Evaluation of prescribing pattern of drugs and compliance to standard treatment guidelines in patients of chronic hepatitis B: a prospective observational study

Ahmad Najmi; Abhishek Singhai; Shilpa Kaore; Jai Kumar Chaurasia; Sameer Khasbage; Abhishek Mishra; Samidha Kushwaha

doi:10.18203/2319-2003.ijbcp20231439

Authors

Ahmad Najmi Department of Pharmacology, AIIMS Bhopal, Madhya Pradesh, India
Abhishek Singhai Department of Medicine, AIIMS Bhopal, Madhya Pradesh, India
Shilpa Kaore Department of Pharmacology, AIIMS Bhopal, Madhya Pradesh, India
Jai Kumar Chaurasia Department of Pathology, AIIMS Bhopal, Madhya Pradesh, India
Sameer Khasbage Department of Pharmacology, AIIMS Bhopal, Madhya Pradesh, India
Abhishek Mishra Department of Pharmacology, AIIMS Bhopal, Madhya Pradesh, India
Samidha Kushwaha Department of Community Medicine, University College of Medical Sciences, New Delhi, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20231439

Keywords:

Chronic hepatitis B, Prescribing pattern, Antiviral drugs, Compliance to guidelines

Abstract

Background: Hepatitis B is a major global health problem. Chronic hepatitis B is characterized by hepatic inflammation, necrosis and persistence of HbsAg for at least 6 months. Chronic liver disease is more predictably associated with impaired metabolism of drugs than acute liver dysfunction. Prescribing drugs in patients with chronic hepatitis B is challenging because of concerns that the drug may exacerbate the liver disease. There is also the fear that the altered liver state may change metabolism and excretion of the drug.

Methods: A cross-sectional prospective study was conducted involving patients diagnosed with chronic hepatitis B at the liver clinic outpatient department (OPD) of AIIMS Bhopal. A total of 102 patients with chronic hepatitis B who met the inclusion criteria were recruited in the study.

Results: Out of 102 prescriptions, 492 drugs were prescribed for the 102 patients. Out of 102 patients, 81 patients (81.66%) were on entecavir monotherapy and rest 21 patients (18.34%) were on tenofovir disoproxil fumarate (TDF) monotherapy. Of the 102-prescription issued, 92.15% (94/102) were compliant and 7.85% (8/102) were noncompliant.

Conclusions: Entecavir was the most common antiviral drug prescribed, followed by tenofovir in patients of chronic hepatitis B. Spironolactone plus torasemide combination was the most common fixed dose combination used among study participants. Liver cirrhosis followed by portal hypertension was the most common complication. Majority of prescriptions were compliant with recommendations for pharmacotherapy and safety guidelines in patients of chronic hepatitis B.

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