Research Journal of Pharmacy and Technology

Open Access Open Access  Restricted Access Subscription Access
Open Access Open Access Open Access  Restricted Access Restricted Access Subscription Access

Drug Utilization Evaluation of Coronary Artery Disease in a Tertiary Care Hospital in Punjab


Affiliations
1 Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, India
2 Department of Clinical Pharmacology, Jaypee Hospital, Noida, Uttar Pradesh, India
     

   Subscribe/Renew Journal


Objective: The main aim of this study was to evaluate the drug utilization of coronary artery disease patients. Materials and methods: This prospective study was carried out over the duration of nine months between August 2017-April 2018 in Guru Gobind Singh medical college and hospital, Faridkot, Punjab, India. All Inpatients who were diagnosed with coronary artery disease were included in the study and written consent was taken from them. The data was collected in a specially designed data collection form and analyzed using IBM SPSS Version 25. Results: Among 390 patients, the majority of them, 59% were males. The mean age of the study population was found to be 59.89 years. Most of the patients were from urban locality 61.5%. The average duration of stay of patients in the hospital was 4.21±1.53 days. Majority of the patients were found to be Sikh religion 48.5%. Only 4% of patients were given a single drug and 44% more than six drugs. The most common drug related problem was class duplication 32. Only 35% prescribed drugs had Irrational dose. When compared to WHO core prescribing indicators 19.16% drugs administered were fixed dose combinations, 46.66% were drugs from the National Essential Medicine List, 78.50% of drugs were prescribed by brand names and 49% of drug therapy had encounters with an antibiotic. Average no. of Drugs per prescription were 8.53. Conclusion: Male gender, urban locality, age group of 51-60 was found to be more prevelent among the study population. Majority of the patients were given Polypharmacy. It was found that dosing or frequency prescribed in 26% cases was irrational. Most common drug related problems was class duplication.

Keywords

Drug Utilization Review, Coronary Artery Disease, Punjab, Prescription Pattern, WHO Core Prescribing Indicators.
Subscription Login to verify subscription
User
Notifications
Font Size


  • Gupta R, Gupta KD. Coronary heart disease in low socioeconomic status subjects in India: “an evolving epidemic”. Indian Heart J. 2009;61(4):358–67.

  • Gupta R, Mohan I, Narula J. Trends in Coronary Heart Disease Epidemiology in India. Ann Glob Heal. 2016;82(2):307–15.

  • Porter G, Grills N. Medication misuse in India: a major public health issue in India. J Public Health (Bangkok). 2016 Jun;38(2):e150–7.

  • Bergman U. The history of the Drug Utilization Research Group in Europe. Pharmacoepidemiol Drug Saf. 2006;15(2):95–8.

  • Sutharson L, Hariharan RS, Vamsadhara C. Drug Utilization in Diabetology Opd Drug Utilization Study in Diabetology Outpatient Setting of a Tertiary Hospital. Indian J Pharmacol. 2003;(35):237–40.

  • Truter I. A review of drug utilization studies and methodologies. Jordan J Pharm Sci. 2008;1(2):91–104.

  • GGC S, A K. High Out-of-pocket Expenditure: A Burden to Patients Undergoing Coronary Artery Bypass Grafting (CABG) in Sri Lanka. Epidemiol Open Access. 2017;7(5):8–13.

  • Deloitte. Cardiovascular diseases in India Challenges and way ahead. International Heart Protection Summit. ASSOCHAM; 2011. p. 1–32.

  • Chauhan S, Aeri BT. The rising incidence of cardiovascular diseases in India : Assessing its economic impact. J Prev Cardiol. 2015;4(4):735–40.

  • V C, P B, S B, A G. Assessment of out of pocket healthcare expenditure among patients attending secondary health care facility in Himachal Pradesh. J Adv Med Dent Scie Res. 2017 May;5(3):67–71.

  • Loganathan K, Deshmukh PR, Raut A V. Socio-demographic determinants of out-of-pocket health expenditure in a rural area of Wardha district of Maharashtra, India. Indian J Med Res. 2017 Nov;146(5):654–61.

  • Pankaj SN, Kanchan M. Economic Effect of Coronary Heart Disease on Households – A study in Mumbai. Int J Med Public Heal. 2016 Nov 15;6(4):184–8.

  • Bhadoria AS, Kapil U, Bansal R, Pandey RM, Pant B, Mohan A. Health-care utilization and expenditure patterns in the rural areas of Punjab, India. J Fam Med Prim Care. 2017;6(2):169–70.

