DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20150863

Pattern of drug use in psoriasis inpatients in the department of dermatology at a tertiary care teaching hospital

Mohammed Rafiuddin Rashed, T. K. Mohammed Muneersha, A. K. Afzal Khan, P. V. Mirshad

Abstract


Background: The pattern of drug use in people hospitalized with a primary diagnosis of psoriasis has never been studied previously in India. The aim of the study was to characterize the prescription pattern of people admitted to hospital with psoriasis so that rational prescribing could be promoted among dermatologists.

Methods: Case files belonging to 32 patients, admitted in the Department of Dermatology with psoriasis, of a tertiary care teaching hospital in Kerala, over a period of 1-year were retrieved with the assistance of the medical records department. The data thus obtained was analyzed using descriptive statistics.

Results: The average age of patients who were admitted with psoriasis was 49.9 years, and their average duration of hospital stay was 7.96 days. A total of 296 formulations were prescribed to 32 patients. Out of 296 formulations, only 10 (3.37%) were generic and rest 286 (96.62%) branded. Fixed dose combinations consisted of 32.43% (96/296) of the prescribed formulations. Psoriasis vulgaris (56.25%) was the most common cause for admission. Of all the prescribed medications, 4 (1.35%) did not contain clear instructions for the route of administration. Strength was clearly mentioned in only 89 (30%) of the preparations. In 98% of the prescriptions, the exact dose was missing.

Conclusions: The study reveals various deficiencies which exist in the prescribing pattern of drugs for management of psoriasis. Educational interventions among the doctors as well as students should be carried out to promote rational drug use.

 


Keywords


Psoriasis, Inpatient management, Dermatology, Drug utilization, Prescription analysis

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References


Griffiths C, Barker J. Psoriasis. In: Burns TB, Cox N, Griffiths C, editors. Rook’s Textbook of Dermatology. 8th Edition. Oxford: Wıley-Blackwell; 2010: 20.1-20.54.

Griffiths CE, Christophers E, Barker JN, Chalmers RJ, Chimenti S, Krueger GG, et al. A classification of psoriasis vulgaris according to phenotype. Br J Dermatol. 2007;156(2):258-62.

Rapp SR, Feldman SR, Exum ML, Fleischer AB Jr, Reboussin DM. Psoriasis causes as much disability as other major medical diseases. J Am Acad Dermatol. 1999;41:401-7.

Langley RG, Krueger GG, Griffiths CE. Psoriasis: epidemiology, clinical features, and quality of life. Ann Rheum Dis. 2005;64 Suppl 2:ii18-23.

Hawro T, Zalewska A, Hawro M, Kaszuba A, Królikowska M, Maurer M. Impact of psoriasis severity on family income and quality of life. J Eur Acad Dermatol Venereol. 2015;29(3):438-43.

Feldman SR, Pearce DJ, Dellavalle RP, Duffin KC. Treatment of psoriasis. UpToDate 2015:1.

Dogra S, Yadav S. Psoriasis in India: prevalence and pattern. Indian J Dermatol Venereol Leprol. 2010;76(6):595-601.

Moreno-Ramírez D. Intermittent treatment regimens and the rational (efficient) use of biologic agents in psoriasis. Actas Dermosifiliogr. 2011;102(4):241-3.

Mirshad P, Afzal Khan A, Fasalu Rahiman O, Mohammed Muneersha T. Prescription audit of corticosteroid usage in the department of dermatology at a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2013;2(4):411-3.

WHO International Working Group for Drug Statistics Methodology, WHO Collaborating Centre for Drug Statistics Methodology, WHO Collaborating Centre for Drug Utilization Research and Clinical Pharmacological Services. Introduction to Drug Utilization Research. Geneva: World Health Organization; 2003: 48.

Steinke SI, Peitsch WK, Ludwig A, Goebeler M. Cost-of-illness in psoriasis: comparing inpatient and outpatient therapy. PLoS One. 2013;8(10):e78152.

Conway P, Currie CJ. Descriptive epidemiology of hospitalisation for psoriasis. Curr Med Res Opin. 2008;24(12):3487-91.

Beyer V, Wolverton SE. Recent trends in systemic psoriasis treatment costs. Arch Dermatol. 2010;146(1):46-54.

Guenther LC. Fixed-dose combination therapy for psoriasis. Am J Clin Dermatol. 2004;5(2):71-7.

Harcharik S, Emer J. Steroid-sparing properties of emollients in dermatology. Skin Therapy Lett. 2014;19(1):5-10.

Rathi SK, D’Souza P. Rational and ethical use of topical corticosteroids based on safety and efficacy. Indian J Dermatol. 2012;57(4):251-9.

Polat M, Lenk N, Yalcin B, Gür G, Tamer E, Artuz F, et al. Efficacy of erythromycin for psoriasis vulgaris. Clin Exp Dermatol. 2007;32(3):295-7.