ABSTRACT
Background: Fixed drug combinations (FDCs)have various advantages and disadvantages. In countries like India there are numerous irrational prescriptions as highlighted by the recent banning of FDCs in October 2018. Studying the prescription pattern helps in developing national database which can be used to promote rational use of drugs.Methods: All the Outdoor Patient Department (OPD) prescriptions from department of Obstetrics and Gynecology (OBG) during the study period were used for the study. The drugs were classified according to Anatomical Therapeutic Chemical (ATC) classification. Other data studied were the number of FDCs and the number of currently banned combinations which were used during the study period.Results: The 41% of the drugs prescribed as FDCs. Most FDCs belonged to alimentary system followed by anti-infectives and blood and blood forming organs group. Vitamin D3 and Calcium combination was the most commonly prescribed FDC. Approximately 20% of these prescribed drugs are currently banned.Conclusions: A significant number of drugs are being prescribed as FDCs which also includes various irrational combinations.
ABSTRACT
Background: To investigate the prevalence of potentially inappropriate medications (PIMs) using updated Beers criteria 2012 and drug utilization study among the elderly patients attending the various outpatient departments (OPDs) of a tertiary care hospital at Pondicherry in India. Methods: This prospective, observational study involving patients aged 65 years and above, was planned and conducted over a period of six months, who attended the various OPDs were included in the study. Prescriptions were collected from the consulting rooms and pharmacy. Results: A total of 600 patients aged 65 years and above were involved in our study. Majority (61.83%) were in the age group of 65-70 years. There was a male preponderance (61.83%). Total of 1769 drugs were prescribed, giving an average of 2.98 drugs per person (range 1 to 9). Polypharmacy (≥ 5drugs) were observed in 99 patients. Of the total 748 disease conditions, cardiovascular diseases were the most prevalent (29.33%) among the elderly patients. Almost 114 patients had comorbid conditions. General medicine department was the highest (28.83%) visited patients. Frequently prescribed drugs belong to the category of analgesic and anti-inflammatory agents (16.50%). Fixed Dose Combination (FDC) was 31%. Almost 110 patients received PIMs from Beers list; majority were belonging to category 1. NSAIDs (30.66%) were the highest PIMs prescribed to musculoskeletal disorders. With regard to WHO indicator, 377(21.31%) drugs were prescribed by generic name. Utilization from Indian national list of essential medicine was 76.82%. Percentage of encounters in which an antibiotic and injections was prescribed to 23.5% and 26.33% respectively. Conclusions: Study has shown the prevalence of disease pattern, comorbidity, drug usage in elderly. PIMs, polypharmacy and FDC were high among the elderly. Prescribers need to be educated about Beers criteria and encouraged for rational prescription.