  • Rao KD, Bhatnagar A, Murphy A. Socio-economic inequalities in the financing of cardiovascular & diabetes inpatient treatment in India. Indian J Med Res. 2011;133(1):57–63.

  • Mohan V, Deepa R, Shanthi Rani S, Premalatha G. Prevalence of coronary artery disease and its relationship to lipids in a selected population in South India: The Chennai Urban Population Study (CUPS no. 5). J Am Coll Cardiol. 2001;38(3):682–7.

  • Zachariah G, Harikrishnan S, Krishnan MN, Mohanan PP, Sanjay G, Venugopal K, et al. Prevalence of coronary artery disease and coronary risk factors in Kerala, South India: A population survey Design and methods. Indian Heart J. 2013;65(3):243–9.

  • Khot UN, Khot MB, Bajzer CT, Sapp SK, Ohman EM, Brener SJ, et al. Prevalence of conventional risk factors in patients with coronary heart disease. JAMA. 2003 Aug 20;290(7):898–904.

  • Gupta R. Regional variations in cardiovascular risk factors in India: India heart watch. World J Cardiol. 2012;4(4):112.

  • Reddy KKR, Rao AP, Reddy TPK. Socioeconomic status and the prevalence of coronary heart disease risk factors. Asia Pacific J Clin Nutr. 2002;11(May 2001):98–103.

  • SHAW LJ, MILLER D, ROMEIS JC, KARGL D, YOUNIS LT, CHAITMAN BR. Gender Differences in the Noninvasive Evaluation and Management of Patients With Suspected Coronary-Artery Disease. Ann Intern Med. 1994;120(7):559–66.

  • R. M, Mathews R, Zachariah R. Coronary heart disease in South Asian immigrants: synthesis of research and implications for health promotion and prevention in nursing practice. J Transcult Nurs. 2008;19(3):292–9.

  • George J, Devi P, Kamath DY, Anthony N, Kunnoor NS, Sanil SS. Patterns and determinants of cardiovascular drug utilization in coronary care unit patients of a tertiary care hospital. J Cardiovasc Dis Res. 2013;4(4):214–21.

  • Bedi US, Singh S, Syed A, Aryafar H, Arora R. Coronary artery disease in south asians: An emerging risk group. Cardiol Rev. 2006;14(2):74–80.

  • Taskeen M, Ali SR, Bharath R, Khan AB. Research Article a Study on Rational Drug Prescribing Pattern in Geriatric Patients in Hyderabad Metropolitan. J Drug Deliv Ther. 2012;2(5):109–13.

  • Dukes MNG. Drug Utilization Studies Methods and Uses. Drug Util Stud Methods Uses. 1993;(45):221.

  • Ajay VS, Prabhakaran D. Coronary heart disease in Indians: Implications of the INTERHEART study. Vol. 132, Indian Journal of Medical Research. 2010. p. 561–6.

  • Zachariah TG, K. S, M. P, Kempaller VJ. Drug utilization study in ischaemic heart disease in a tertiary care hospital, Mangalore, India. Int J Basic Clin Pharmacol. 2017 Jun 23;6(7):1799.

  • Balady GJ, Williams MA, Ades PA, Bittner V, Comoss P, Foody JM, et al. Core Components of Cardiac Rehabilitation/Secondary Prevention Programs: 2007 Update: A Scientific Statement From the American Heart Association Exercise, Cardiac Rehabilitation, and Prevention Committee, the Council on Clinical Cardiology; the Councils o. Circulation. 2007 May 22;115(20):2675–82.

  • Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34(38):2949–3003.

  • Of R, In I. JBS 2: Joint British Societies’ guidelines on prevention of cardiovascular disease in clinical practice. Heart. 2005 Dec 1;91(suppl_5):v1–52.

  • Gibbons RJ, Miller TD. Optimal Medical Therapy for Known Coronary Artery Disease. JAMA Cardiol. 2017;1–6.

  • Bangalore S, Steg G, Deedwania P, Crowley K, Eagle KA, Goto S, et al. β-Blocker Use and Clinical Outcomes in Stable Outpatients With and Without Coronary Artery Disease. JAMA. 2012 Oct 3;308(13):1340.

  • 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 Diagnostic Res. 2013;7(4):666–70.

  • WHO. DDD definition and general consideration. Vol. 2014, WHO Collaborating Centre for Drug Statistics Methodology (WHOCC). 2014.

  • Shankar PR, Upadhyay DK, Subish P, Bhandari RB, Das B. Drug utilisation among older inpatients in a teaching hospital in western Nepal. Singapore Med J. 2010;51(1):28–34.

