Drug utilization in emergency medicine department at a tertiary care teaching hospital: A prospective study

Rajagopalan

Emergency Medicine International

et al. 2014

Objective. To generate data on the drug utilization pattern and cost of drug treatment and to determine the rationality of prescriptions. Methods. A retrospective cross-sectional drug utilization study was conducted in the medical emergency unit of our hospital. Patient case records were reviewed to extract data on the pattern of drug use. Cost of drug treatment for the emergency visit was calculated by referring to the cost mentioned in Monthly Index of Medical Specialties and the rationality of prescriptions was evaluated using WHO core indicators of drug utilization. Results. 1100 case records were reviewed. Majority of patients received proton pump inhibitors followed by multivitamins. The median cost per prescription was 119.23$ (7.32$–7663.46$). Majority (49.9%) of drug cost was driven by antibiotics alone. An average of 4.9 drugs was prescribed per prescription. There were 14.89% encounters with antibiotics. 75.17% of the drugs were given as injectables and only 29.27% of the drugs were prescribed as generics. Conclusion. There is need to rationalize the drug therapy in terms of increasing prescribing of drugs by generic name and to avoid overuse of PPIs and multivitamins in emergency unit. Also the hospital pharmacy should be encouraged to procure more cost effective alternative antibiotics in future.

Section: Discussionmentioning

confidence: 99%

Drug Utilization Study in Medical Emergency Unit of a Tertiary Care Hospital in North India

Rajagopalan

Emergency Medicine International

et al. 2014

“…The proportion of prescriptions with antimicrobials (68%) and injections (98%) was relatively higher than some other published studies [ 19 , 20 ], though this needs to be explored. Because ICU patients are 5-10 times more likely to develop nosocomial infections, a high rate of antibiotic prescriptions is possibly justified with prophylactic administration of drugs to stop the development and spread of infections.…”

Section: Discussionmentioning

confidence: 69%

Treatment Cost Along With Pattern of Disease and Therapy in the Intensive Care Unit of a Tertiary Care Teaching Hospital in India

Atal,

Najmi,

Pathan

et al. 2024

Cureus

Background The intensive care unit (ICU) represents an important platform for conducting drug utilization analysis using defined daily dose (DDD)/100 bed-days and the financial burden of treatment as patients are seriously ill and are often suffering from chronic critical illnesses. Therefore, in this study, we evaluated the drug utilization patterns and cost of treatment in the ICU. Methods A retrospective observational analysis of the medical records obtained for the medical ICU of an apex tertiary care teaching hospital in central India was conducted for a period of three years from 2017 to 2019. All the patients admitted to the medical ICU during the study tenure were included in the study. Patients hospitalized in neonatal intensive care unit (NICU), pediatric intensive care unit (PICU), and surgical ICU were excluded from the study. The socio-demographic and clinical data, utilization of different classes of drugs, WHO-Anatomic Therapeutic Chemical (WHO-ATC) classification, DDD/100 bed days, hospital stay, etc. were analyzed. A partial pharmaco-economic analysis of the average cost of admission to patients was done. Results Data from 280 patients was assessed. The mean age was 47 ± 19.18 years and 58% were males. Antibiotics and injections were prescribed to 96% and 97.5% of the patients, respectively, during their ICU stay (median: seven days). Antimicrobial drugs were most frequently prescribed (n=1096, 68%); the most common were beta-lactams and carbapenems, followed by drugs acting on the central nervous system (5%) and cardiovascular system (4.3%). Cefoperazone/sulbactum, ceftriaxone, and piperacillin/tazobactam were the most utilized antibiotics with 8, 16, and 6 DDD/100 bed-days, respectively, while proton pump inhibitors, analgesics, and anti-epileptics were the most frequently prescribed non-antimicrobial drug class. The median cost of treatment per ICU admission was Indian Rupees (INR) 23,347 (IQR 12,552- 65,524). Conclusion Drug utilization assessment provides crucial information for understanding the usage of drugs in the settings of the ICU, and should be conducted regularly to help in the proper planning and implementation of rational drug use. Treatment costs reflect the high economic burden seen in ICU admissions.

Open Access Maced J Med Sci

“…The average patient consumed 3−4 types of drugs. In other studies, it was found that many drugs given to patients in the ED were gastrointestinal drugs such as ondansetron, proton pump inhibitor (PPI), diuretics such as furosemide, and NSAIDs such as aspirin [24], [25].…”

Section: Description Of Drug Typementioning

confidence: 99%

Possibility of Potentially Inappropriate Medication at Admission and Discharge Among Older People Patients in Emergency Department Using the 2019 Beers Criteria

Hamidah

Puspitasari²,

Dharmayati

et al. 2023

BACKGROUND: Elderly patients are associated with an increasing prevalence of chronic degenerative diseases which need emergency services which can be a factor in the occurrence of potentially inappropriate medication (PIM). The use of PIM increases the risk of patients requiring hospitalization, drug-related problems, and adverse health outcomes with a prevalence of up to 2–3 times. AIM: This study aimed to determine the possible incidence of admission and discharge events on PIM in Elderly patients (>60 years old) visiting the emergency department (ED). MATERIALS AND METHODS: This is a retrospective and observational study at Universitas Airlangga Teaching Hospital in Surabaya for 4 months. This study involved Elderly patients who visited the ED. The 2019 Beers criteria were used to identify the use of PIM. Spearman rho analysis was used to determine the relationship between the possibility of hospital admission and the discharge of patients with PIM. RESULTS: Most patients were female (50.4%) and aged 60−96. The percentage of elderly patients who received PIM and hospital admission was 73.1%, while those who received PIM and hospital discharge were 26.9%. The Spearman rho analysis showed a weak relationship between the possibility of hospital admission or discharge (p-value 0.000, R 0.255) with PIM. CONCLUSION: There is a weak but significant correlation between PIM and patient admission and discharge. Elderly patients are more at risk of being hospitalized due to PIM. The number of ED patients who received PIM had a high prevalence of being hospitalized compared to patients who did not receive PIM.