Combination Therapy in Diabetes Mellitus Patients Attending Outpatient Department in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Assessing anti-diabetic drug use patterns in hospitals is an important activity which helps to promote the rational use of drugs and may suggest measures to change prescribing habits for the better. This study aimed to find the use of combination therapy in diabetes mellitus patients attending the outpatient department of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among 201 diabetes mellitus patients in the internal medicine department from 2 March 2022 to 30 June 2022 for a duration of four months after approval from the Institutional Review Committee (Protocol No: IRC-LMC-01/R-022). Diabetic patients prescribed at least one anti-diabetic drug in prescription forms were included. Socio-demographic profiles, clinical characteristics and anti-diabetic drug use pattern-related data were collected. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 201 patients, 134 (66.66%) (60.14-73.18, 95% Confidence Interval) patients were given combination therapy. The most common combination therapy was metformin 500 mg and sitagliptin 50 mg. A total of 324 anti-diabetic drugs were used. The average number of drugs prescribed per patient was 1.6±0.7. The number of anti-diabetic drugs prescribed by generic name and from the national essential drugs list was 74 (22.83%) and 188 (58.02%) respectively. Biguanides were used in 176 (87.56%) patients. Conclusions: These findings were similar to some other studies conducted in similar settings. In most patients, combination drug therapy was more prevalent. Among combination therapy, two drug combinations were more prevalent. Keywords: diabetes mellitus; drug combinations; outpatients; teaching hospital.

Prescribers Perception on Drug Promotional Literatures in A Tertiary Care Hospital in Nepal.

BACKGROUND: Drug promotional literatures can often be misleading and have biased information and can contribute to irrational use of medicines. Thus, it is necessary that prescribers critically analyze the drug promotional literatures presented to them. This study attempts to understand if the prescribers at Tribhuvan University Teaching Hospital are aware about the necessary information that should be present in a drug promotional literature. METHODS: A descriptive cross-sectional study was conducted over six months in which prescribers at Tribhuvan University Teaching Hospital were provided with the self-administered questionnaire and were requested to submit the filled in questionnaire. Prescribers presently working at Tribhuvan University Teaching Hospital, attending out patient department services and had received drug promotional literatures within last six months were included in this study. RESULTS: During the study, 163 of the received questionnaires met the inclusion criteria and were utilized for analysis. Advertisement, reminder items and others type of drug promotional literatures were commonly received by prescribers included in our study. Higher proportion of faculties (35.29%) preferred reprint type of drug promotional literatures. Most of the participants (47.85%) searched for 5-8 WHO-Ethical Criteria for Medicinal Drug Promotion criteria when referring a drug promotional literature. It was seen that 42.94% of prescribers realised that at least two out of four types of information related to negative attribute of the promoted medicines were missing. CONCLUSIONS: The prescribers with least duration of clinical exposure are more likely to always prescribe the medicines promoted to them. Prescribers were more confident on claims made in drug promotional literatures if they were supported using scientific evidences.