DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20172228

A prospective observational study on prescribing patterns of drugs used in alcoholic liver disease patients at tertiary care teaching hospital

Zeebaish S., Hemalatha P., Eswari P. V. S. N., Kodandaraman T., Lakshmi P., Apoorva G.

Abstract


Background: Rational drug prescribing can be defined as appropriate drugs prescribed in the right dose, at correct time intervals and for a sufficient duration. Alcoholic Liver Disease (ALD) and its complications are the principle cause for morbidity and mortality rate and accounts for elevated social and economic costs. The drug use will be a challenge for the physicians as there was no specific treatment for ALD, and decisions regarding treatment are critically depends on the symptoms and complications.

Methods: A uni-centric prospective (observational) study was conducted for a period of 6months, to evaluate the current prescribing patterns used in treating ALD. All the patients admitted with diagnosis of ALD in General medicine department, both male and female medical wards were included in the study. General medicine outpatient department, special population such as pregnancy and psychiatry, patients below 18years and those who are not willing to sign in informed consent form was excluded from the study.

Results: Number of males (98.02%) between age group 31-40years (29.6%) was more prone when compared to females (1.77%). Portal hypertension (30.35%) followed by jaundice (11.30%) and Ascites (10.71%) were frequently observed complications associated co-morbidities with ALD. WHO prescribing indicators showed deviation from there standard reference values. Diuretics (15.73%), antibiotics (13.14%), vitamin supplements (11.11%) and antacids (10.13%) categories were the most commonly prescribed for patients. The drugs prescribed from NLEM-2015 (82.11%) shows deviation from standard values.

Conclusions: Futhermore, multi-centered studies should be conducted to draw best results on prescribing patterns of ALD in India.


Keywords


Alcoholic liver disease, Complications, Prescribing patterns, Prospective observational study

Full Text:

PDF

References


Jamdade VS, Malik A, Kolati SR, Reddy D, Lahkar M. Prescription pattern of drugs and WHO prescribing indicators used in alcoholic liver disease patients in a tertiary care teaching hospital in Northeastern India. Int J Pharm Bio Sci. 2015;6(4):503-10.

Shankar PR, Pai R, Dubey AK, Upadhyay DK. Prescribing patterns in the orthopedics outpatient department in a teaching hospital in Pokhara, western Nepal. Kathmandu University Medical Journal. 2006;4(2):1-6.

Marsano LS, Christian M, Hill D, Barve S, Mcclain CJ. Diagnosis and treatment of alcoholic liver disease and its complications. Diagnosing and treating alcoholic liver disease. 2003;22(3):247-56.

Prakash O, Ayub A, Hamid S. Hepatic Encephalopathy. New Advances in the Basic and Clinical Gastroenterology. 2012;24:495-510.

O’Shea RS, Dasarathy S, McCullough AJ. The Practice Guidelines Committee of the American Association for the study of Liver Diseases and the Practice Parameters Committee of American College of Gastroenterology. Alcoholic Liver Disease. Hepatology. 2010;51(1):307-28.

European Association for the Study of the Liver Clinical Practical Guideline, Adopted. April 2016:13-17.

Bouneva I, Abou-Assi S, Heuman DM, Mihas AA. Alocoholic Liver Disease. Hospital Physician; 2003:31-38.

European Association for the Study of the Liver Clinical Practical Guideline: Management of Alcoholic Liver Disease. Journal of Hepatology, 2012;57:399-420.

Bruha R, Dvorak K, Petrtyl J. Alcoholic liver disease. World journal of Hepatology. 2012;4(3):81-90.

McCullough AJ, O’Connor JFB. Alcoholic liver disease: Proposed recommendations for the American College of Gastroenterology. The American Journal of Gastroenterology. 1998;93(11):2022-36.

Desalegn AA. Assessment of drug use pattern using WHO prescribing indicators at Hawassa university teaching and referral hospital, south Ethipia: a cross sectional study. BMC Health Services Research. 2013;13:1-6.

Vijayan M, Anisha KA, Sanal A, Kumar S, Roshni PR. Clinical profile and prescribing pattern of cirrhosis in a tertiary care Hospital. Indian Journal of Pharmacy Practice. 2014;7(3):69-74.

Nand N, Malhotra P, Dhoot DK. Clinical profile of alcoholic liver disease in a tertiary care centre and its correlation with type, amount and duration of alcohol consumption. Journal of the Association of Physicians of India. 2015;63:14-20.

Lucena MI, Andrade RJ, Tognoni G, Hidalgo RN. Felipe Sanchez de la Cuesta and the Spanish collaborative study group on therapeutic management in liver disease. Multicenter hospital study on prescribing patterns for prophylaxis and treatment of complications of cirrhosis. Eur J Clin Pharmacol. 2002;58:435-40.