The observational, cross-sectional study of drug utilization 90% and use of dipeptidyl peptidase-4 inhibitor in the patients with type 2 diabetes mellitus
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20194771Keywords:
Diabetes, DPP-4 inhibitors, Drug utilization study, Daily defined dose, DU 90%Abstract
Background: Diabetes is a chronic metabolic disease which affects the quality of life. It leads to multiple complications due to metabolic involvement. Out of multiple drugs used to treat diabetes, dipeptidyl peptidase 4 (DPP-4) inhibitors are comparatively new drugs used for type-2-diabetes mellitus (DM) treatment. This study aimed to find out the drug utilization (DU) 90% and use of DPP-4 inhibitors in patients with type-2-DM.
Methods: A prospective, cross-sectional, observational study was conducted at a private healthcare clinic of an endocrinologist in Nashik. Type-2-DM patients of both sexes were selected and a total of 199 patients were enrolled in the study. The consented patients were interviewed and prescription copies were collected. After studying them; statistical analysis was done and results and conclusions were drawn.
Results: Out of total prescribed drugs, 58.77% of drugs were anti-diabetics. It was observed that the biguanides were most frequently (25.32%) prescribed while the least prescribed drugs were meglitinide analogues (0.08%). Most commonly utilized anti-diabetic found to be metformin. Vildagliptin 50 mg is the most commonly prescribed drug from DPP-4 inhibitors. Most of the drugs from the DPP-4 inhibitor group came under DU90%.
Conclusions:DPP-4 inhibitors are showing wide acceptability by endocrinologists for type-2-DM management, according to this study. Performing repetitive drug utilization pattern study and circulation of standard treatment guidelines to practising physicians can be required. To emphasize the point on generic prescription, more awareness should be created. So that these can responses to further cost-effective and rational prescribing practices.
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References
Pradhan SC, Shewade DG, Shashindran CH, Bapna JS. Drug utilization studies. The National Medical J India 1988;1(4):185-9.
World Health Organization. Introduction to drug utilization research. Printed in Oslo, Norway, 2003:33-41. Available at https://apps.who.int/ medicinedocs/en/d/Js4876e/. Accessed on 3 June 2019.
Insulin, Oral Hypoglycemic Drugs and Glucagon: Hormones and Related Drugs. In: KD Tripathi. Essentials of Medical Pharmacology. 7th ed. Jaypee Brothers Medical Publishers (P) Ltd; 2013;5(19):258-82.
Gupta V, Kalra S. Choosing a Gliptin. Indian J Endocrinol Metabol. 2011;15(4):298-308.
Powers AC, D'Alessio D. Endocrine Pancreas and Pharmacotherapy of Diabetes Mellitus and Hypoglycemia. In: Brunton LB, Lazo JS, Parker KL, eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics. 11th ed. New York, NY: McGraw-Hill; 2005.
Detournay B, Halimi S, Robert J, Deschaseaux C, Dejager S. Hypoglycemia hospitalization frequency in patients with type 2 diabetes mellitus: a comparison of dipeptidyl peptidase 4 inhibitors and insulin secretagogues using the French health insurance database. Vascular Health Risk Manag. 2015;11:417-25.
Montillaa S, Marchesinib G, Sammarcoa A, Trottaa MP, Sivieroa PD, Tominoa C, et al. Drug utilization, safety, and effectiveness of exenatide, sitagliptin, and vildagliptin for type 2 diabetes in the real world: Data from the Italian AIFA Anti-diabetics Monitoring Registry. Nutrition, Metabolism Cardiovascular Diseases; Elsevier. 2014;24:1346-53.
WHO Collaborating Centre for Drug Statistics Methodology. Guidelines for ATC classification and DDD assignment. 22nd ed. 2019. Available at https://www.whocc.no. Accessed on 3 July 2019.
Pedicino D, Liuzzo G, Trotta F, Giglio AF, Giubilato S, Martini F, et al. Adaptive Immunity, Inflammation, and Cardiovascular Complications in Type 1 and Type 2 Diabetes Mellitus. Hindawi Publishing Corporation J Diabetes Res. 2013;184258:11.
George PS, Pearson ER, Witham MD. Effect of vitamin D supplementation on glycaemic control and insulin resistance: a systematic review and meta-analysis. Diabet Med. 2012;29:e142-e150.
Luigi B, Julie K. Management of Type- 2 diabetes mellitus in Adults, Focus on individualizing non-insulin therapies. J Pharma Therap. 2012;37(12):687-96.
Ahren Bo. Use of DPP-4 inhibitors in type 2 diabetes: focus on sitagliptin. J Diabetes Metabol Syndrome Obesity. 2010;3:31-41.
Mishriky BM, Cummings DM, Tenenberg RJ. The efficacy and safety of DPP4 inhibitors compared to Sulfonylureas as add-on therapy to metformin in patients with Type 2 diabetes: A systematic review and meta-analysis. J Diabetes Res Clin Pract. 2015;109(2):378-88.
Foroutan N, Muratov S and Levine M. Safety and efficacy of dipeptidyl peptidase-4 inhibitors vs sulfonylurea in metformin-based combination therapy for type 2 diabetes mellitus: Systematic review and meta-analysis. Clin Investigative Med. 2016:39(2):48-62.
Ghosh S, Trivedi S, Sanyal D, Modi KD, Kharb S. Teneligliptin real-world efficacy assessment of type 2 diabetes mellitus patients in India (TREAT-INDIA study). J Diabetes, Metabol Syndrome Obesity: Targets Therapy. 2016:8(9):347-53.
McCann VJ, Davis RE. Pyridoxine and diabetic neuropathy: a double-blind controlled study. J Diabetic Care. 1983;6(1):102-3.
Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, et al. Diabetes and Cardiovascular Disease A Statement for Healthcare Professionals From the American Heart Association. AHA Scientific Statement; 1999;100:1134-46.
World Health Organization. The selection and use of essential medicines. World Health Organ Tech Rep Ser. 2014;(985):1-219.