Drug utilization study in diabetic patients attending medicine outpatient department of a tertiary care hospital

Suthar, Satish D.; Dholaria, Nirav K.; Chavda, Dinesh A.; Jiyo, Chacko; Bhansali, Nishant B.; Gosai, Tushar R.; Trivedi, Hiren R.

doi:10.1007/s13410-014-0224-9

Cited by 4 publications

(2 citation statements)

References 25 publications

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“…The usage of pre-mixed insulin (30% regular/70% NPH) was reported as 27.5% compared to a study conducted in Shimoga district of Karnataka (28.57%). 20 The voglibose prescriptions were 21.7% that is commensurable to a Taiwan study focusing on α-glucosidase inhibitors usage (19.21%). 21 Metformin was the most commonly prescribed first-line antihyperglycemic agent followed by glimepiride and glibenclamide.…”

Section: Discussionmentioning

confidence: 76%

Effectiveness of Second-Line Agents in the Treatment of Uncomplicated Type 2 Diabetes Mellitus: An Observational Tertiary-Care Based Study

Gill

Adiga

Varma

2018

JYP

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Background:The rational prescribing of second-line drugs in type 2 diabetes mellitus (DM) require clear guidelines. There is no sufficient empirical evidence to support the use of one second-line agent over the other and when to initiate second-line drug is still under discrepancy. Objectives: To analyze the utilization pattern and effectiveness of second-line agents in uncomplicated type 2 DM. Methodology: 240 uncomplicated type 2 DM patients who were ≥ 18 years receiving either metformin/sulfonylurea or metformin+sulfonylurea was divided into four add-on treatment group 1, 2, 3, 4; that were added pioglitazone, dipeptidyl peptidase-4(DPP-4) inhibitor, voglibose, and insulin [pre-mixed insulin (30%regular/70%NPH)] respectively and received the second-line agents for a duration of 6 months or longer. Effectiveness was based on the reduction in glycosylated hemoglobin (HbA 1C ), fasting plasma glucose (FPG) and postprandial blood glucose (PPBG) values over 3 and 6 months was done using repeated measures analysis of variance (ANOVA HbA 1C , FPG, and PPBG was statistically significant within each group at each time interval with p-value < 0.001. Conclusion: All the add-on groups exhibited a significant reduction in HbA 1C , FPG, and PPBG over 3 and 6 months. DPP-4 inhibitors exhibited least hypoglycemic episodes. DPP-4 inhibitors are trending and marginally more effective second-line OHA in uncomplicated type 2 DM. Key words: Anti-diabetic drugs, FPG, HbA 1C , PPBG, Second-line agents. Key message: The present study gives information on the effectiveness of second-line agents when used in combination with metformin or sulfonylurea or both in type-2 DM during clinical practice. This study gives a real-world evidence on the glycemic index achieved with second-line add-on drugs having good efficacy and tolerability over a period of 6-months.

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Section: Discussionmentioning

confidence: 76%

Effectiveness of Second-Line Agents in the Treatment of Uncomplicated Type 2 Diabetes Mellitus: An Observational Tertiary-Care Based Study

Gill

Adiga

Varma

2018

JYP

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“…Metformin is mostly considered as an ideal first-line agent for the treatment of Type 2 diabetes 13 . Apart from that the cost of metformin is very low when compared with other hypoglycemic drugs and is affordable.…”

Section: Discussionmentioning

confidence: 99%

Drug Use Pattern Among Diabetic Hospitalized Patients Managed With Oral Hypoglycemic Drugs, Insulin, Both Oral Hypoglycemic Drugs and Insulin in Tertiary Care Teaching Hospital

