A prospective study of drug utilization pattern in cardiac intensive care unit at a tertiary care teaching hospital
Keywords:Cardiac intensive care unit, Cardiovascular diseases, Prescription
Background: Cardiovascular diseases remain the most common cause of sudden death. Appropriate drug therapy in cardiac intensive care unit (CICU) is crucial in managing cardiovascular emergencies and to decrease morbidity and mortality. The present study was conducted to observe the emergency cardiac diseases which are most frequently being treated and to study the prescribing prevalence among inpatients in CICU.
Methods: A prospective, observational study was carried out among 102 patients admitted in CICU at a tertiary care teaching hospital, Karnataka, for a period of 3 months. Demographic data, clinical history, and complete drug therapy received during their stay in CICU was noted.
Results: In our study, males (64.7%) had a higher incidence of cardiovascular emergencies than females (35.3%). Hypertension (32.4%) and Type 2 diabetes mellitus (28.4%) were the frequently associated co-morbid conditions. Antiplatelet drugs 80 (78.4%) was most commonly prescribed, followed by hypolipidemic drugs 75 (73.5%) and anticoagulants 65 (63.7%). The mean duration of stay in the hospital was 4.79±1.9 days. The average number of drugs per prescription was 7.8±2.2. Percentage of drugs prescribed by generic names was 52.9%. The percentage of drugs prescribed from essential drug list was 75.1%.
Conclusions: Antiplatelet drugs were the most frequently prescribed drug group. Mean number of drugs per prescription were high. The prescribing pattern could be improved by reducing the number of drugs per prescription and by prescribing generic drugs to reduce the economic burden of the patients.
Pendhari SR, Chaudhari DR, Burute SR, Bite BM. A study on the drug utilization trends in the cardiovascular emergencies in a tertiary care hospital. J Clin Diagn Res. 2013;7(4):666-70.
Chandrashekar K, Saritha MK, Meti V. Prescription audit in tertiary care centre. Asian J Med Clin Sci. 2012;1(2):70-4.
Shankar R, Partha P, Shenoy N. Prescribing patterns of drugs among patients admitted with cardiovascular disorders in the internal medicine ward: prescribing patterns in inpatients. Internet J Pharmacol. 2001;1(2).
Barot PA, Malhotra SD, Rana DA, Patel VJ, Patel KP. Drug utilization in emergency medicine department at a tertiary care teaching hospital: a prospective study. J Basic Clin Pharm. 2013;4(4):78-81.
Introduction to Drug Utilization Research. World Health Organization 2003. Available at: http://www.apps.who.int/medicinedocs/en/d/Js4876e/. Accessed 08 April 2015.
Zafar F, Ali H, Naveed S, Korai OU, Rizvi M, Naqvi GR, et al. Drug utilization pattern in cardiovascular diseases: a descriptive study in tertiary care settings in Pakistan. J Bioequiv Availab. 2015;7(1):059-62.
Al-Junid SM, Ezat WP, Surianti S. Prescribing patterns and drug cost among cardiovascular patients in Hospital Universiti Kebangsaan Malaysia. Med J Malaysia. 2007;62(1):59-65.
Sreedevi K, Rao JV, Fareedullah M, Vijayakumar S. A study on prescription pattern of statins in cardiovascular disease. Der Pharm Lett. 2011;3(3):393-6.
Dawalji S, Venkateshwarlu K, Thota S, Venisetty PK, Venisetty RK. Prescribing pattern in coronary artery disease: a prospective study. Int J Pharm Res Rev. 2014;3(3):24-33.
Christian RP, Rana DA, Malhotra SD, Patel VJ. Evaluation of rationality in prescribing, adherence to treatment guidelines, and direct cost of treatment in intensive cardiac care unit: a prospective observational study. Indian J Crit Care Med. 2014;18(5):278-84.
Parissis JT, Farmakis D, Nieminen M. Classical inotropes and new cardiac enhancers. Heart Fail Rev. 2007;12(2):149-56.
Sivasankar V, Ramalakshmi S, Harika T, Ramesh M, Kousalya K. The prescribing pattern of dopamine and dobutamine in congestive heart failure patients in a tertiary care teaching hospital. World J Pharm Sci. 2014;2(4):404-8.
Muhit MA, Rahman MO, Raihan SZ, Asaduzzaman M, Akbar MA, Sharmin N. Cardiovascular disease prevalence and prescription patterns at a tertiary level hospital in Bangladesh. J Appl Pharm Sci. 2012;2(3):80-4.
Tripathi KD. Drug affecting renin-angiotansin system and plasma Kinins. In: Tripathi KD, editor. Text Book of Essentials of Medical Pharmacology. 7th Edition. New Delhi: Jaypee Brother Medical Publication; 2013: 495-511.
Patel MK, Barvaliya MJ, Patel TK, Tripathi C. Drug utilization pattern in critical care unit in a tertiary care teaching hospital in India. Int J Crit Illn Inj Sci. 2013;3(4):250-5.
Bangalore S, Kamalakkannan G, Parkar S, Messerli FH. Fixed-dose combinations improve medication compliance: a meta-analysis. Am J Med. 2007;120(8):713-9.
Rathnakar UP, Shenoy A, Ullal SD, Shivaprakash, Sudhakar P, Shastry R. Prescribing patterns of fixed dose combinations in hypertension, diabetes mellitus and dyslipedimia among patients attending a cardiology clinic in a tertiary care teaching hospital in India. Pharm Glob (IJCP). 2011;2(6);1-3.
Tasneem S, Fouzia N. Drug utilization study in ischemic heart diseases associated with diabetes and hypertension. Int J Pharm Bio Sci. 2010;1(3):1-4.
Vooss AT, Diefenthaeler HS. Evaluation of prescription indicators established by the WHO in Getulio Vargas - RS. Braz J Pham Sci. 2011;47(2):385-90.
Vries TP, Henning RH, Hogerzeil H, Fresle DA. WHO Guide to Good Prescribing. Available at: http://www.apps.who.int/medicinedocs/pdf/whozip23e/whozip23e.pdf. Accessed 08 April 2015.