Informatics Publishing Limited

Abstract

Full Text

Abstract

OBJECTIVE: To analyze drug prescription pattern in COPD patients using GOLD treatment guidelines.

METHODOLOGY: A prospective observational study was conducted in General Medicine department of a tertiary care hospital for a period of 6 months. All COPD Patients with tobacco smoking, along with co morbidities and those who visited the hospital for acute exacerbation of the disease inclusive of both genders aged above 18 years were enrolled in the study. Upon prior consent from the patients, data was collected which includes the patient demographics and medications prescribed. The medication charts were analysed using GOLD treatment guidelines.

RESULTS: A total of 100 patients of either sex who fulfilled our inclusion criteria were evaluated. Among them, COPD was reported more in male patients(78%) as compared to females(22%). 35% were in the age group of 61-70 years while 1% were below 20 years of age as well as between 20-30 year age group. Antibiotics (42%) were the most prescribed class of drug in which Ceftriaxone (44%) and Azithromycin (25%) were mostly preferred. Parentral steroids were used in 20% of the patients and all of them received Hydrocortisone (50%) whereas 19% were prescribed with Methyxanthines in which Doxofylline (56.89%) was the most preferred drug. The most prescribed combination therapy was salbutamol+ ipratropium bromide and budesonide (40%). The most preferred route of administration was oral route (44.5%). 89% of the drugs were written in trade names, while 11% of the drugs were mentioned with their generic name.

DISCUSSION&CONCLUSION: It was found that majority (89.7%) of the drugs were given in accordance with Global Initiative for Chronic Obstructive Lung Disease criteria recommendations. This study reveals that generic prescription is very low and suggests that efforts must be made to encourage prescribers for generic prescribing which may have a multitude of benefits.

Keywords

Full Text

Abstract

METHODOLOGY: A prospective - observational study on diabetic knowledge was done in Inpatient and outpatient Department of a tertiary care hospital in Bangalore for a period of 6 months. The patients (inpatients and out-patients) suffering from Type-2 DM of either sex who were aged 35 years or above and satisfied the study criteria such as patient who are diagnosed with type2 DM for more than 1 year, who are on either parentral or oral hypoglycemic were enrolled prospectively for six months. The patient, clinical, medication and socio-economic data were collected. Different levels of education considered were: Post-gradates, graduates, schooling and illiterate. Michigan Diabetes Knowledge Testing scale was given to the enrolled patients to self-administer the scale in patient waiting area. Each answer was dichotomously scored. Accordingly, each correct answer is awarded a score of one while every incorrect or unsure answer was awarded a score of zero. The total score was categorized as: Score > 17= Better Knowledge, Score 11-17 = Average Knowledge and Score < 11 = Poor knowledge.

RESULTS and DISCUSSION: Totally 400 patients (Males 61%, Females 39%, mean age+/-0.6176) suffering from Type-2 DM were enrolled. Majority of the patients were graduates (198) 50% followed by patients with school level education (116), 29% , illiterate patients were (69), 17% and least number of patients were post graduates (17) 4%. Among the study patients, majority (205) 51.25% had poor knowledge followed by 182 patients (45.5%) who had average knowledge. However, 3.25% patients had showed better knowledge. This indicates that majority of the patients were with poor knowledge which resembles previous study conducted in South Africa that shows 66.9% of the population studied passed the diabetes knowledge test with more than 50% score².

CONCLUSION: Majority of the patients suffering from Type-2 DM have poor knowledge about their disease irrespective of their education level. This urges the need for educating diabetic patients.

Keywords

Full Text

Abstract

Methodology: The study protocol was approved by the hospital human ethical committee. The patients of either sex who were aged between 18 and 60 years and admitted within 72 hours of their onset of emergency conditions were enrolled prospectively as per our study criteria for six months. The patients clinical and medication data were collected from the case records. Further, the data was analyzed and compared against national essential medication list.

Results and Discussion: Totally 100 emergency patients (Males 51%, Females 49%) were enrolled. Mean age of the patients was 36.3±1.1years. Of these cases, most commonly found emergencies were Fever (33%) followed by Acute Gastroenteritis (22%), and Upper respiratory tract infection (11%) among others. On average, 3.9±1.5 drugs were prescribed per patient.

Anti-pyretics (80.66%), antibiotics (11.33%) and analgesics and antiinflammatory drugs (8%) were found prescribed for patients suffering from fever. Acetaminophen (81%) was prescribed to treat high fever (over 100°F), Diclofenac(75%) was found prescribed for treating patients suffering from fever with body pain and Amoxicillin(60%) was found prescribed for treating the patients suffering from fever who are susceptible for infections. The results obtained in our study was similar to the results shown by Dhamija P et al.

Proton pump inhibitors (56%), Anti emetics (18.33%), Anti-diarrhoeals (7%) and Antimicrobials (%) were found prescribed for patients with Acute gastroenteritis. Pantoprazole (97.1%) was most extensively used Proton pump inhibitor. Ondansetron(71.4%) was used as Anti emetic. Loperamide (55.55%) was used for treating diarrhoea. Ofloxacin + Ornidazole infusion combination was used to treat gastroenteritis patients susceptible to infections. This study results were comparable to the study done by Pantanwala et al. All the prescribed drugs were utilized under nurse direct observation. The total number of drugs evaluated during the study was compared to the national list of essential medicines and was found to show 52.30% compliance to the NLEM 2011 which was better as shown in the study of Barot et al.

