Medication use pattern and quality assessment of psychiatry outpatient department prescriptions of a tertiary care hospital

Ayan K. Pati; Siddhartha Ghosh

doi:10.18203/2319-2003.ijbcp20190136

Authors

Ayan K. Pati Department of Pharmacology, IQ City Medical College, Durgapur, West Bengal, India
Siddhartha Ghosh Department of Pharmacology, IQ City Medical College, Durgapur, West Bengal, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20190136

Keywords:

Outpatients, Prescribing pattern, Psychiatry, Psychotropic drugs, Prescription audit

Abstract

Background: Psychiatric illness is a major but often underreported health burden. The field of psychopharmacotherapy is continuously evolving therefore needs monitoring to prevent irrationality. In this setting, authors analyzed the prescribing pattern of psychotropic drugs while simultaneously monitoring prescription quality in a tertiary care teaching private hospital.

Methods: A 6 month-prospective observational study was conducted in psychiatry out-patient department. Prescription pattern was analyzed using World Health Organization (WHO) drug use indicators. The quality of the prescriptions was assessed as per prescription writing guidelines issued by The Department of Health and Family Welfare, Government of West Bengal.

Results: Of the 745 prescriptions analyzed, depression and psychosis constituted the bulk of diagnosed cases irrespective of any gender predominance. The average number of psychotropic drugs per prescription was 2.85±1.48. Antidepressants, sedative-hypnotic and anxiolytics are most commonly prescribed drugs. 37.58% of psychotropic drugs were given as fixed dose combination, most common being risperidone with trihexyphenidyl. Only 2.91% of the drugs were prescribed in generic name whereas 53.99% were enlisted in national essential medicine list 2015. Polypharmacy and therapeutic duplication were noted in 41% and 26.84 % of prescriptions and dose, duration and frequency were not mentioned in 2.68%, 53.02% and 19.00% of the prescription respectively.

Conclusions: Use of psychotropic drugs follows closely with different treatment guideline, though routine uses of central anticholinergics with atypical antipsychotics are not recommended. Despite high utilization of NLEM, more generic prescribing, correct prescription dosing schedule, avoidance of polypharmacy and non-Judicious use of multivitamin FDCs may significantly improve treatment outcome.

Metrics

Metrics Loading ...

References

Rode SB, Ajagallay RK, Salankar HV, Sinha U. A study on drug prescribing pattern in psychiatry out-patient department from a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2017 Jan 24;3(3):517-22.

Gupta N, Sharma D, Garg SK, Bhargava VK. Auditing of prescriptions to study utilization of antimicrobials in a tertiary hospital. Indian journal of pharmacology. 1997 Nov 1;29(6):411-5.

Elm E Von, Altman DG, Egger M, Pocock SJ, Peter C, Gøtzsche P, et al. guidelines for reporting observational studies Strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Br Med J. 2007;335(October):19-22.

World Health Organization. How to investigate drug use in health facilities. 1993:1-92. Available at: http://apps.who.int/medicinedocs/pdf/s2289e/s2289e.pdf.

Report of the Core-Committee for Revision of National List of Essential Medicines. November 2015. Available at: http://cdsco.nic.in/WriteReadData/NLEM-2015/Recommendations.pdf. Accessed 1 November 2018.

Standard Treatment Guidelines: For Primary Health Care facilities. Second edition. Department of Health and Family Welfare. Government of West Bengal. February 2011. Available at: http://www.ihfwkolkata.org/stg/stg2.html#. Accessed November 1, 2018.

Piparva K, Singh A, Trivedi H, Parmar D, Gajera M. Drug utilization study of psychotropic drugs in outdoor patients in a teaching hospital. Indian J Psychol Med. 2011;33(1):54.

Mukherjee S, Sen S, Chatterjee SS, Biswas A. Prescribing pattern of psychotropic medications in psychiatry outpatients at a tertiary care teaching hospital in India: a prospective cross-sectional study. Int J Hospital Res. 2014; 3(3):113-22.

Thakkar KB, Jain MM, Billa G, Joshi A, Khobragade AA. A drug utilization study of psychotropic drugs prescribed in the psychiatry outpatient department of a tertiary care hospital. J Clin Diagnostic Res. 2013;7(12):2759-64.

Ashton H. Guidelines for the rational use of benzodiazepines. Drugs. 1994 Jul 1;48(1):25-40.

Role of anticholinergic medications in patients requiring long-term antipsychotic treatment for psychotic disorders. Available at: www.who.int/mental_health/mhgap/evidence/psychosis/q6/en/. Accessed November 1, 2018.