DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20172111

Evaluation of rational drug use pattern using WHO prescribing indicators in a medical intensive care unit of a tertiary teaching hospital in Kerala, India

Shobha P., Messaline Sunitha

Abstract


Background: ICU patients are exposed to more number of life saving drugs and face drug related problems like therapeutic failure, drug interactions and frequent adverse drug reactions. The cost of ICU hospitalisation and money spent on medicines is also a huge burden on these patients. A study of prescribing pattern in an ICU set up will serve as a medical audit to monitor and evaluate the prescribing practices to make it more rational and cost effective.

Methods: A prospective observational study was carried out in a medical ICU of a tertiary care hospital. All the inpatients admitted in the medical ICU during the study period of 2 months were included in the study. The data obtained from the case sheets were used to assess the prescribing pattern and rationality of drug use.

Results: A total of 101 patients were admitted in 2 months. The most common illness for which the patients (22) were admitted was respiratory problems. Average number of drugs per prescription was 6.9. Cardiovascular system (23.9%) drugs were the most frequently prescribed. Pantoprazole (77) was the single most commonly prescribed drug. 40% of the drugs were prescribed from the essential drug list. The average cost of medicines incurred per person in our study was 5126.33 in INR.

Conclusions: Polypharmacy and unwanted prescription of proton pump inhibitors can be avoided by prescribing more generics and drugs from essential drug list.


Keywords


Intensive care unit, Prescribing pattern, Polypharmacy, Rational drug use

Full Text:

PDF

References


World Health Organization. Introduction to drug utilization research. Geneva: WHO, 2003.

Townsend PL, Reynolds JR, Zaske DE. Applied Pharmacokinetics in the Intensive Care Unit. In: Irwin RS, Cerra FB, Rippe JM eds. Irwin and Rippe’s Intensive Care Medicine, 4th Ed. Philadelphia, Lippincott‐Raven Publishers; 1999:1413.

Niederman MS. Appropriate use of antimicrobial agents: Challenges and strategies for improvement. Crit Care Med. 2003;31:608‐16.

John LJ, Devi P, John J, Guido S. Drug utilization study of antimicrobial agents in medical intensive care unit of a tertiary care hospital. Asian J Pharm Clin Res. 2011;4(2):81-4.

Srishyla MV, Krishnamoorthy M, Naga Rani MA. Prescription audit in an Indian hospital setting using the DDD (defined daily dose) concept. Indian J Pharmacol. 1994;26:23-8.

Grand AL, Hogerzeil HV, Haaijer-Ruskamp FM. Intervention research in rational use of drugs: a review Health Policy and Planning. Oxford University Press. 1999;14(2):89-102.

Meena VK, Atray M, Agrawal A. Evaluation of Drug Utilization Pattern in Indoor Patients of Medicine Department at Tertiary Care Teaching Hospital in Southern Rajasthan. Int J Pharm Sci Res. 2016;7(9):3835-40.

Shankar PR, Partha P, Dubey AK, Mishra P, Deshpande VY. Intensive care unit drug utilization in a teaching hospital in Nepal. Kathmandu University Medical Journal. 2005;3(2):130-7.

Shelat PR, Gandhi AM, Patel PP. A Study of Drug Utilization Pattern According to Daily Define Dose in Intensive Care Unit at Tertiary Care Teaching Hospital, India. Journal of Young Pharmacists. 2015;7(4):349-58.

Kaur S, Rajagopalan S, Kaur N, Shafiq N, Bhalla A, Pandhi P, Malhotra S. Drug Utilization Study in Medical Emergency Unit of a Tertiary Care Hospital in North India. Emergency Medicine International. 2014:973578.

Barot PA, Malhotra SD, Rana DA, Patel VJ, Patel KP. Drug utilization in emergency medicine department at a tertiary care teaching hospital: A prospective study. J Basic Clin Pharma. 2013;4(4):78-81.

Raja S, Mohapatra S, Kumar J, Rani RJ. Prescription Patterns of Hypolipidaemic Drugs in a Tertiary Care Teaching Hospital of Southern India. JCDR. 2014;8(4):HC01-3.

Jacob J, Thomas C, Naaz A, Ramasamy R, Nazeem T, Shekar S. Study of Prescription Pattern in an Intensive Care Unit: A Prospective Observational Study. WJPPS. 2007;5(1):1125-32.

Daley RJ, Rebuck JA, Welage LS, Rogers FB. Prevention of stress ulceration: Current trends in critical care. Crit Care Med. 2004;32(10):2008-13.