Assessment of drug utilization pattern of antidiabetic drugs in type-2 diabetes outpatient of a tertiary care teaching hospital western Rajasthan
Keywords:Diabetes mellitus, Prescribing pattern, Rational drug use, Oral hypoglycemic agent
Background: Glycemic control remains the major therapeutic objective for prevention of target organ damage and other complications arising from diabetes. Poor glycemic control in diabetes mellitus can be prevented by using rational use of oral hypoglycemic agents (OHA). Rational use of the drugs in populations can be effectively evaluated using drug utilization studies.
Methods: The present study was conducted in the outpatient departments of General Medicine at Sardar Patel Medical College associated group of PBM Hospital, a tertiary care teaching hospital. It was a cross sectional prospective study carried out over a period of four months from September 2020 to January 2020. Patients were enrolled on the basis of inclusion and exclusion criteria.
Results: Total 300 patient prescription patterns were studied, out of which 58.33% were males and 41.66% were females. Most of the patients were in the age group of 51-60 years. Average number of anti-diabetic drugs per prescription was found to be 1.99. biguanides was the most commonly prescribed drug (97%) as mono therapy and combination therapy followed by sulfonylureas (65.6%), DPP 4 inhibitors (24%) Majority of the patients (66%) were on multidrug therapy.
Conclusions: Metformin was the most frequently prescribed drug in diabetes. Prescription by Brand name is a matter of concern. Overall, monotherapy was found to be predominant over combination therapy. There was no significant increase in the prescribing of newer oral antidiabetic agents like GLP-1receptor inhibitors and DPP-4 inhibitors. glimepride + metformin combination was the most commonly prescribed combination.
King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998;21(9):1414-31.
IDF Diabetes Atlas, 6th ed. 2013; 1-160. Available at: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/19-atlas-6th-edition.html. Accessed on 01 January 2021.
Bope ET, Kellerman RD. Conn’s Current Therapy. Saunders-Elsevier, Philadelphia, United States of America. 2014;701-4.
Venugopal K, Mohammed MZ. Prevalence of hypertension in type-2 diabetes mellitus. CHRISMED J Health Res. 2014;1(4):223-7.
Richard AH. Diabetes Mellitus/Pathophysiology: Etiologic factors associated with diabetes mellitus. In: Stephen M Setter, John R White. Textbook of Therapeutics: Drug and Disease Management. 8th ed, Lippincott Williams and Wilkins-Wolters Kluwer, Philadelphia, United States of America; 2007.
Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diab. 2008;26(2):77-82.
El-Kaissi S, Sherbeeni S. Pharmacological management of type 2 diabetes mellitus: An update. Curr Diabetes Rev. 2011;7(6):392-405.
Tognoni G, Liberati A, Pello L, Sasanclli E, Spagnoli A. Drug utilization studies and epidemiology. Rev Epifemiol. 1983;31:59–71.
Diagnostic Criteria. ICMR Guidelines for Management of Type 2 Diabetes. Link: https://goo.gl/OlX3z1. Accessed on 10 January 2021.
Vengurlekar S, Shukla P, Patidar P, Bafna R, Jain S. Prescribing pattern of antidiabetic drugs in Indore city hospital. Indian J Pharmaceut Sci. 2008;70(5):637-40.
Yurgin N, Secnik K, Lage MJ. Antidiabetic prescriptions and glycemic control in German patients with type 2 diabetes mellitus: a retrospective database study. Clin Ther. 2007;29(2):316-25.
Upadhyay DK, Palaian S, Ravi Shankar P, Mishra P, Sah AK. Prescribing pattern in diabetic outpatients in a tertiary care teaching hospital in Nepal. J Clin Diagn Res. 2007;1(4):248-55.
Kannan, Arshad, Kumar S. A study on drug utilization of oral hypoglycemic agents in type-2 diabetic patients. Asian J Pharm Clin Res. 2011;4:60-4.
Sutharson L, Hariharan RS, Vamsadhara C. Drug utilization study in diabetology outpatient setting of a tertiary hospital. Indian J Pharmacol. 2003;35(4):237-40.
Karthikeyan V, Maadhusudhan S, Selvamuthukumran S. Studies on Prescribing Pattern in the Management of Diabetes Mellitus in Rural Teaching Hospital. Saudi J Med Pharm Sci. 2016;2(5):100-7.
Alex SM, Bs S, Smitha S, Kn J, Menon AS. Drug Utilization Pattern of antidiabetic drugs Among Diabetic Outpatients In A Tertiary Care Hospital. As J Pharmaceut Clinic Res. 2015;8:144-6.
Jain J, Sharma P, Jain J, Raja M Utilization pattern of oral hypoglycaemic agents for diabetes mellitus type 2 patients attending out-patient department at tertiary care centre in Bhopal. Int J Bas Clinic Pharmacol. 2016;5:1826-30.
Sivasankari V, Manivannan E, Priyadarsini SP. Drug utilization pattern of anti-diabetic drugs in a rural area of Tamilnadu, South India – A prospective, observational study. Int J Pharm Biol Sci. 2013;4:514–9.