A survey of prescription pattern of anti-diabetic drugs on diabetic patients with cardiovascular complications within Dhaka metropolis
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20164095Keywords:
CVD, Dhaka, Diabetes, Hypoglycemic agents, PrescriptionAbstract
Background: This survey study was designed to analyze the current prescription pattern of anti-diabetic drugs that used in diabetic patients with cardiovascular complications within Dhaka metropolis.
Methods: The present study has been conducted by out-patient department in a number of well-known general and specialized government and private hospitals in Dhaka, Bangladesh for 5 months. 1200 prescriptions and questionnaire were randomly evaluated for this present survey. A standard questionnaire was prepared, containing 17 different questions, to conduct the survey based on patient’s demographic data such as which type of diabetes they have contained, age, gender, education and their self-assessment of health, disease history and medication.
Results: Among the patients involved in this study, there were 46% (550) male and 54% (650) female between the ages of 30 and 75 years. Between 46 and 70 years, 19% male and 31% female were found to be diabetic indicating that in this age group female are mostly affected by diabetes. About 2020 antidiabetic drugs were prescribed by the physicians in which 30.43% contained single, 54.16% contained two and 15% contained more than two anti-diabetic drugs. Amongst antidiabetic medications, metformin was the most commonly prescribed drug which was given in 30.69% patients followed by glimepride 10.9%, 5.45% had glipizide, 1% pioglitazone and other drugs. A total of 7.43% drug was prescribed by fixed dose combinations. Highest percentage of male diabetic patients with hypertension (86%), dyslipidemia (100%) and other complications (57%) was found at 75 years of age while no female patients were found under the same condition at the same age.
Conclusions: The findings can serve as a guide to choose the formulation and combination of anti-diabetic drugs in this part of the world before developing & marketing any new drug. Therefore it is necessary to create better awareness among people, focus on rational use of anti-diabetic drugs and also motivate our physicians to prescribe the generic drugs.
References
Michael H. Statin/fibrate combination in patients with metabolic syndrome or diabetes: evaluating the risks of pharmacokinetic drug interactions. Expert Opin. Drug. 2006;5(1):145-56.
DeFronzo RA, bonadonna RC, Ferrannini E. Pathogenesis of NIDDM: A balanced overview. Diabetes Care. 2002;15:318-68.
Alessandra, Lucianne, Roberta, Catia C, Carlos, Brito G. Impact of Diabetes on Cardiovascular Disease: Int. J. Hyper. 2013:2-5.
Diabetes in America, National Institutes of Health, National Institute of diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA, 2nd edition, 1995.
Amanda NL, Samuel DJ. The Comorbidities of Diabetes and Hypertension: Mechanisms and Approach to Target Organ Protection. J Clin Hypertens. 2011;13(4):244-6.
Arshag DM. Management of type 2 diabetes mellitus Apharmacoepidemiology. 2009:150-159.
Rafael C. Type 2 diabetes, dyslipidemia, and vascular risk: Rationale and evidence for correcting the lipid imbalance. American heart journal. 2005;150:859-70.
Alvin C. Harrison's Principles of Internal Medicine; Diabetes Mellitus, 1995:345.
Practitioner’s manual: Valid prescription requirements. U. S. Department of justice, Drug enforcement administration. 2006 Edition.
Yuen YH, Chang S, Chong CK, Lee SC, Critchlev JA, Chan JC. Drug utilization in a hospital general medical outpatient clinic with particular reference to antihypertensive and antidiabetic drugs. J Clin Pharm Ther. 1998;23:287-94.
Ramachandran G, Rohith V, Isabella Topno. Evaluation of prescribing pattern of anti-diabetic drugs using WHO prescribing indicators in a tertiary care hospital in Puducherry: A cross-sectional study. The Pharma Innovation Journal 2015;4(5):76-80.
Alebiosu CO. Antidiabetics/Antihypertensives prescription profiles in OSUTH, Sagamu and environment. Nigerian J Clin Prac. 2004;7(1):15-20.
Eze, Ojieabu. Pattern of Prescriptions among Elderly Diabetic- Hypertensive Patients in a Nigerian Teaching Hospital. Afr. J. Biomed. Res. 2010;13(3):169-73.
Good CB. Polypharmacy in Elderly patients with diabetes. Diabetes Spectrum. 2002; 15:240-248.
Vengurlekar S, Shukla P, Patidar P, Bafna R, Jain S. Prescribing pattern of antidiabetic drugs in Indore city hospital. Indian J Pharm Sci. 2008;70:637-40.
Shaktibala D, Mirza Atif B, Mohammad A, Amit V, Shalu B. Study of prescribing pattern in diabetes mellitus patients in a tertiary care teaching hospital at dehradun, uttarakhand. Int J Med Sci Pub H. 2014;3(11):1-8.
Dhanraja E, Raval AD, Yadav R, Bhansali A, Tiwari P. Prescribing pattern of antidiabetic drugs and achievement of glycemic control in T2DM patients in tertiary care hospital in North India. Int J Diab Dev C. 2013:33:140-6.
Krentz AJ, Bailey CJ. Oral antidiabetic agents: Current role in type 2 diabetes mellitus. Drugs. 2005;65:385-411.
Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F, Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement’ Circulation. 2005;112(17):2735-52.
Epstein M, Sowers JR. Diabetes mellitus and hypertension. Hypertension. 1992;19:403-18.
The National High Blood Pressure Education Program Working Group. National High Blood Pressure Education Program Working Group report on hypertension in diabetes. Hypertension. 1994;23:145-58.
Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA. 2004;291:335-42.