Sriram¹,

Dhanapal²

2018

J. Pharm. Sci. Innov.

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To observe and document the drug use pattern in hospitalized diabetic patients. To determine the choice of therapy based on age, gender, complications, duration of the disease. To find out the commonly occurring adverse drug reactions associated with antidiabetics. The present study involves prospective observational study for patients with diabetes. The methodology involves collection and documentation of patients medical and medication history, blood glucose levels, and duration, choice of therapy with diabetes. During the period of study, a total of 143 cases were collected and reviewed, among that 91% cases were type 2 diabetes mellitus and 9 % cases were type 1 diabetes mellitus. In this study females were higher in range than males. Most of the patients were with the age group of 41 to 60 followed by the age group 61 to 70 was affected by diabetes mellitus. The overall study shows Insulin was used more in most of the prescriptions for both single as well as doublet therapy. Next, to that Metformin was used as first line agent all type2 diabetes patients. Sulfonylureas such as Glimepiride Glibenclamide were used as second line agent. Oral anti-diabetic drugs still dominate the drug prescribing pattern, but there was a little change in the study towards the use of Insulin preparations in the management of Type 2 diabetes mellitus because of the severe diabetic level and insulin deficiency. Insulin preparations were found to be more effective than oral antidiabetics for hospitalized patients.

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Patterns of drug therapy, glycemic control, and predictors of escalation – non-escalation of treatment among diabetes outpatients at a tertiary care center

Atal

Joshi

Misra

et al. 2021

Journal of Basic and Clinical Physiology and Pharmacology

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Objectives The study was conducted to assess patterns of prescribed drug therapy and clinical predictors of need for therapy escalation in outpatients with diabetes mellitus (DM). Methods This was a prospective cohort study, conducted at an apex tertiary care teaching hospital in central India for a period of 18 months. The demographic, clinical, and treatment details on the baseline and follow up visits were collected from the patients’ prescription charts. Glycemic control, adherence, pill burdens along with pattern of antidiabetic therapy escalation, and deescalations were analyzed. Results A total of 1,711 prescriptions of 925 patients of diabetes with a mean age of 53.81 ± 10.42 years and duration of disease of 9.15 ± 6.3 years were analyzed. Approximately half of the patients (n=450) came for ≥1 follow up visits. Hypertension (59.35%) was the most common comorbidity followed by dyslipidemia and hypothyroidism. The mean total daily drugs and pills per prescription were 4.03 ± 1.71 and 4.17 ± 1.38, respectively. Metformin (30.42%) followed by sulphonylureas (SUs) (21.39%) constituted majority of the AHA’s and dual and triple drug therapy regimens were most commonly prescribed. There were improvements in HbA1c, fasting/postprandial/random blood sugar (FBS/PPBS/RBS) as well as adherence to medication, diet, and exercise in the follow up visits. Among patients with follow ups, therapy escalations were found in 31.11% patients, among whom dose was increased in 12.44% and drug was added in 17.28%. Apart from Hb1Ac, FBS, and PPBS levels (p<0.001), characteristics such as age, BMI, duration of diagnosed diabetes, presence of hypertension and dyslipidemia, and daily pill burdens were found to be significantly higher in the therapy escalation group (p<0.05). Inadequate medication adherence increased the relative risk (RR) of therapy escalation by almost two times. Conclusions Disease and therapy patterns are reflective of diabetes care as expected at a tertiary care center. Higher BMI, age, pill burden, duration of diabetes, presence of comorbidities, and poor medication adherence may be the predictors of therapy escalation independent of glycemic control and such patients should be more closely monitored.

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Drug utilization study in diabetic patients attending medicine outpatient department of a tertiary care hospital

Cited by 4 publications

References 25 publications

Effectiveness of Second-Line Agents in the Treatment of Uncomplicated Type 2 Diabetes Mellitus: An Observational Tertiary-Care Based Study

Effectiveness of Second-Line Agents in the Treatment of Uncomplicated Type 2 Diabetes Mellitus: An Observational Tertiary-Care Based Study

Drug Use Pattern Among Diabetic Hospitalized Patients Managed With Oral Hypoglycemic Drugs, Insulin, Both Oral Hypoglycemic Drugs and Insulin in Tertiary Care Teaching Hospital

Patterns of drug therapy, glycemic control, and predictors of escalation – non-escalation of treatment among diabetes outpatients at a tertiary care center

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