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Evaluation of Prescribing Practices of Metformin in Patients with Type-2 Diabetes Mellitus


Affiliations
1 Department of Pharmacy Practice, School of Pharmaceutical Sciences, VISTAS, Pallavaram, Chennai-600117, Tamilnadu, India
     

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Objectives: To evaluate the prescribing patterns of metformin in patients with type-2 diabetes mellitus and determine whether they are in accordance with published contraindications and precautions. Methods: Medical records of patients admitted with type-2 diabetes mellitus, who received at least one dose of metformin were identified and enrolled into the study. Patient demographic, clinical and biochemical data pertaining to diabetes and its risk factors were collected and documented. Prescribing patterns of metformin in these patients wereevaluated using the drug chart. All the prescriptions were checked for its accordance with published contraindications and precautions. Prescriptions in patients with type-2 diabetes mellitus were compared to the standard prescribing guidelines as per American Diabetes Association to analyse its compliance with recommended guidelines to determine whether metformin was prescribed to patients possessing any of the risk factors associated with development of lactic acidosis. Results: Metformin was used as the first line therapy in 138 patients with type 2 diabetes mellitus, either as mono-therapy or at some instances in combination with other oral hypoglycaemic agents or insulin. About 56 patients were found to have either one or more absolute contraindications and 113 patients had precautionary conditions, despite which the therapy was continued in about 89.13% of the patients. Conclusion: The prescribing contraindications of metformin were found to be high and hence it is necessary to create awareness regarding contraindications and precautionary conditions regarding metformin among physicians and other health care professionals so as to prevent the incidence ling tern adverse effects like lactic acidosis.

Keywords

Metformin, Diabetes Mellitus, Lactic Acidosis, Prescribing Practice, Prescribing Contraindications.
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  • DeFronzo RA. Pharmacologic therapy for type 2 diabetes mellitus. Ann Intern Med 1999;131:281-303.
  • Calabrese AT, Coley KC, DaPos SV, Swanson D, Rao RH. Evaluation of Prescribing Practices: Risk of Lactic Acidosis with Metformin Therapy. Arch Intern Med 2002,162:434-437.
  • Bennett WL, Maruthur NM, Singh S. Comparative effectiveness and safety of medications for type 2 diabetes: an update including new drugs and 2-drug combinations. Ann Intern Med 2011;154: 602-613.
  • VijanS, Sussman JB, Yudkin JS, Hayward RA. Effect of patients’ risks and preferences on health gains with plasma glucose level lowering in type 2 diabetes mellitus. JAMA Intern Med2014,174:1227-1234.
  • Agarwal AA, Jadhav PR, Deshmukh YA. Prescribing pattern and efficacy of anti‑diabetic drugs in maintaining optimal glycemic levels in diabetic patients. J Basic Clin Pharm2014, 5(3):79-83.
  • Huang W, Castelino RL, Peterson GM. Metformin usage in type 2 diabetes mellitus: are safety guidelines adhered to.Intern Med J.2014;44(3):266-272.
  • Misbin RI, Green L, Stadel BV, Gueriguian JL, Gubbi A, Fleming GA. Lactic acidosis in patients with diabetes treated with metformin. N Engl J Med1988;338(4):265-266.
  • Holman RR, Paul SK, Bethel MA, Matthews DR, Neil HA. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med2008; 359: 1577-1589.
  • Buse JB, Ginsberg HN, Bakris GL. American Heart Association. American Diabetes Association. Primary prevention of cardiovascular diseases in people with diabetes mellitus: a scientific statement from the American Heart Association and the American Diabetes Association. Diabetes Care 2007;30: 162-172.

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  • Evaluation of Prescribing Practices of Metformin in Patients with Type-2 Diabetes Mellitus

Abstract Views: 167  |  PDF Views: 0

Authors

P. Maheshwari
Department of Pharmacy Practice, School of Pharmaceutical Sciences, VISTAS, Pallavaram, Chennai-600117, Tamilnadu, India
T. S. Shanmugarajan
Department of Pharmacy Practice, School of Pharmaceutical Sciences, VISTAS, Pallavaram, Chennai-600117, Tamilnadu, India

Abstract


Objectives: To evaluate the prescribing patterns of metformin in patients with type-2 diabetes mellitus and determine whether they are in accordance with published contraindications and precautions. Methods: Medical records of patients admitted with type-2 diabetes mellitus, who received at least one dose of metformin were identified and enrolled into the study. Patient demographic, clinical and biochemical data pertaining to diabetes and its risk factors were collected and documented. Prescribing patterns of metformin in these patients wereevaluated using the drug chart. All the prescriptions were checked for its accordance with published contraindications and precautions. Prescriptions in patients with type-2 diabetes mellitus were compared to the standard prescribing guidelines as per American Diabetes Association to analyse its compliance with recommended guidelines to determine whether metformin was prescribed to patients possessing any of the risk factors associated with development of lactic acidosis. Results: Metformin was used as the first line therapy in 138 patients with type 2 diabetes mellitus, either as mono-therapy or at some instances in combination with other oral hypoglycaemic agents or insulin. About 56 patients were found to have either one or more absolute contraindications and 113 patients had precautionary conditions, despite which the therapy was continued in about 89.13% of the patients. Conclusion: The prescribing contraindications of metformin were found to be high and hence it is necessary to create awareness regarding contraindications and precautionary conditions regarding metformin among physicians and other health care professionals so as to prevent the incidence ling tern adverse effects like lactic acidosis.

Keywords


Metformin, Diabetes Mellitus, Lactic Acidosis, Prescribing Practice, Prescribing Contraindications.

References