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K. A. Drisyamol ¹, M. Minu ¹, P. Renoy ¹, L. T. Vennapusa ¹, N. M. Mahesh ¹, M. S. Krishnamurthy ²

Affiliations
1 Department of Pharmacy Practice, Krupanidhi College of Pharmacy, Bangalore, IN
2 Department of General Medicine, M.V.J. Medical College and Research Hospital, IN

Abstract

Objective:To assess the pattern of prescribing for elderly patients who were suffering from hypertension and type-2 diabetes mellitus.

Methodolgy: It was a prospective observational study for six months carried out on in-patients who were admitted to general medicine units. The study protocol was approved by the human ethical committee. The patients of either sex and aged above 60 years and diagnosed as suffering from hypertension and diabetes mellitus. The clinical, social and medication data was collected from the case records into a specialised patient profile form to analyze prescribing pattern of medications. All data was analyzed using descriptive statistics.

Results and Discussion: Totally 57 prescriptions were collected from the same number of study patients. In which 40 prescriptions were collected from male patients while 17 prescriptions were from female patients. Out of57 prescriptions, 25(43.84%) were prescribed with one antihypertensive and one antidiabetic combination. In which the most frequently prescribed combination was amlodipine + insulin (26.31%) followed by telmisartan+ insulin (10.52%) among other combinations. Among 57 prescriptions, remaining 25 prescriptions were with combination of two antidiabetics and one antihypertensive medication such as metformin + Glimipiride + amlodipine (21.05%) combination was frequently prescribed among others. Among 57, in 3 prescriptions, combination of three antidiabetics and one antihypertensive medication such as insulin + metformin + Glimipiride + amlodipine were prescribed. Whereas, in another 2 prescriptions, the most frequently prescribed two antihypertensive and one antidiabetic combination was telmisartan + metformin + Glimipiride (3.50%).The remaining one prescription was found to be with insulin + telmisartan + hydrochlorothiazide (1.75%) combination. These combinations were prescribed based on the frequent changes of blood sugar and blood pressure in few patients suffering from hypertension and diabetes mellitus.

Conclusion: The combination of medications such as amlodipine + insulin and metformin + Glimipiride + amlodipine is frequently prescribed to treat hypertensive patients suffering from diabetes mellitus.

Keywords

Geriatrics, Antihypertensive Medications, Anti-Diabetic Medications.

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M. Minu ¹, N. M. Mahesh ¹, P. Renoy ¹, K. A. Drisyamol ¹, V. Tanuja ¹, M. S. Krishnamurthy ²

Affiliations
1 Department of Pharmacy Practice, Krupanidhi College of Pharmacy, Bengaluru, IN
2 Department of General Medicine, MVJ Medical College &Research Hospital, Bengaluru, IN

Abstract

Introduction:The Medical Council of India had passed the order, recently, to all the physicians in our country about writing all components of the prescriptions for diagnosed patients. The earlier studies show that the elderly people commonly suffer from hypertension and diabetes mellitus. However, some components of a prescription are not written by few physicians in a given set-up. Therefore, an auditing of prescriptions is needed to ensure proper utilization of the medications by the treated patients.

Objective:To verify whether the Hospital based prescriptions were in accordance with the national prescription guideline.

Methodology: A prospective observational study for six months carried out in in-patients who were admitted to general medicine. The study protocol was approved by the human ethical committee. The patients of both sex and aged <60years and diagnosed as suffering from hypertension as per JNC -7 guidelines were enrolled. The prescriptions were reviewed for physician information and advice(Name, signature),patient information (Name,Age,Gender, clinicaldata(diagnosis) drug information(dose, frequency, route of administration)and legibility.Data was collected into case report form. All data was analyzed using descriptive statistics.

Results and Discussion:150 prescriptions were analyzed, out of which 53% were male patientsand 47% were female patients.All prescriptions were containing the basic information of the patients and physician, complete diagnosis of clinical signs and symptoms.The Drugs were prescribed in brand names in majority of the prescription (80.6%).The most commonly prescribed antihypertensive was CCB like Amlodipine and combination therapy was aRb+DIURETICS like Telmisartan and Hydrochlorothiazide. 86.6%prescriptions were legible to read. 53.3%prescriptionswere complete in terms of dose, route, frequency and dosage form. Medication to be taken in relation with food timings were mentioned only in 43.3% cases. 59% of prescription were containing physician advice on diet.In 97% prescriptions follow up date was documented by physician. The average cost of medicine per month for a patient was Rs 231.76.

Conclusion: We could conclude that certain aspects of the prescription writing failed to comply with the Prescription guidelines. Prescription writing is to be improved so that a health system could be developed that would have more benefits and less unwanted effects.Cost can be minimized by increasing the compliance and adherence of patients to medicines by providing awareness through social media and newspaper.

Keywords

Auditing, Physicians, Prescription, Components.

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P. Renoy ¹, K. A. Drisyamol ¹, M. Minu ¹, L. T. Vennapusa ¹, N. M. Mahesh ¹, M. S. Krishnamurthy ²

Affiliations
1 Department of Pharmacy Practice, Krupanidhi College of Pharmacy, Bangalore, IN
2 Department of General Medicine, M.V.J. Medical College and Research Hospital, Bengaluru, IN

Abstract

Introduction: In elderly hypertensive patients, blood pressure is over 140/90mmHg. Diuretics, renin angiotensin aldosterone system inhibitors, beta blockers, calcium channel blockers, alpha blockers and direct vasodilators are commonly prescribed to treat geriatric hypertensive patients. The choice of drugs for a particular patient changes at short intervals because of factors like changes in vascular compliance, efficacy, side effects, cost and launch of new drugs in pharmaceutical market. These facts indicate the need for assessment of prescribing pattern of antihypertensives.

Objective: The prescribing pattern of antihypertensive medications was assessed in elderly patients who were suffering from hypertension.

Methodology: It was a prospective observational study for six months carried out on in-patients who were admitted to general medicine units. The study protocol was approved by the human ethical committee. The patients of either sex and aged above 60 years and satisfying the study criteria such as diagnosed newly as suffering from hypertension as per Joint National Committee (JNC-7) guidelines and prescribed with antihypertensive medications were enrolled. The clinical, social and medication data was collected from the case records into a specialised patient profile form to analyze prescribing pattern of medications. All the data was analyzed using descriptive statistics.

Results and Discussion: Totally 93 prescriptions were collected from the study patients. The proportion of male to female patients was 53:46 and their mean age was 68.74 ± 8.6years. Of 93 prescriptions, 50 (53.76%) prescriptions were containing antihypertensive medications as monotherapy and 43 (46.23%) prescriptions were containing antihypertensive medications as combination drug therapy.

Of 50 prescriptions that were containing single antihypertensive medications, amlodepine was frequently 26 (52%) found prescribed among others. The results obtained in our study were similar to the study results conducted by Mohammed A et al. Among 43 prescriptions that were containing combination of antihypertensive medications, telmisartan+ hydrochlorothiazide were the drug combinations that were frequently 22 (51.16%) found prescribed among others.The results obtained in our study were similar to the study results conducted by Arshad HM et al.

This combination was reported as fixed dose combinations used in hospitals in for treating patients enrolled in other studies.

Conclusion: The medications such as amlodipine and telmisartanand hydrochlorothiazide are frequently prescribed as monotherapy and combination therapy respectievely to treat elderly patients suffering from hypertension.

Keywords

Prescribing Pattern, Geriatrics, Antihypertensives.

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