Drug utilization in a hospital general medical outpatient clinic with particular reference to antihypertensive and antidiabetic drugs

Yuen, Yin; Chang, Sophie; Chong, Chun-Kong; Lee, S C; Critchley, J. A. J. H.; Chan, Jacky

doi:10.1046/j.1365-2710.1998.00161.x

Cited by 34 publications

(36 citation statements)

References 29 publications

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“…[4][5][6] Furthermore, parenteral PPIs are relatively expensive, and inappropriate use can increase the treatment cost significantly for patients, especially in developing countries. 7 Achieving appropriateprescribing practices regarding parenteral PPIs will be necessary to obviate these issues and challenges. Numerous methods have been used to evaluate patterns of drug use in hospitals, including prescription and physician surveys, analysis of drug sales or drug consumption data, and reviews of medical records.…”

Section: Introductionmentioning

confidence: 99%

“…Numerous methods have been used to evaluate patterns of drug use in hospitals, including prescription and physician surveys, analysis of drug sales or drug consumption data, and reviews of medical records. 7 Among these methods, prescription surveys have been the most popular for evaluating prescribing practices or medication use in hospitals. Such surveys are quick and inexpensive, and do not require the participation of prescribers or patients.…”

Section: Introductionmentioning

confidence: 99%

“…Such surveys are quick and inexpensive, and do not require the participation of prescribers or patients. 7 Health-care in India is highly privatized and poorly regulated. 8 IV PPIs are widely prescribed in hospitals.…”

Section: Introductionmentioning

confidence: 99%

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Prospective Assessment of Prescribing Pattern of Intravenous Proton Pump Inhibitors in an Indian Tertiary-Care Teaching Hospital

Churi¹,

Jogani²

2015

IJOPP

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Context: Inappropriate use of intravenous proton pump inhibitors (IV PPIs) has been a major challenge for private health-care setups. Inappropriate prescribing may result in increased shortages of IV PPIs in hospitals, therapeutic burden, adverse effects, and treatment costs. Therefore, the study was sought to determine drug utilization patterns (appropriateness and inappropriateness) of IV PPIs in an Indian tertiary-care teaching hospital. Aims: To assess the drug utilization pattern of IV PPIs in a tertiary-care teaching hospital. Settings and Design: This was a prospective observational study. Methods and Material: This study was conducted over a period of one month. Patients who were ≥18 years of age, who were admitted in the internal medicine, surgery, or gastroenterology wards, and who were receiving IV PPIs were included in the study. Paediatric patients and outpatients were not enrolled in the study. Ddemographics, past medication and surgery, current medical condition and medication, dose, dosing interval, duration of therapy, length of stay, and endoscopic details of each patient was collected from patients' case notes, treatment charts, and laboratory/diagnostic test reports, and evaluated for appropriateness regarding indication. Statistical analysis: Chi square test (χ 2 ) was used to analyze the data. Results: Prospective assessment involved 611 patients over a 1-month period. For prophylaxis (stress ulcer, pre-operative and postoperative prophylaxis) and treatment, IV PPIs were prescribed inappropriately to 289 (89.2%) internal medicine and 97 (34.04%) surgery ward patients. Prolonged therapy was found in patients who received IV PPIs for stress ulcer prophylaxis. Conclusion: This study revealed significant inappropriateness of PPI administration with particular reference to indication to use, duration of therapy, and changeover of therapy in an Indian tertiary-care teaching hospital.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prospective Assessment of Prescribing Pattern of Intravenous Proton Pump Inhibitors in an Indian Tertiary-Care Teaching Hospital

Churi¹,

Jogani²

2015

IJOPP

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“…Similar patterns of prescribing to those found in this study have been reported in earlier smaller studies in other clusters of Hong Kong. [31][32][33] Hypertension is the second commonest condition seen in primary care clinics in the public health-care sector, 33 and the majority of the local population is under the public health services for management of hypertension. 34 In addition, hypertensive patients on different classes of antihypertensive drugs had different demographic and clinical characteristics.…”