  • Eze UIH, Olowo AO. Prescribing patterns and inappropriate use of medications in elderly outpatients in a tertiary hospital in Nigeria. Trop J Pharm Res. 2011;10(1):19–25.

  • Ali H ZF. Drug Utilization Pattern in Cardiovascular Diseases: A Descriptive Study in Tertiary Care Settings in Pakistan. J Bioequiv Availab. 2015;7(1):59–62.

  • Biradar SM, . P, Nayakawadi N, Indu P, Ghodkari MR, Warad V, et al. Prescribing Pattern, Drug Utilization and Clinical Pharmacy Services in Acute Coronary Syndrome Patients. Am J Drug Discov Dev. 2017;7(2):63–9.

  • Kumar A, Kumar R. Pharmacists interventions and pharmaceutical care in an indian teaching hospital: A prospective study. Int J Adv Res Pharm …. 2012;2(3):386–96.

  • Isah A, Ross-Degnan D, Quick J, Laing R, Mabadeje A. The development of standard values for the WHO drug use prescribing indicators. In: International Conferences on Improving Use of Medicines (ICIUM). 2004. p. 1–6.

  • Mamatha V, Parashivamurthy BM, Suneetha DK. Study of drug utilization pattern in emergency medicine ward at a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2017;6(4):868–73.

  • Otoom S, Batieha A, Hadidi H, Hasan M, Al-Saudi K. Evaluation of drug use in Jordan using WHO patient care and health facility indicators. East Mediterr Heal J. 2002;8(4–5):544–9.

  • Pudasaini N, Singh C, Sagar GC, Sapkota S. Drug prescribing pattern and prescription error in elderly: A retrospective study of inpatient record. Asian J Pharm Clin Res. 2011;4(SUPPL. 1):83– 6.

  • Kumari R, Idris M, Bhushan V, Khanna A, Agrawal M, Singh S. Assessment of prescription pattern at the public health facilities of Lucknow district. Indian J Pharmacol. 2008;40(6):243.

  • Babar HS, Hussain S, Maqsood Z, Dad HA, Khan M, Rahman AA, et al. Adherence to prescription format and compliance with who core prescribing indicators. J Pharm Sci Res. 2014;6(4):195– 9.

  • De-Vries T, Henning R, Hogerzeil H, Fresle D. Guide to Good Prescribing: a practical manual. Who. 1994;142.


Abstract Views: 206

PDF Views: 0




  • Drug Utilization Evaluation of Coronary Artery Disease in a Tertiary Care Hospital in Punjab

Abstract Views: 206  |  PDF Views: 0

Authors

Ankit Gaur
Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, India
Kanad Deepak
Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, India
Mahendra Singh Rathore
Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, India
Amit Sharma
Department of Pharmacy Practice, ISF College of Pharmacy, Moga, Punjab, India
Irfanul Haque
Department of Clinical Pharmacology, Jaypee Hospital, Noida, Uttar Pradesh, India

Abstract


Objective: The main aim of this study was to evaluate the drug utilization of coronary artery disease patients. Materials and methods: This prospective study was carried out over the duration of nine months between August 2017-April 2018 in Guru Gobind Singh medical college and hospital, Faridkot, Punjab, India. All Inpatients who were diagnosed with coronary artery disease were included in the study and written consent was taken from them. The data was collected in a specially designed data collection form and analyzed using IBM SPSS Version 25. Results: Among 390 patients, the majority of them, 59% were males. The mean age of the study population was found to be 59.89 years. Most of the patients were from urban locality 61.5%. The average duration of stay of patients in the hospital was 4.21±1.53 days. Majority of the patients were found to be Sikh religion 48.5%. Only 4% of patients were given a single drug and 44% more than six drugs. The most common drug related problem was class duplication 32. Only 35% prescribed drugs had Irrational dose. When compared to WHO core prescribing indicators 19.16% drugs administered were fixed dose combinations, 46.66% were drugs from the National Essential Medicine List, 78.50% of drugs were prescribed by brand names and 49% of drug therapy had encounters with an antibiotic. Average no. of Drugs per prescription were 8.53. Conclusion: Male gender, urban locality, age group of 51-60 was found to be more prevelent among the study population. Majority of the patients were given Polypharmacy. It was found that dosing or frequency prescribed in 26% cases was irrational. Most common drug related problems was class duplication.

Keywords


Drug Utilization Review, Coronary Artery Disease, Punjab, Prescription Pattern, WHO Core Prescribing Indicators.

References