Drug utilization pattern in type II diabetes mellitus patients attending non-communicable disease clinic in a tertiary care hospital
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20190662Keywords:
Drug utilization, Non-communicable disease clinic, Type II diabetes mellitusAbstract
Background: Diabetes mellitus is a metabolic disorder. Early institution of treatment is necessary to prevent complications. Since treatment of diabetes requires lifetime therapy; this study is designed to understand the prescription trends at Non Communicable Disease clinic set up and to provide rationale.
Methods: This cross-sectional, observational study was conducted over a period of 2 months (May 2017- June 2017). Details of demographic data, duration and family history of diabetes, antidiabetic medications prescribed, history of comorbid diseases and drugs prescribed by physician for the treatment of comorbid diseases were collected in a structured format. Height and weight were recorded, and body mass index was calculated.
Results: Study population included 294 patients and patients in the age groups of 40-59 years formed the bulk. 39% patients were overweight and 19.39% were obese. 93.20% patients were prescribed with metformin. 37 patients received insulin injection. 64.29% received more than one antidiabetic drug. Hypertension (82.05%) was the most common comorbid disease. Amlodipine was the most commonly prescribed antihypertensive drug.
Conclusions: Metformin was the most commonly prescribed antidiabetic drug. Utilization of newer antidiabetic drug is inferior. Use of rationale fixed dose combination improves patient compliance.
References
International Diabetes Federation. IDF DIABETES ATLAS, 2017. Available at: http:// www.diabetesatlas.org. Accessed 14 October 2018.
White WB, Kupfer S, Zannad F, Mehta CR, Wilson CA, Lei L et al. Cardiovascular mortality in patients with type 2 diabetes and recent acute coronary syndromes from the examine trial. Diab Care 2016;39(7):1267-73.
Fernandes SD, Fernandes SDA. Economic burden of diabetes mellitus and its socio-economic impact on household expenditure in an urban slum area. Int J Res Med Sci. 2017;5(5):1808-13.
WHO. What is drug utilization research and why it is needed? In: introduction to drug utilization research-World Health Organization; 2003:8-12. Available at: http://apps.who.int/medicinedocs/pdf/s4876e/s4876e.pdf. Accessed 4 December 2018.
Alam, MS, Aqil M, Qadry SAS, Kapur P, Pillai KK. Utilization pattern of oral hypoglycemic agents for Diabetes mellitus type 2 patients attending out-Patient department at a University Hospital in New Delhi. Pharmacol Pharmacy. 2014;5:636-45.
Sharma, Chopra SC , Sharma DK , Singla J , Kapoor V. Drug utilization study in diabetic patients seeking medical treatment in a north Indian rural medical college hospital. Int J Basic Clin Pharmacol. 2018;7(5):912-6.
Alex SM, Sreelekshmi BS, Smitha S, Jiji KN, Menon AS, Uma Devi P. Drug utilization pattern of anti-diabetic drugs among diabetic outpatients in a tertiary care hospital. Asian J Pharm Clin Res. 2015;8(2):144-6.
Dashputra AV, Badwaik RT, Borkar AS, Date AP, Kalnawat NR. Pattern of antidiabetic drugs used in outpatient and hospitalized patients in a Tertiary Health Institute of Central India. J Cont Med A Dent. 2014;2(3):48-54.
Krentz AJ, Bailey CJ. Oral antidiabetic agents: current role in type 2 diabetes mellitus. Drugs. 2005;65(3):385-411.
Sola D, Rossi L, Schianca GPC, Maffioli P, Bigliocca M, Mella R, et al. Sulfonylureas and their use in clinical practice. Arch Med Sci. 2015;11(4):840-8.
Kakade A, Mohanty IR, Rai S. Assessment of prescription pattern of antidiabetic drugs in the outpatient department of a Tertiary Care Hospital. Int J Clin Endocrinol Metab. 2017;3(1):1-7.
Adhikari PM, Pai MR. Drug utilisation study in geriatric type 2 diabetic patients. J Clin Diag Res. 2007;1(5):440-3.
Acharya KG, Shah KN, Solanki ND, Rana DA. Evaluation of antidiabetic prescriptions, cost and adherence to treatment guidelines: A prospective, cross-sectional study at a tertiary care teaching hospital. J Basic Clin Pharma. 2013;4(4):82-7.
Park CY, Kang JG, Chon S, Noh J, Oh SJ, Lee CB et al. Comparison between the therapeutic effect of Metformin, Glimepiride and their combination as an add-On treatment to Insulin Glargine in uncontrolled patients with Type 2 Diabetes. PLoS One 2014;9(3):e87799.
Chazan AC, Gomes MB. Gliclazide and bedtime insulin are more efficient than insulin alone for type 2 diabetic patients with sulfonylurea secondary failure. Brazilian J Med Biol Res. 2001 Jan;34(1):49-56.
Tatti P, Pahor M, Byington RP, Di Mauro P, Guarisco R, Strollo G, et al. Outcome results of the Fosinopril Versus Amlodipine Cardiovascular Events Randomized Trial (FACET) in patients with hypertension and NIDDM. Diab Care. 1998 Apr 1;21(4):597-603.
Patel A, Mac Mahon S, Chalmers J, Neal B, Woodward M, Billot L et al. Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): a randomised controlled trial. Lancet. 2007;370(9590):829-40.
Muramatsu T, Matsushita K, Yamashita K, Kondo T, Maeda K, Shintani S et al. Comparison between valsartan and amlodipine regarding cardiovascular morbidity and mortality in hypertensive patients with glucose intolerance: NAGOYA HEART Study. Hypertension. 2012;59(3):580-6.
Maiti T, Chakrabarty S, Mandal S, Panda A, Gangopadhyay T, Dan S. A study on drug utilization pattern in patients of Type II diabetes mellitus attending referral diabetic clinic at a tertiary care teaching hospital in rural Bengal. Eur J Pharmaceut Med Res. 2016;3(9):641-7.
