Assessment of Rational Drug Prescribing pattern in Geriatric Patients in Hyderabad Metropolitan

Abstract

Background: Polypharmacy and inappropriate prescriptions are prominent prescribing issues among geriatric patients. Beer's criteria, Drug-Drug interaction of common OTC drugs and WHO essential drug lists have been developed to assist in the reduction of potentially inappropriate medications prescribed to geriatric patients. Objective: This study was carried out to find out the rational prescription of drugs in the geriatric patients and to also investigate Polypharmacy. Methodology: A retrospective study on rational drug prescribing pattern in geriatric patient was carried out using prescriptions issued to the geriatric patients, 65 years and above, attending the outpatient and inpatient department of various hospitals and clinics of Hyderabad. A total of 125 prescriptions were collected and analyzed by using Beer's Criteria. Results: In this study we observed that almost all prescriptions were with polypharmacy. Only 3% of drugs were prescribed on generic names and remaining all is on brand names. 11 (13.75%) prescriptions had one or more potentially inappropriate medicines from Beer's Criteria and in 9 (11.25%) prescriptions drug-drug interactions were ascertained according to drugdrug interactions of common OTC drugs. Conclusion: Prevalence of polypharmacy was high which is usually unavoidable in the geriatric patients. Extending clinical pharmacist services can significantly improve rational use of medicines in geriatric population.

Drug utilization study of psychotropic drugs in psychiatry out-patient department of a tertiary care hospital in Kerala: a geriatric perspective

“…The percentage of male and female patients are 44.44% and 55.56% respectively. This finding is similar to the findings of study done by Nandagopal et al 8 Majority of the patients were in the age group of 61-70 years which was found similar to the study conducted by Bhaveshaikh et al 3 Patients with depressive disorders accounted for large majority (38.89%) of the patients attending the psychiatric OPD followed by schizophrenia and other psychotic disorders (30.56%) which is comparable to other studies done in India. 9,10 Analysis of prescription pattern as per the WHO prescribing indicators showed that the average number of drugs per prescription in this study was 2.69.…”

“…11 Giving drugs in the form of injections is not a common practice in psychiatry, barring emergency situations. The percentage of encounters with an injectable prescribed in this study was only 0.03% when compared to study done by Nandagopal et al 8 In this study out of the total 237 psychotropic drugs, 41.77% of psychotropic drugs were prescribed from NLEM (2015) and 17.72% from the WHO model list of essential medicines (2017). Compared to other reference studies, the percentage of drugs prescribed from EML was lower in the present study.…”

“…11 Out of the total 291 drugs prescribed only 2.06% of the drugs were prescribed by generic name which is much less when compared to the WHO standards. 8 WHO highly recommends prescribing medications by generic name as a safety precaution for patients because it identifies the drug clearly, enables better information exchange and allows better communication between health care providers. 12 Prescribing by generic names also decrease the cost of treatment which is important for a country like India which faces cost restraints due to low socioeconomic status of…”

Predictors Associated With Adverse Drug Reactions Among Geriatric Patients in an Outpatient Clinic

“…The average number of drugs per prescription in our study was 4.84 which are higher than the WHO optimal level of ≤3, indicating polypharmacy [20]. A higher rate of polypharmacy was seen in a study by Nandagopal et al, in Hyderabad, with an average of 7.02 [21]. Although the average in our study was lesser, it still requires that caution be taken to diminish the potentially higher risk of adverse health outcomes among the elderly.…”

“…Our study showed that antihypertensives were the most commonly prescribed drug class followed by antidiabetics. In comparison to this, a study by Nandagopal et al revealed that antidiabetics (21.9%), followed by antibiotics (17.78%), were frequently prescribed [21]. According to the systems organ classification, 16.65% of the ADRs affected the metabolic and nutritional disorders.…”