scholarly journals STUDY ON MEDICATION APPROPRIATENESS AMONG GERIATRICS IN TERTIARY CARE TEACHING HOSPITAL

2021 ◽  
Vol 12 (1) ◽  
pp. 40-45
Author(s):  
Lakshmi P ◽  
Ramya Kuber B
Keyword(s):  
Geriatric Patients ◽  
Tertiary Care ◽  
Inappropriate Prescribing ◽  
General Medicine ◽  
Beers Criteria ◽  
Prescribing Pattern ◽  
Geriatric Population ◽  
Study Results ◽  
Medication Appropriateness ◽  
Patient Department

Introduction: Older patients are considered as special population, the pharmaceutical care with focus of increasing medication appropriateness and reducing medication related problems is needed. Elderly patients have a higher prevalence of chronic and multiple illness and physiological changes associated with aging may masquerade as illness. Aim & Objectives: To assess and evaluate the drug prescribing pattern and inappropriate prescribing by using beers criteria 2015 among Geriatric patients. Materials & Methodology: A prospective observational study was conducted in general medicine out-patient department, SVRRGGH, Tirupati for period of 6months.The patients of general medicine out-patient department with age above 65yrs old were included in the study. The Patients who are not willing to participate in the study, inpatients and terminally ill patients were excluded from the study. Results & Discussion: Among 200 patients, distribution of age majority of the patients is male (71%) followed by females (29%), Most of patients have multiple diseases (64%) followed by Single disease (29%). All potentially inappropriate medicines (PIMS) are classified as category A, B, C. Drugs have to be avoided in geriatric patients (Category A) being the most common category of inappropriate as per Beers criteria updated by American Geriatric Society 2015.Our study reported 174 drugs as PIMs. Conclusion: It is also necessary to improve the geriatric care, as this age group possess risk for many diseases and medication use. In future a multidisciplinary approach, steps to be taken involving physicians, nurses and pharmacists has a team for bringing out rational drug use in geriatric population.

scholarly journals PRESCRIBING PATTERN IN GERIATRIC PATIENTS IN MEDICAL OPD OF A TERTIARY CARE TEACHING HOSPITAL

2021 ◽  
pp. 132-134
Author(s):  
KANIKA KHAJURIA ◽  
VIJAY KHAJURIA
Keyword(s):  
Prescription Drugs ◽  
Geriatric Patients ◽  
Inappropriate Medication ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Brand Names ◽  
Beers Criteria ◽  
Prescribing Pattern ◽  
Geriatric Population ◽  
Cross Sectional

Objectives: Geriatric population is increasing globally and they suffer from multiple disorders necessitating administration of number of drugs. The objective of the present study was to examine the prescribing pattern in geriatric patients in a medical OPD. Methods: An observational, cross-sectional study was conducted in medical OPD of Government Medical College, Jammu, over a period of a month after approval of the Institutional Ethics Committee. Patients above 65 years of age who gave consent were included in the study. The prescriptions were analyzed for demographic profile (age and gender), average number of drugs per prescription, drugs by generic or brand names, fixed drug combinations (FDCs), and percentage of potentially inappropriate as per Beers criteria. Results: A total of 200 patients were included comprised 64% of males and 36% of females. The most of patients were in the age group of 65–69 years (37.5%). A total of 200 prescriptions contained 1128 drugs amounting to average 5.64 number of drugs per prescription. Maximum prescriptions had 1–5 drugs (61%) followed by 6–10 drugs (38.5%). Majority of drugs were prescribed by brand name (93.26%) and only 6.73% of drugs were prescribed by generic name. About 10.46% FDCs were prescribed. Maximum drugs prescribed were from respiratory system (20.3.1%), followed by GIT (18.4%), antimicrobials (17.2%), cardiovascular (10.99%), NSAIDs (9.3%), and vitamins (8.4%). Forty-one drugs (20.5%) in patients were potentially in appropriate drugs based Beers criteria and belonged mostly to anticholinergic, antihistaminic, sedatives, NSAIDs, and H2 blockers. Conclusions: The present study demonstrates that polypharmacy and potentially inappropriate medication are still present in OPD prescription of geriatric population. Generic prescribing still lacks. Application of Beers criteria and increasing awareness about polypharmacy should be encouraged.

scholarly journals A prospective study on prescribing pattern of drugs in geriatric patients in the department of medicine in a tertiary care center

