Prescription pattern among patients having mild to moderate bronchial asthma using metered dose inhaler and dry powder inhaler in tertiary hospital in western india
Keywords:Bronchial asthma, Dry powder inhaler, Meterd dose inhaler, Prescription pattern
Background: Bronchial asthma is a syndrome characterized by airflow obstruction that manifests as shortness of breath, wheezing and cough. The treatment is tailored according to the severity of the disease. The drugs used for treatment of bronchial asthma include inhaled corticosteroids, beta-2 agonists, methylxanthines, leukotriene antagonists and mast cell stabilizers. Despite the availability of all these drugs, which are recommended for the treatment, not every patient achieves complete control of the disease. The reason behind this could be irrational prescribing of drugs for the treatment and errors in the technique of using inhaler devices. Though rational prescribing of drugs and correct technique for the use of inhaler can be improved by proper training of target population, but there is paucity of such data in our country.
Methods: This study was planned to monitor prescription pattern and errors in use of inhalation devices, in patients diagnosed as cases of mild to moderate bronchial asthma, attending Out Patient Department (OPD) of respiratory medicine of a tertiary hospital. A total of 207 patients were recruited and their prescription pattern and inhalation technique were assessed.
Results: The study showed that inhaled short acting β2-agonists and inhaled corticosteroids were the most commonly used drug groups, which were prescribed to all the patients in the study, followed by long acting β2-agonists, leukotriene antagonists and methylxanthines in decreasing order.
Conclusions: As a conclusion, the treating physicians were prescribing according to the laid down guidelines. It is concluded that such studies should be periodically done to ensure the adherence to the treatment guidelines.
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's principles of internal medicine. 18th Edi. McGraw Hill Professional; 2015:1036.
World Health Organization: Media centre. Bronchial asthma Factsheet No. 206. 2016. Available at http//http://www.who.int/mediacentre/factsheets/fs206/en.
Peters SP, Ferguson G, Deniz Y, Reisner C. Uncontrolled asthma: A review of the prevalence, disease burden and options for treatment. Respir Med. 2006;100(7):1139-51.
Melani AS, Bonavia M, Cilenti V, Cinti C, Lodi M, Martucci P, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105(6):930-8.
Pandey A, Tripathi P, Pandey RD. Prescription pattern in asthma therapy at Gorakhpur hospitals. Lung India: official organ of Indian Chest Society. 2010;27(1):8.
Jin J, Sklar G, Min Sen Oh V, Chuen Li. Factors affecting therapeutic compliance: A review from the patient’s perspective. Therapeutics and Clinical Risk Management. 2008;4(1):269-86.
Darba J, Ramírez G, García-Bujalance L, Torvinen S, Sánchez-de la Rosa R, Sicras A. Identification of factors involved in medication compliance: incorrect inhaler technique of asthma treatment leads to poor compliance. Patient Prefer Adherence. 2016:135.
Rafeeq MM, Murad H. Evaluation of drug utilization pattern for patients of bronchial asthma in a government hospital of Saudi Arabia. Niger J Clin Pract. 2017;20(9):1098-1105.
Suh DI, Yang HJ, Kim BS, Shin YH, Lee SY, Park G, Kim WK, Kim HB, Baek H, Kim JK, Kim JT. Asthma Severity and the Controller Prescription in Children at 12 Tertiary Hospitals. Allergy, asthma & immunology research. 2017;9(1):52-60.
Turi KN, Gebretsadik T, Lee RL, Hartert TV, Evans AM. Seasonal patterns of Asthma medication fills among diverse populations of the United States. J Asthma. 2017 Sep 7:1-7.
Chou CL, Perng DW, Lin TL, Lin AM, Chen TJ, Wu MS, et al. Analysis of prescription pattern and guideline adherence in the management of asthma among medical institutions and physician specialties in Taiwan between 2000 and 2010. Clin Ther. 2015;37(10):2275-85.