A study of drug utilisation pattern in patients of chronic kidney disease at a tertiary care hospital

Authors

  • Latha Kamath Department of Pharmacology, Mysore Medical College, Mysore, Karnataka, India
  • Hema N. G. Department of Nephrology, K.R. Hospital, Mysore Medical College, Mysore, Karnataka, India
  • Himamani S. Department of Nephrology, K.R. Hospital, Mysore Medical College, Mysore, Karnataka, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20190131

Keywords:

Chronic kidney disease, Drug utilization, Prescribing pattern, Pharmacoepidemiology

Abstract

Background: Chronic kidney disease (CKD) is a major public health issue and widely prevalent non-communicable disease in India. CKD has a complex pharmacotherapy and it inevitably requires poly-pharmacy. CKD patients require to take medications for a lifelong period, which makes it very important to study the prescribing trends on a regular basis. The main objective of the study was to analyse current prescribing trends in the management of CKD patients and to know whether the prescribing rationality was maintained.

Methods: After Institutional Ethics Committee approval, a prospective         Cross-sectional study was carried out at Nephrology department of a tertiary care hospital for a period of six months from 1st June 2017 to 30th November 2017. Patients diagnosed with CKD by treating Nephrologist were included and their prescriptions were analysed to study the prescribing patterns.

Results: A total of 120 cases were analysed during the study, of which 81.7% were males and 18.3% were females. Analysis of WHO core drug prescribing indicators showed that the average number of drugs prescribed per patient was 5.13, percentage of drugs prescribed by generic name was 30.03%, percentage of patients with an injection prescribed was 16.6%, percentage of drugs prescribed from essential medicine list was 65.8% and percentage of patients prescribed with an antibiotic was 10.8%. Antihypertensive drugs (39.9%) were the most commonly used drugs, followed by, calcium salts (12.01%), multi-vitamins (7.6%), oral iron supplements (6.8%), erythropoietin (6.3%) and ulcer protectives (6.1%).

Conclusions: Maximum number of drugs were prescribed from cardiovascular class of drugs. Calcium channel blockers and diuretics were the commonest group of antihypertensives prescribed. The principle of rational prescribing was followed.

References

Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, et al. Global prevalence of chronic kidney disease - a systematic review and meta‑analysis. PLoS One. 2016 Jul;11(7).

World Health Organization: Burden of Disease Project. Available at: http://www3.who.int/whosis/menu.cfm. Accessed 22 October 2018.

Santra S, Agrawal D, Kumar S, Mishra SS. A study on the drug utilization pattern in patients with chronic kidney disease with emphasis on antibiotics. J Integrative Nephrol Androl. 2015 Jul 1;2(3):85.

Ahlawat R, Cruz SD, Tiwari P. Drug utilization pattern in chronic kidney disease patients at a tertiary care public teaching hospital: Evidence from a cross-sectional study. J Pharma Care Health Sys. 2015 Dec;3:149-53.

Pavitra R Y, Geetha M, Aggarwal R and Somashekar H S. Drug utilization pattern of antihypertensive drugs in chronic kidney disease patients in a tertiary care hospital. IOSR J Dental Med Sci. 2014 Nov;13(11):23-7.

Laporte JR, Orme ML. Drug utilization and the teaching of rational drug use. WHO Reg Publ Eur. 1993;45:183-91.

Singh AK, Farag YM, Mittal BV, Subramanian KK, Reddy SR, Acharya VN, et al. Epidemiology and risk factors of chronic kidney disease in India–results from the SEEK (screening and early evaluation of kidney disease) study. BMC Nephrol. 2013 Dec;14(1):114-92.

Piparva KG, Parmar DM, Singh AP, Gajera MV, Trivedi HR. Drug utilization study of psychotropic drugs in outdoor patients in a teaching hospital. Indian J Psychol Med. 2011 Jan;33(1):54-8.

Drug Use Evaluation. World Health Organization. Available at: http://www.who.int/medicines/technical_briefing/tbs/11-PG_Drug-Use-Evaluation_final-08.pdf. Accessed 25 October 2018.

Rajeshwari, Nagabushan H, Prakash GM, Rekha MC. Assessment of quality of life and drug usage among hemodialysis patients at a tertiary care hospital. Int J Pharm Clin Sci. 2016 Sept;5(3):65-72.

Chawla S, Ranjan A, Singh N.P, Garg N and Kumar A. Assessment of drug utilization and quality of life in patients of chronic kidney disease in a tertiary care hospital. World J Pharm Pharm Sci. 2016;5(9):1214-26.

Tamiselvan T, Veerapandiyan AK. Study of drug utilisation pattern of chronic renal failure patients in a tertiary care hospital. Int. J Pharm Pharm Sci. 2014;6(9):482-84.

Devi DP, George J. Diabetic nephropathy: prescription trends in tertiary hospital. Indian J Pharm Sci. 2015;70:374-78.

Al Ramahi R. Medication prescribing patterns among chronic kidney disease patients in a hospital in Malaysia. Saudi J Kidney Dis Transpl. 2012;23:403-8.

Tripathy JP, Thakur JS, Jeet G, Chawla S, Jain S, Pal A, et al. Prevalence and risk factors of diabetes in a large community-based study in North India: results from a STEPS survey in Punjab, India. Diabetol Metabol Syndrome. 2017 Dec;9(1):8.

Prabhakaran D, Jeemon P, Ghosh S, Shivashankar R, Ajay VS, Kondal D, et al. Prevalence and incidence of hypertension: results from a representative cohort of over 16,000 adults in three cities of South Asia. Indian Heart J. 2017 Jul 1;69(4):434-41.

Chang PY, Chien LN, Lin YF, Wu MS, Chiu WT, Chiou HY. Risk factors of gender for renal progression in patients with early chronic kidney disease. Med. 2016 Jul;95(30):1-19.

Bajait CS, Pimpalkute SA, Sontakke SD, Jaiswal KM, Dawari AV. Prescribing patterns of medicines in chronic kidney disease with emphasis on phosphate binders. Indian J Pharmacol. 2014;46:35-9.

Sonawane KB, Qian J, Hansen RA. Utilization patterns of antihypertensive drugs among the chronic kidney disease population in the United states: a cross-sectional analysis of the national health and nutrition examination survey. Clin Ther. 2014:15:802-4.

Jessani S, Bux R, Jafar TH. Prevalence, determinants, and management of chronic kidney disease in Karachi, Pakistan - a community based cross-sectional study. BMC Nephrol. 2014;15:1471-92.

Navaneethan SD, Sakhuja A, Arrigain S, Sharp J, Schold JD. Practice patterns of phosphate binder use and their associations with mortality in chronic kidney disease. Clin Nephrol. 2014;82:16-25.

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Published

2019-01-24

How to Cite

Kamath, L., G., H. N., & S., H. (2019). A study of drug utilisation pattern in patients of chronic kidney disease at a tertiary care hospital. International Journal of Basic & Clinical Pharmacology, 8(2), 170–175. https://doi.org/10.18203/2319-2003.ijbcp20190131

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Original Research Articles