2021 ◽  
Vol 10 (3) ◽  
pp. 293
Author(s):  
Priya Mohan B. N. ◽  
Suma Jayaram
Keyword(s):  
Elderly Population ◽  
Geriatric Patients ◽  
Care Center ◽  
Tertiary Care ◽  
Inappropriate Prescribing ◽  
The Elderly ◽  
Economic Security ◽  
Screening Tools ◽  
Male Population ◽  
Prescribing Pattern

Background: India stands at 3rd position with large elderly population in the world. Elderly population has special problems related to health, social support, and economic security. Comorbidities in elderly people are frequent, which require use of multiple medications which increases the number of inappropriate medications    noncompliance, economic burden, adverse drug reactions (ADRs), and drug interactions. The overall incidence of ADR is two to three times higher due to physiological and pharmacological variations. Currently used screening tools for inappropriate prescription in old age are: Beers criteria and inappropriate prescribing in the elderly tool (IPET).Methods: A prospective observational study of elderly patients of either sex admitted in the medicine ward, conducted from May 2019-November 2019. A total of 102 prescriptions were collected and analysed. Data was analysed using Microsoft excel.Results: In this study most of the patients (67 out of 102) were in the age group 65-70 years with male population (73%) dominance. Most of the patient were admitted due to cardiovascular (35.84%) and respiratory system (14.15%) disorder. Anti-diabetics (17.64%) followed by anti-microbials (14.24%) were the most commonly prescribed medicines in this study. Our study revealed poly pharmacy in geriatric patients with an average number of drugs per prescription being 6.07. According to BEER’s criteria 3.47% of total drugs prescribed were inappropriateConclusions:  In this study most of the patients had co morbid conditions, cardiovascular disease and diabetes being the common cause led to polypharmacy. A high number of potential prescription errors were found. 

POLYPHARMACY IN HOSPITALIZED GERIATRIC PATIENTS IN A TERTIARY CARE HOSPITAL – A PROSPECTIVE STUDY

2019 ◽  
Vol 3 (10) ◽  
Author(s):  
CH. Krishna Vamsi ◽  
A. Sushmitha ◽  
P. Supriya ◽  
A. Rajani ◽  
G. Ravi
Keyword(s):  
Drug Therapy ◽  
Cost Saving ◽  
Geriatric Patients ◽  
Tertiary Care ◽  
General Medicine ◽  
Therapeutic Benefit ◽  
Care Hospital ◽  
Geriatric Population ◽  
Collection Form ◽  
The Cost

Background: The current focus of research is on polypharmacy and the presence of unnecessary medications in the treatment and also the cost of the unnecessary medications. Objectives: To find out the prevalence of polypharmacy in geriatric patients, reasons for unnecessary drug therapy, the cost of unnecessary drug therapy and to check the quality of life of the patients. Methodology: A total of 200 patients were included and the study was conducted in the department of General Medicine. The participants enrolled in the study involve inpatients only after filling a properly written informed consent. The data is collected in a pre-designed data collection form. Results: The study showed that of the 200 cases collected, 54% were female patients most of them falling under the age group of 60-65yrs. Of the 200 patients 43.5% received more than 5 drugs per prescription. The reason found for unnecessary drug therapy is therapeutic duplication with mostly prescribed class of drug as Antibiotics. Total expense of unnecessary drug therapy is equal to INR.21.641. Conclusion: Prevention of unnecessary drug therapy problem can be conducted through reduction of drug use. It is recommended to eliminate all medications without therapeutic benefit, goal or indication. Prevention of unnecessary drug therapy will also contribute in cost saving among elderly patients. Keywords: Polypharmacy, Unnecessary medications, Geriatric population, Cost saving.

scholarly journals A PROSPECTIVE STUDY ON GERIATRIC PRESCRIBING PATTERN AND MEDICATION ADHERENCE IN A TERTIARY CARE HOSPITAL

2017 ◽  
Vol 10 (12) ◽  
pp. 220
Author(s):  
Seema Anjum M ◽  
Chinchu Jacob ◽  
Chinchu Jacob ◽  
Akhil Benchamin ◽  
Akhil Benchamin ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Tertiary Care ◽  
General Medicine ◽  
Study Data ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Disease Pattern ◽  
A Prospective Study