Conclusion: The medications such as Acetaminophen, Diclofenac, and Amoxicillin are frequently utilized to treat emergency patients with fever while Pantoprazole, Ondansetron, Loperamide and Ofloxacin and Ornidazole combination was utilized to treat emergency patients with gastritis and these drugs were prescribed according to national essential drug list.

Keywords

Full Text

Abstract

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

Full Text

Abstract

Objective:To analyze the severity level of the disease clinically in patients who are diagnosed assuffering from chronic obstructive pulmonary disease.

Methodology: A prospectiveobservational study was conducted in General Medicine department of a tertiary care hospital for a period of 6 months. All COPD patients of either sex aged above 18 years were enrolled in the study. Upon prior consent from the patients; Personal interview was held to collect data including age, gender and occupation. Dyspnoea was graded by MRC Scale as grades 0-4.

Results: Among 100 patients studied, COPD was reported more in male patients(78%) as compared to females(22%). 44% of the patients were in the age group of 61-70 years.

As per the socioeconomic status, patients were divided into three grades as follows Grade-I:-People in administration, Grade-II: - Employees, clerical staff, Grade-III:-Gardeners, security guards, drivers, peon and others. It was found that Grade-3 employees showed a greater incidence of COPD. Out of 100 patients studied, most of them hadmMRC grade-3 (32%) followed by Grade-1 (25%), Grade-2 (24%), Grade- 4 (16%) and Grade-0 (3%).

Discussion and Conclusion: The mMRC scale can be used as an effective tool for screening in rural set up where the facilities for spirometric evaluation of COPD are nonexistent. Apart from that,mMRC scale is a convenient and comprehensive tool for respiratory therapists in planning the rehabilitation programs in patients with lower socioeconomic status.

Keywords

Full Text

Abstract

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

Full Text

Abstract

Methodology: The study protocol was approved by the hospital human ethical committee. The patients (in-patients and out-patients) suffering from Type-2 DM of either sex who were aged 35 years and above and patient diagnosed with Type 2 DM for more than one year who were either on parenteral or oral anti diabetic medication treatment were prospectively enrolled for six months. The patient, clinical, medication and socioeconomic data were collected into specialized patient profile form. Different levels education considered were: Post-gradates, graduates, schooling and illiterate. The patient medication adherence was assessed using Morisky Medication adherence scale. Each answer was dichotomously scored. Accordingly, each correct answer is awarded a score of zero while every incorrect or unsure answer was awarded a score of one. The scores were totalled and categorized as: Score 0 = High adherence, Score 1-3 = Moderate adherence and Score > 3 = Poor adherence.

Result and Discussion: Totally 450 patients (Males 61%, Females 39%) suffering from Type-2 DM were enrolled. Mean age of the patients was 61years. Majority of the enrolled patients were graduates (198) 50% followed by the patients with basic level of school education( 116) 29% , and (69) 17% were illiterate and least number of patients were post graduates (17) 4 %.

Among the patients who were assessed for their medication adherence, majority (219) (54.75%) had poor adherence followed by 31.5% patients who had moderate adherence. However, (13.75%) patients had high adherence. This indicates that majority of patients were not adherent to their medications. Research has shown that patients with diabetes mellitus have one of the lowest medication adherence rates at 65% to 85%.Factors that could influence the patients adherence were assessed and were able to find with four clear causes included forgetfulness (64.25%),feeling better (75%),feeling worse(79.25%) and inconvenience (61.75%).

Conclusion: Majority of the patients suffering from Type-2 diabetes mellitus have poor medication adherence.

Keywords

Full Text

Abstract

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

Full Text

Abstract

Background: Vaccines have thrived as one of the most successful health interventions that have diminished occurrence of infectious diseases and improved quality of life in the population. Although the vaccination coverage has been gradually increasing, the average total immunization coverage is far less than the desired outcome. Parental decisions regarding vaccination are very vital for increasing the vaccination rate and parent compliance to the immunization schedule.

Objective: To analyze the extent of parents' Knowledge, Attitude and Practice(KAP) about child vaccination in rural areas such that it can be correlated with the immunization status of their child amongst native participants of Bangalore.

Methodology: A prospective cross-sectional study was carried out on 110 Parents residing in rural areas of Bangalore who had children below 5 years of age. The sociodemographic details of the parents were collected and they were made to fill a KAP Questionnaire. Each question under Knowledge and Attitude was scored to assess their KAP level regarding child vaccination. The immunization status of the child was assessed by counting on the parents' word for it.

Results: A total of 110 parents participated in the study from different rural clusters of Bangalore. Assessment of the extent of Knowledge, attitude and practice about child vaccination showed that a majority of them (72.7 %,) had good knowledge score followed by average (21.8%) and poor (5.4%) whereas 85.4% of the respondents were found to have good attitude towards child vaccination. The immunization status of the child was assessed by counting on the parents' word for it and.68.1% children were completely immunized whereas 7.2 % received incomplete immunization. The immunization status of the remaining 24.5% of the children was uncertain as assessment was not possible due to lack of surety in the parents part regarding the immunization status of their child. Although parental knowledge was not found to be significantly associated with the immunization status of their child, there was a significant association between the attitude of parents towards child vaccination and the immunization status of their child. A very significant correlation was also seen between the parental knowledge and attitude score with p≤0.0001.

Conclusion: The parental Knowledge, Attitude and Practice about child vaccination are important determinants of the immunization status of their child. A combined effort from the members of the healthcare team and social health workers can definitely make the attainment of the targeted immunization coverage rate in the country possible.

Keywords

Full Text

References