DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20174794

Evaluation of indoor prescriptions of depression in psychiatry department of a tertiary care hospital in North India

Gurpreet Kaur Randhawa, Navyug Raj Singh, Prithwijit Kundu, Swati Prabhakar

Abstract


Background: Depression is one of most common psychiatric illnesses affecting the human population and poses significant economic burden to society. Prescription for depression usually involves multiple medications sometime irrationally prescribed.

Methods: Present study involved evaluation of 65 indoor prescriptions of patients diagnosed with depression from Psychiatry Department in a tertiary care hospital. The prescriptions were evaluated on basis of WHO Core Indicators for writing a good prescription. The demographic characteristics of the patient population were studied. Number of drugs prescribed per prescription and the average number per prescription were calculated to assess polypharmacy. The cost involved in treatment using latest market data from drug information source and the rationality of prescriptions were also evaluated.

Results: 80% of the prescriptions were not in accordance with the WHO Core Indicators. An average of 2.415±1.102 medications were prescribed per prescription indicating polypharmacy. Insignificant difference was observed in cost per prescription per month of medicines when compared with lowest priced products available in market.

Conclusions: Polypharmacy was found in most prescriptions and monotherapy was instituted in five prescriptions only, with clonazepam as the most prescribed antidepressant drug. Majority of prescriptions did not conform to WHO core indicators for prescription writing.


Keywords


Prescription analysis, Prescription audit, Polypharmacy, WHO core indicators

Full Text:

PDF

References


Marcus M, Yasamy M, van Ommeren M, Chisholm D, Saxena S. Depression: A Global Health Concern. Available at http://www.who.int/mental_health/management/depression/who_paper_depression_wfmh_2012.pdf. [accessed on 15.05.2017].

USA suicide: 2014 - official final data. Available at https://dphhs.mt.gov/Portals/85/amdd/documents/Professional%20Persons/2014USSuicideData.pdf. [accessed on 16.05.2017].

Bromet E, Andrade LH, Hwang I, Sampson NA, Alonso J, de Girolamo G, et al. Cross-national epidemiology of DSM-IV major depressive episode. BMC Med. 2011;9:90.

Murphy JM, Laird NM, Monson RR, Sobel AM, Leighton AH. A 40-year perspective on the prevalence of depression: the Stirling County Study. Arch Gen Psychiatry. 2000;57:209-15.

Poongothai S, Pradeepa R, Ganesan A, Mohan V. Prevalence of depression in a large urban South Indian population - The Chennai Urban Rural Epidemiology Study (CURES-70). PloS One. 2009;4:E7185.

Nandi DN, Banerjee G, Mukherjee SP, Ghosh A, Nandi PS, Nandi S. Psychiatric morbidity of a rural Indian community changes over a 20-year interval. Br J Psychiatry. 2000;176:351-6.

Pothen M, Kuruvilla A, Philip K, Joseph A, Jacob KS. Common mental disorders among primary care attenders in Vellore, South India: Nature, prevalence and risk factors. Int J Soc Psychiatry. 2003;49:119-25.

Spence R, Roberts A, Ariti C, Bardsley M. Focus on: Antidepressant Prescribing. Trends in the prescribing of antidepressants in primary care. The Health Foundation, Nuffield Trust 2014. Available at http://eprints.mdx.ac.uk/16512/.

Lieberman J. History of the use of antidepressants in primary care. Primary care companion. J Clin Psychiatry. 2003;5:6-10.

Gartlehner G, Hansen RA, Morgan LC, Thaler K, Lux L, Noord MV, et al. Second-generation antidepressants in the pharmacologic treatment of adult depression. An update of the 2007 comparative effectiveness review. Comparative Effectiveness Reviews No. 46; 2011. Available at http://www.diva-portal.org/smash/record.jsf?pid=diva2%3A810275&dswid=3098.

Bitter I, Filipovits D, Czobor P. Adverse reactions to duloxetine in depression. Expert Opin Drug Saf. 2011:10;839-50.

Guide to Good Prescribing, WHO Action Programme on Essential Drugs Geneva.1994. Available at http://apps.who.int/medicinedocs/pdf/whozip23e/whozip23e.pdf.

Central Nervous System. In: Arora V, eds. Drug Update: Sri Ganganagar. 2017:340-446.

Dutta S, Kaul V, Beg MA, Sindhu S, Singh NK, Dutta S, et al. A psychotropic drug use study among depression patients attending private psychiatric practitioners of Dehradun, Uttarakhand. Int J Med Sci Public Health. 2015;4:634-8.

Swamy MK, Wagle L, Giri V. Drug utilization pattern of psychotropic drugs in psychiatric outpatient department of rural tertiary care teaching hospital. Int J Pharm Sci Res. 2016;7(8):3497-08.

Kavitha VD, Bhandari PR. First prescription analysis study of depression in a tertiary hospital. World J Pharm Sci. 2017;5(1):49-53.

Uchida N, Chong MY, Tan CH, Nagai H, Tanaka M, Lee MS, et al. International study on antidepressant prescription pattern at 20 teaching hospitals and major psychiatric institutions in East Asia: Analysis of 1898 cases from China, Japan, Korea, Singapore and Taiwan. Psychiatry Clin Neurosci. 2007;61(5):522-8.

Chattar KB, Karve AV, Subramanyam A, Tondare SB. Prescription pattern analysis of antidepressants in psychiatric outpatient department of tertiary care hospital in India. Asian J Pharm Clin Res. 2016;9(4):77-9.