  Objectives: To identify potentially inappropriate medications (PIMs) using Beers criteria 2015 and to recommend safer alternative medication for the above. To assess the medication adherence in geriatric patients and to categorize according to their adherence.Methods: This is prospective, interventional study. A total of 90 patients aged 65 years and above were involved in the study. Data were collected and recorded. The prescriptions were analyzed for appropriateness using updated Beers criteria 2015 and assess medication adherence using 8-item Morisky questionnaire.Results: Majority of the patients were in the age group of 65-74 years. Males (53%) showed predominance than females. The highest rate of (53%) polypharmacy was found in general medicine department than other departments. Out of 147 disease conditions observed, chronic renal failure (21.1%) was the most common condition. A total of 66 patients had comorbid conditions. Most frequently prescribed medications belonged to cardiovascular drugs (56; 14.62%). A total of 46 patients received PIMs; majority belonged to Category 1 - amitriptyline. Commonly prescribed medication in PIMs belonged to central nervous system medications (20%). Majority of patients were low adherent (51.11%) in which female patients showed preponderance in low adherence.Conclusion: Study showed prevalence of disease pattern, medication use, polypharmacy, PIMs, and medication adherence. It is important for pharmacists to stay updated and prescribers need to be educated and encouraged about Beers criteria for rational prescription for better pharmaceutical care and increased medication adherence.

scholarly journals EVALUATION OF PRESCRIPTION WITH POLYPHARMACY AMONG GERIATRIC POPULATION IN A TERTIARY CARE HOSPITAL: A PROSPECTIVE CROSS SECTIONAL STUDY

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Sruthimol V ◽  
Aneena Saji Abraham ◽  
Gowtham S ◽  
Priya M ◽  
Ramalakshmi S ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Inappropriate Prescribing ◽  
Cross Sectional Study ◽  
Vulnerable Groups ◽  
Care Hospital ◽  
Sectional Study ◽  
Medication Appropriateness Index ◽  
Geriatric Population ◽  
Cross Sectional ◽  
Medication Appropriateness

ABSTRACT BACKGROUND Elderly population are the largest consumers of prescribed drugs and are the most vulnerable groups in our society. Prescribing for older patients presents many unique challenges, particularly with respect to variables such as polypharmacy, altered pharmacokinetic and pharmacodynamics responses.  This study was carried out to evaluate the appropriateness of prescription in geriatric population by using medication appropriateness index METHOD This Prospective, observational cross-sectional study was carried out in 100 patients for 6 months at Vijaya Hospital, Vadapalani. The study participants included inpatients of either gender, age greater than 65 years and patients receiving more than 4 medications.  The outpatients, patients with cancer and HIV were excluded from the study. Data was collected in data collection form and each drug in a prescription was analysed and scored by using Medication Appropriateness Index questionnaire (MAI).   RESULTS Out of 1012 drugs prescribed among 100 patients, a total of 912 drugs (90.12%) were considered to be appropriate whereas 100 drugs (9.88%) were considered to be inappropriate. The major category of inappropriate prescribing encountered in our study was ineffective medications (5.03%) for different conditions based on Beers criteria. Prescription analysis of the drug chart indicate,  the drugs with least expensive alternative comprises 1.08% followed by impractical directions (0.69%), drug-disease interactions (0.39%), unnecessary duplications (0.39%) and incorrect  directions (0.19%). The mean MAI score of inappropriate prescribing per drug was 0.02 ± 0.23 and score per patient was 0.22 ± 0. 55.   CONCLUSION The data from the present study shows that 9.88% of drugs prescribed were considered to be inappropriate. A clinical pharmacist can reduce the frequency of inappropriate prescribing by regular medication chart review and thereby reducing polypharmacy  

scholarly journals Drug utilization pattern and appropriateness of prescription in IPD geriatric patients in a tertiary care teaching hospital

2020 ◽  
Vol 10 (1) ◽  
pp. 55
Author(s):  
Shuchisuta P. Pathy ◽  
Sachchidanand Pandey ◽  
Bhabagrahi Rath ◽  
Rinu Rani Dash
Keyword(s):  
Drug Use ◽  
Drug Utilization ◽  
Geriatric Patients ◽  
Tertiary Care ◽  
World Health ◽  
Potentially Inappropriate Medications ◽  
Utilization Pattern ◽  
Geriatric Population ◽  
Prescribing Indicators ◽  
Inappropriate Medications

