A Study and Report on Due (Drug Utilization Evaluation) of Cardiovascular and Endocrine Disorders/Diseases in Inpatient Units of Hospitals

Mekkanti Manasa Rekha; Umme Kulsum; Rinku Mathappan

Abstract

In recent years drug utilization studies have become a potential tool to be used in the evaluation of health systems. On the process of drug utilization studies focus on factors related to prescribing, dispensing, administering, and taking of medication, and its associated events. Drug utilization data are available from databases- computerized or otherwise. From these databases different types of information, qualitative or quantitative or referring to a particular population are available. for collecting information on drug utilization Patient files and computer registries are widely used as instruments. depending upon the timing of data collection Prospective, Concurrent or Retrospective Drug Utilization studies may be used. Importance of drug utilization studies in pharmacoepidemiology has been increasing due to their close association to other areas like- public health, pharmacovigilance, Pharmacoeconomics and pharmacogenetics. This research article highlights various aspects, cycle, steps, need, scope, types, future perspectives. The Objective of the study is to evaluate the drug utilization pattern of drugs among the in-patient unit of cardiac and endocrine department of tertiary care hospital. By using a method of a prospective, interventional study was carried out in inpatient unit of cardiac and endocrine department of government ESI hospital Indiranagar, for a period of 6 months. Patient’s demographics, indications for admission, duration of hospital stay, and various drugs prescribed were observed and analyzed statistically. Resulted that a sample size of 180 patients with endocrine/cardiologic diseases were randomly opted for this study. The details of patient’s medication therapy were collected from patients through personal interview, case sheets, treatment charts and data collection forms. Determination and categorization required counselling by pharmacist in verbal about 88.8% were accepted. Out of 42 cases required communication between of DRPs were done using The PCNE classification scheme for Drug-Related Problems V5.01 by the pharmacist. The DRPs identified by pharmacist were reported and interventions made were documented. About 196 drug related problems were found in the study with the major problems being drug-drug interactions (13.7%) followed by generic substitution (10.2%). The mean drug related problem per patient was found to be 1.06. A total of 204 interventions were made by clinical pharmacist among which 114(55.8%) interventions were at prescriber level, 58(28.4%) interventions were at drug level, 17(8.3%) at the patient level and 15(7.3%) were other interventions or activities. Distribution based upon the degree of acceptance of interventions showed that among 59 drug regimen change interventions proposed by pharmacist, only 54.2% were accepted. Out of 70 monitoring required interventions made by pharmacist, about 78.5% were accepted. Among 18 cases pharmacist and other healthcare professionals a percentage of 88.8% was accepted and among 15 adverse drug reporting cases made in formal note form, 100% were accepted. The present study concludes that DUE (Drug Utilization Evaluation) as part of clinical practice plays a crucial role in identification of drug related problems which frequently happens in all investigated clinical department i.e., in endocrine or cardiology departments. Mean number of drugs per prescription were high. The prescribing pattern could be improved by reducing the number of drugs per prescription and by prescribing generic drugs to reduce the economic burden of the patients as these drugs are used for long time. Prescription Indicators recommended by the WHO can help the Health Care Centers to obtain better organization and improve healthcare attention to the public. An alarmingly low number of the drugs were mentioned by their generic names. Prescription of generic names can be recommended by the WHO can help the Health Care Centers to obtain better organization and improve healthcare attention to the public. The study recommends that there is a need for the regulatory agencies to develop a standard prescription format and implement it throughout the country. Also, it was observed during the study that irrational practices of prescribing the drugs are quite common. There is poor compliance of the physicians with WHO core prescribing indicators. Irrational prescribing is quite common, that is usually associated with various undesired drug effects, toxicities, tolerances, and resistance. Polypharmacy is quite common and the concept of generic prescribing in strict conditions must be implemented about the prescription and the administration of injectable drugs, and their use should be minimized to the extent possible.

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