Drug utilization pattern in critical care unit in a tertiary care teaching hospital in India

Patel, M.; Barvaliya, Manish; Patel, Tejas; Tripathi, Chandra Bhushan

doi:10.4103/2229-5151.124128

Cited by 17 publications

(7 citation statements)

References 16 publications

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“…However, a rationality assessment was not done formally in this analysis. However, the cost of treatment was lower than the study conducted by Patel et al from India [ 6 ] and Inan et al from Turkey [ 16 ]. The variation in the type and severity of indications of conditions in admitted patients, the different prescribing patterns, or currency differences may be the cause of the variations in the average cost of treatment between these analyses.…”

Section: Discussionmentioning

confidence: 76%

“…This can be attributed to the fact that more patients in serious conditions spent longer time in our ICU and required more medications and investigations. The majority of the expense is attributable to the antimicrobials prescribed, and it is known that the practice of overprescribing frequent, broad-spectrum antibiotics is rather common [ 2 , 6 ]. However, a rationality assessment was not done formally in this analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Despite these studies, there is a dearth of data about disease presentations as well as drug prescribing patterns in the ICUs in India, especially in tertiary-level centers in central India. Periodic evaluation of drug utilization in the ICU can be very helpful for the optimization of the healthcare system, proper use of resources, and modifying/monitoring prescription policies [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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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

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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.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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

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“…This is comparable to other previous studies. In an American study conducted in a trauma ICU, the average number of prescribed drugs was 9.1 while an Indian study showed an average of 13.5 drugs [6].…”

Section: Discussionmentioning

confidence: 99%

Trends in Prescription Pattern in Medical Indian Icu and It’s Impact on Patient Outcome

KOLA

HEMASREE

KISHORE

2022

Int J Pharm Pharm Sci

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Objective: The objective of this study is to evaluate the trends in prescribing pattern in medical ICU concerning patient age, gender, past, and current illness along with comorbidities for the evasion of polypharmacy and to improve patient outcomes. Methods: A prospective analysis of the case records of patients admitted to the ICU of Yashoda hospital in India was carried out. Results: 120 patients were evaluated, consisting of 77% male patients. The mean±SD of age is 53.81±14.63. The majority of the study subjects belonged to the age group of 50-67 y (32%) Most common causes for admission to the ICU were Respiratory diseases and Stroke. Diabetes mellitus and Hypertension are the most common co-morbidities identified. The total number of drugs used were 1502 during this study period. The average number of drugs per prescription is 12. The range is between 2-30. The average number of antibiotics per prescription is 3. Commonly prescribed drug classes were the GI agents in 100% of patients, followed by antimicrobial agents (AMAs) in 95.8% of patients. About 42.5% of patients received 3 antibiotics per day. 55 potential drug-drug interactions were interpreted in 46 patients. 30(55%) were moderate interactions 25(45%) were major interactions, which were addressed. De-escalation of antibiotics was seen in 29% of patients while escalation in 13%. The death rate is only 5% in our ICU setting. Conclusion: This prescription pattern study can provide a framework for continuous prescription audit in the ICU

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“…This leads to decreased treatment outcomes, drug resistance, increased treatment costs, and death. 12 , 13 There are different methods to decrease and avoid these medication errors, including the institution of committees to develop policies on RDU, appropriate implementation, and enforced regulation of clinical guidelines, continuous monitoring, and evaluation of drug use utilization. 14 – 16…”

Section: Introductionmentioning

confidence: 99%

Irrational drug use and its associated factors at Debre Markos Referral Hospital’s outpatient pharmacy in East Gojjam, Northwest Ethiopia

2021

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Objectives: Half of all drugs are used irrationally around the world, and about half of patients take their medications correctly. Inappropriate use of drugs leads to antibiotic resistance, medication therapy problems, and an increase in drug costs. This study aimed to assess irrational drug use and its associated factors at the outpatient pharmacy of Debre Markos Referral Hospital. Methods: A hospital-based cross-sectional study was used. Systematic random sampling was used as a sampling technique. The data were collected with a structured checklist. The data were entered into EPI Data Version 3.1 and analyzed using SPSS version 20. Descriptive statistics and logistic regression analysis were used for data analysis. Results: The average number of drugs per patient encounter was 2.14. The prevalence of antibiotics use per encounter was 39.3%. Polypharmacy was detected in 62.2% of prescriptions, and injections were prescribed in 13% of prescriptions. The percentage of drugs prescribed with a generic name was 95.5%. In multivariable logistic regression, comorbidities, professionals’ training, and prescribers’ experience were significantly associated with polypharmacy. Patient age, comorbidity, presence of chronic disease, professionals training, and type of diseases were significantly associated with antibiotic prescribing. Conclusion: Our findings revealed there were practices of polypharmacy and antibiotics overuse. Continuous seminars and training on rational prescribing and periodic prescription surveys are recommended to prevent irrational drug use.

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Drug utilization pattern in critical care unit in a tertiary care teaching hospital in India

Cited by 17 publications

References 16 publications

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

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

Trends in Prescription Pattern in Medical Indian Icu and It’s Impact on Patient Outcome

Irrational drug use and its associated factors at Debre Markos Referral Hospital’s outpatient pharmacy in East Gojjam, Northwest Ethiopia

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