Background: Drug utilization research provides insights into different aspects of drug use and drug prescribing such as pattern, quality, determinants and outcomes of drug use. Polypharmacy is considered to be hazardous for the elderly, because of their greater vulnerability to drugs and multiple drug use. Prescription of potentially inappropriate medications (PIMs) has been found to be a common cause of morbidity and mortality among the geriatric population and has necessitated the creation of criteria for the safe use of medicines among them. Objectives of the study were to assess the drug utilization pattern in geriatric patients and analyse their prescriptions as per the World Health Organization (WHO) core prescribing indicators and STOPP and START criteria.Methods: An observational, cross-sectional study was conducted from May 2019 to August 2019 in inpatient department of general medicine of VIMSAR, Burla. Prescriptions of ≥65 year patients were collected and documented by active surveillance from the medicine ward.Results: Majority of the patients were in age group of 65-75. Stroke is the more common comorbidities among geriatric population. Average number of medication per prescription is 5.42. About 78.74% of drugs are injectable. The percentage of antibiotics prescribed to patient is 27.75%. Based on STOPP criteria potentially inappropriate medications PIM is 7% and START criteria PIM is 29%.Conclusions: Our study suggests that prevalence of polypharmacy was high which is usually unavoidable in geriatric patients and less PIM is suggestive of adherence to WHO core prescribing indicators, and prescription of drugs as per STOPP and START guidelines are indicative of scope for improvement.

scholarly journals Medications for Anxiety: A Drug utilization study in Psychiatry Inpatients from a Tertiary Care Centre of Western Nepal

1970 ◽  
Vol 1 (4) ◽  
pp. 119-125 ◽  
Author(s):  
Indrajit Banerjee ◽  
Bedanta Roy ◽  
Brijesh Sathian ◽  
Indraneel Banerjee ◽  
Sai Sailesh Kumar ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Physical Dependence ◽  
Tertiary Care ◽  
Psychiatric Inpatient ◽  
Common Disease ◽  
Utilization Pattern ◽  
Tertiary Care Centre ◽  
Prescribing Pattern ◽  
Study Results ◽  
Anxiolytic Drugs

Background   Anxiety is the most widespread psychiatric disorder and generalized anxiety disorder is the most common disease seen in the primary care setting. Currently there are a number of anxiolytic drugs commercially available in the market for treatment of these disorders such as Benzodiazepines like Diazepam, Chlordiazepoxide, Alprazolam, Betablockers like Propranolol and H1 Antihistaminics like Hydroxyzine. Some of the newer anxiolytics like Buspirone in Azapirone group is marketed as better anxiolytic drug than the traditional drugs.  Buspirone is promoted as a better drug for anxiety, as it does not cause any sedation, tolerance or physical dependence. A need for study further increases as there is no sufficient data on utilization pattern of anxiolytics on Nepalese population. This is the first study done in the utilization pattern of anxiolytic drugs in inpatient in Nepal.  Methods This is an observational study undertaken between 1st October 2009 and 31st March 2010 at the Psychiatric inpatient Department of Manipal Teaching Hospital. The prescribing pattern of Anxiolytic drugs was measured. Out of a total of 240 cases who were admitted to psychiatry inpatient ward, 38 cases have received Anxiolytic drugs. Those who were critically ill with anxiety were included in the study.  Results Out of 240 cases who were admitted to psychiatry inpatient, 130 were male patients (54.2%), 95% CI [47.9,60.5] and the rest were female patients (45.8%), CI [39.5,52.1] . In 38 cases of anxiety, the age of the patient <40 years 89.5% and >40 years 10.5%. Anxiety was more common in females 71.1% than in males 28.9%. 68.4% of the patients were unemployed whereas only 31.6% of the patients were employed. 78.9% of the drugs were prescribed by trade name. Among the anxiolytics, the commonest drug prescribed was Alprazolam (50%), followed by Clonazepam (31.6%), Chlordiazepoxide (15.8%) and Lorazepam (2.6%). Conclusion Utilization patterns of drugs for anxiolytics were according to treatment guidelines and suggested a trend towards the use of shorter acting Benzodiazepines such as Alprazolam. Continuous and prolonged use of longer acting Benzodiazepines has resulted in dependence and may have withdrawal symptoms when the dosage of these drugs is reduced or treatment is stopped.http://dx.doi.org/10.3126/nje.v1i4.5753 Nepal Journal of Epidemiology 2011;1(4):119-125

scholarly journals PRESCRIPTION PATTERN OF DIURETICS IN A TERTIARY CARE HOSPITAL

2019 ◽  
Vol 8 (3) ◽  
Author(s):  
P G Chithara ◽  
Dr. Yogananda R ◽  
Dr. Bharathi DR
Keyword(s):  
Drug Interaction ◽  
Tertiary Care ◽  
General Medicine ◽  
Oral Route ◽  
Prescribing Patterns ◽  
Research Centre ◽  
Intravenous Route ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Drug Drug Interaction

