Study of drug prescription pattern and adverse drug reaction monitoring in patients with hypertension and diabetes visiting outpatient department in a government tertiary care hospital in Maharashtra, India

Rucha M. Shinde, Anand S. Kale, Mahadeo P. Sawant


Background: Drug utilization study is an important tool to study the clinical use of drugs and its impact on healthcare system. DUS in patients with HTN and DM is essential to observe the changing prescribing attitude of physicians with the aim to promote rational use of drugs and to minimize the adverse drug reactions.

Methods: A cross sectional observational study was conducted on randomly selected patients attending medicine outpatient department in a tertiary care hospital. Drug prescription sheets of 600 patients were studied for 18 months from January 2016 to June 2017 and the prescribing pattern was analysed using the World Health Organization basic drug indicators.

Results: Total 2029 drugs were prescribed to 600 patients that belonged to various classes. The average number of drugs prescribed per encounter was 3.4. Majority (61.5%) drugs were prescribed using generic names. Percentage encounters with the antibiotics and injections were 6.3 and 11.5 per cent respectively. 38% drugs were prescribed from the 20th edition of WHO Model List of Essential Medicines. PDD in the current study was found to be significantly less than WHO DDD in all drugs. All of the prescriptions in the present study conformed to WHO guidelines and majority of them with JNC VIII guidelines.

Conclusions: The findings of this study are comparable to those of other studies. However, there is a scope of improvement in areas such as overdosing, prescribing more by generic names instead of brand names and from WHO Model List of Essential Medicines.


Defined daily dose, Drug utilization, Essential medicines, Generic drugs, Overdosing, Prescribed daily dose

Full Text:



Venugopal K, Mohammed MZ. Prevalence of hypertension in type-2 diabetes mellitus. CHRISMED J Health Res. 2014 Oct 1;1(4):223.

Colosia AD, Palencia R, Khan S. Prevalence of hypertension and obesity in patients with type 2 diabetes mellitus in observational studies: a systematic literature review. Diabetes Metab Syndr Obes. 2013;6:327-38.

Anchala R, Kannuri NK, Pant H, Khan H, Franco OH, Di Angelantonio E, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014 Jun;32(6):1170-7.

Sandozi T, Emani VK. Survey of prescription pattern of anti-hypertensive drugs in hypertensives and hypertension associated diabetics. Int J Pharm Bio Sci. 2010;1(4):23-6.

Sweileh WM, Sawalha AF, Zyoud SH, Al-Jabi SW, Tameem EJ, Shraim NY. Evaluation of antihypertensive therapy in diabetic hypertensive patients: impact of ischemic heart disease. Pharm Pract (Granada). 2009;7(1):40-6.

Hussain Z, Sana A, Mohammed S, Razzaq MA. Patterns of drug therapy among diabetic hypertensive patients with other complications. Int J Pharma Pharmaceu Sci. 2014;6(6):270-7.

Shah J, Khakhkhar T, Bhirud S,Shah RB, Date S. Study of utilization pattern of antihypertensive drugs in hypertensive diabetic patients with or without educed renal function at tertiary care teaching hospital. Int J Med Sci Public Health. 2013;2(2):175-80.

Muhammad J. Audit of paediatric prescriptions for the common paediatric problems. Pak J Med Sci. 2007;23(6):932-5.

Johnson ML, Singh H. Patterns of antihypertensive therapy among patients with diabetes. J Gen Intern Med. 2005;20(9):842-6.

Solanki KC, Mistry RA, Singh AP, Jadav SP, Patel NM, Trivedi HR. Drug utilization study of anti-hypertensive drugs and their adverse effects in patients of a tertiary care hospital. J Clin Exp Res. 2013;1(3):58-67.

WHO Collaborating Centre for Drug Statistics Methodology:Guidelines for ATC classification and DDD assignment. Oslo: WHO; 2015.

Shuttleworth M. Hawthorne Effect [Internet].(cited 2017 August 10). Available at: