heparin was prescribed in majority of inpatients of all the departments followed by Acenocoumarol and Enoxaparin. Only few Patients from departments other than cardiology and neurology are prescribed with Enoxaparin, Dalteparin Warfarin and Rivaroxaban. In the discharge prescriptions, Acenocoumarol and Enoxaparin were mainly observed. Among all the prescriptions, 7 cases are found to be prescribed with anticoagulants without any indication, which may increase treatment cost burden on patients. Dose adjustment for lower molecular weight heparin for patients with renal impairment was observed in the present hospital. But the monitoring parameters PT, PTT & INR are performed only in few patients. Moderate drug interactions are found in the prescriptions with mainly heparin and Acenocoumarol.

Anticoagulant Utilization and Cost Analysis among Cardiology Inpatients in a Tertiary Care Teaching Hospital of Western Nepal

“…These findings of our study were consistent with those of a study from our neighboring country, India [ 3 ], where unfractionated heparin and enoxaparin were prescribed above the optimal dose (1.3 and 1.1, respectively), warfarin was prescribed below the optimal dose (0.53), and NOAC (rivaroxaban) was prescribed within the WHOs provided optimal dose (1.0). The utilization of enoxaparin was more than twice in our study.…”

“…About 7 million people worldwide are taking anticoagulants for the management of their chronic diseases [ 2 ]. Anticoagulants are frequently prescribed drugs in deep vein thrombosis, pulmonary embolism, myocardial infarction, unstable angina, atrial fibrillation, acute coronary syndrome, rheumatic heart disease, vascular surgery, and prosthetic heart valve, in both inpatient and outpatient settings [ 3 ]. They are divided into oral (coumarin derivatives: warfarin and acenocoumarol) and parenteral agents [indirect thrombin inhibitors: unfractionated heparin (UFH) and low molecular weight heparin (LMWH), such as enoxaparin, dalteparin, and direct thrombin inhibitor, lepirudin].…”

[Retracted] Related Factors and Economic Burden Evaluation of Nosocomial Infection in Patients with Chronic Kidney Disease

“…Helping patients correctly understand their own health, apply health knowledge and skills, and improve self-care ability will help them maintain good health and quality of life. It is a health behavior designed to manage symptoms and signs of disease, reduce its impact on social functioning, mood, and relationships, and manage disease in the longterm [14].…”

“…Helping patients correctly understand their own health, apply health knowledge and skills, and improve self-care ability will help them maintain good health and quality of life. It is a health behavior designed to manage symptoms and signs of disease, reduce its impact on social functioning, mood, and relationships, and manage disease in the long-term [ 14 ]. The self-management model originated in the field of psychobehavioral therapy and was subsequently applied to health education programs for patients with chronic diseases.…”