Diuretics are drugs that increase the rate of urine flow; clinically useful diuretics also increase the rate of excretion of Na+ (natriuresis) and an accompanying anion, usually Cl. Diuretics are a mainstay of therapy for a wide variety of diseases ranging from hypertension to the nephrotic syndrome. Objective: To study the prescribing patterns of diuretics in General Medicine and ICU. To assess the drug-drug interaction of diuretics. To study the route of administration of diureics. Materials and methods: A prospective observational study was conducted over a period of six months at general medicine and ICU department of Basaveshwara Medical College and Hospital and Research Centre, Chitradurga.a otal of 100 in-patients are included as study subject. Results: Mostly prescribed diuretic in this study were furosemide (52.9%), followed by mannitol (28.1%), spironolactone (11.57%), torsemide (5.79%), amiloride (0.82%) and hydrochlorothiazide (0.82%). Out of 100 prescriptions 84.4% of diuretics prescribed in intravenous route, 15.6% of diuretics prescribed in oral route. Out of 100 prescriptions total 89 drug interactions with diuretics are found. In that 2.3% major interactions and 67.4% moderate interactions and 30.3% minor interactions are found. Conclusion: Prescription monitoring helped to reduce the diuretic usage errors with respect to dose and drug-drug interaction with other prescribed drugs to provide better patient care. Keywords:  prescribing pattern, drug-drug intraction, diuretics

scholarly journals RATIONALE OF ANTIBIOTIC PRESCRIPTION IN PATIENTS VISITING A TERTIARY CARE SOUTH INDIAN HOSPITAL

2021 ◽  
pp. 27-30
Author(s):  
MOHAMED AHMED ◽  
PAWAN KUMAR ◽  
KISHORE DV ◽  
PRABHAT KUMAR ◽  
RUBEENA KAUSER ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Tertiary Care ◽  
General Medicine ◽  
Critical Issue ◽  
Care Hospital ◽  
Sensitivity Testing ◽  
Prescribing Pattern ◽  
Cross Sectional ◽  
Specific Patient ◽  
South Indian

Objective: Antimicrobials are the class of drugs that are used irrationally in most cases leading to rise in instances of antimicrobial resistance altering the effect of such agents. Antimicrobial resistance has become a critical issue universally nerving the need to monitor the utilization pattern and rationality in prescribing of antibiotics. This helps in selection of most appropriate antibiotic for the specific patient and achieving the goals of the therapy. Methods: A prospective cross-sectional study with a sample size of 600 participants was conducted in department of general medicine of a tertiary care hospital. Inpatients prescribed with antibiotics were included in the study and their case sheets were reviewed to analyzing the prescribing pattern. The medication usage pattern was then assessed for rationality in prescribing was evaluated. The results obtained were statistically analyzed using SPSS Software. Results: It is noted that a more number of males participated and the greatest number of the patients were from the age group of 31-45. The diagnosis found in the majority of the patients was respiratory tract infection followed by others. On scrutinizing the prescriptions, it was noted that cephalosporins and penicillins were most often prescribed, and on an average single, antibiotic was frequently used with the preferred route of administration in most of the prescriptions being injection route. Though many of the antibiotics were prescribed empirically, it was observed that 59% of them were most appropriately dosed and maximum patients that are around 57% were cured from their illnesses. Conclusion: This study provided important baseline information on antimicrobial use within a large tertiary care teaching hospital and identified potential targets for future antimicrobial stewardship programs. The culture and sensitivity testing suggested that the drug resistance was more for most commonly prescribed antibiotics in the hospital. Increased targeted prescribing based on sensitivity tests will bring down the high use of empiric broad-spectrum antibiotic use.

scholarly journals Study on Prescribing Pattern of Antibiotics in a Pediatric Out-Patient Department in a Tertiary Care Teaching and Non-Teaching Hospital

2016 ◽  
Vol 9 (4) ◽  
pp. 253-259 ◽  
Author(s):  
Ashok Kumar Malpani ◽  
Manjunath Waggi ◽  
Asmila Rajbhandari ◽  
Gunda Anil Kumar ◽  
Reddy Nikitha ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Prescribing Pattern ◽  
Care Teaching ◽  
Patient Department
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