Section: Strengths and Weaknesses Of This Studymentioning

confidence: 99%

Profiles of mortality among Chinese hypertensive patients in Hong Kong: a cohort study

et al. 2009

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We studied the profiles of all-cause and cardiovascular (CVS) mortality among users of different antihypertensive classes in a Chinese population. From electronic patient records, a cohort study was conducted among 18 338 patients who ever newly prescribed an a-blocker, thiazide diuretic, b-blocker, calcium channel blocker (CCB) or agents acting on the renin-angiotensin system (RAS) without drug discontinuation or switching in the public primary-care sector in a large Territory of Hong Kong during January 2004-June 2007. The odds ratios of mortality (all-cause and CVS) were evaluated according to the prescribed antihypertensive drug classes by Cox proportional hazards regression analyses. A total of 823 deaths (4.5%) were reported during the study period. The crude proportions of all-cause mortality were highest in a-blockers (6.2%) and CCB (5.7%), but lowest in b-blockers (2.8%). Compared with CCB, patients on thiazide diuretics were shown to have statistically significantly lower all-cause (adjusted hazard ratios (aHRs) 0.75, 95% CI 0.60, 0.93, P ¼ 0.010) and CVS mortality (aHR 0.40, 95% CI 0.21, 0.78, P ¼ 0.007), but the 95% CI of the odds ratios of the major drug classes overlapped. When each drug class was used as a reference group, or when patients with only uncomplicated hypertension were included, their respective 95% CI similarly overlapped. Antihypertensive drug classes were associated with statistically comparable odds of all-cause and CVS mortality. This finding from real-life clinical practice further supports the position statements from international guidelines, which recommend that the major antihypertensive drug classes are suitable for initiating pharmacotherapy for the management of hypertension.

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“…It is also important to consider the recommendations of international bodies on hypertension that help to improve prescribing practice of physicians and ultimately, the clinical standards. 7 The adverse drug reaction and prescription pattern of different antihypertensive medication are also not well studied in Nepalese population despite of clearly mentioned in textbook and literature. The result on side effect profile and prescription pattern would provide the necessary information on side effect of different antihypertensive medications as well as some information on reasons of poor compliance of antihypertensive medication.…”

Section: Introductionmentioning

confidence: 99%

Adverse drug reaction profile and prescription pattern of antihypertensive drug monotherapy at tertiary care hospital Nepalgunj, Nepal

Neupane

Rai

2017

Int J Basic Clin Pharmacol

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Background: Hypertension is the leading cause of morbidity and mortality worldwide which requires long term therapy to prevent complication associated with it. As drugs are used for longer duration it is necessary to know potential undesirable effects for making the appropriate choice. Aim and objective of the study was to monitor the adverse drug reactions (ADRs) and to know prescribing pattern of antihypertensive monotherapy.Methods: The present work was an open, non-comparative, observational study conducted on seventy-three (73) hypertensive patients who were prescribed single antihypertensive drug at medical OPD of Nepalgunj Medical college by conducting patient interviews, recording the data on ADR monitoring form.Results: Calcium channel blockers were found to be the most frequently associated drugs with adverse drug reactions (n=12), followed by diuretics (n= 6), Angiotensin converting enzyme inhibitors (n=3), β-blockers (n= 2) and Angiotensin receptor blocker (n=1). Among individual drugs, amlodipine was found to be the commonest drug associated with adverse drug reactions (n = 10). On analysis of prescription pattern again amlodipine was most commonly prescribed antihypertensive monotherapy followed by hydrochlorothiazide.Conclusions:Amlodipine was most commonly associated with ADRs and it was also most commonly prescribed antihypertensive drugs as monotherapy. The above findings would be useful for physicians in rational prescribing.

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Drug utilization in a hospital general medical outpatient clinic with particular reference to antihypertensive and antidiabetic drugs

Abstract: The use of antihypertensive and antidiabetic drugs accounted for most of the drug usage in this study. Use of newer and more expensive agents has further increased drug expenditure. Monitoring drug usage and their correlations with clinical outcomes are warranted.

Cited by 34 publications

References 29 publications

Prospective Assessment of Prescribing Pattern of Intravenous Proton Pump Inhibitors in an Indian Tertiary-Care Teaching Hospital

Prospective Assessment of Prescribing Pattern of Intravenous Proton Pump Inhibitors in an Indian Tertiary-Care Teaching Hospital

Profiles of mortality among Chinese hypertensive patients in Hong Kong: a cohort study

Adverse drug reaction profile and prescription pattern of antihypertensive drug monotherapy at tertiary care hospital Nepalgunj, Nepal

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