Naturalistic evaluation of prescription pattern in glaucoma clinic of a tertiary care hospital: A developing country’s perspective

Abstract

A BSTRACT Background: Glaucoma is a chronic, gradual and progressive eye disorder characterized by visual loss and involving the typical changes in optic nerves and associated structures. Currently, the mainstay treatment lies in the reduction of intraocular pressure (IOP) involving the usage of two or three medications concurrently. However, prescription pattern of antiglaucoma drugs remains largely unstudied so far. Therefore, there is a dire need of drug utilization studies to ensure rational prescribing for better treatment outcomes. Aim: This study was conducted to assess the prescription pattern in glaucoma patients to encourage rational use of drugs. Materials and Methods: The pertinent data of confirmed glaucoma patients were entered in a predesigned case record form (CRF) including patient demographic details, type of glaucoma, number of drug prescribed, drug dosage and dosage formulation with prior patient consent, and finally, the data were analyzed using Microsoft Excel. Results: A total of 247 glaucoma patients were recorded in the study. The mean SD number of drugs per prescription was 2.18 (1.68). Monotherapy was prescribed to 72 (29.15%) patients, and the most common monotherapy prescribed was timolol, whereas in fixed-dose combinations (FDCs), brimonidine and timolol FDCs were most commonly encountered. Furthermore, prescriptions consisting of generic drugs only and prescribed as per the National List of Essential Medicines (NLEM) were 48 (19.43%) and 41 (16.59%), respectively. Conclusion: This study showed the judicious use of medications in tune with principles of rational drug use in our center, and the rationale practices can be extended to the peripheral centers of the country for better drug utilization.

Glaucoma Drug Prescription Pattern in North India: Public vs Private Sector Hospitals

“…In our study, we found that the mean drugs in the prescriptions from both centers were comparable: 1.98 ± 0.99 and 1.92 ± 1.11, in 1.41 ± 0.59 and 1.51 ± 0.64, from the public and private hospitals, respectively. In a naturalistic evaluation of glaucoma prescription patterns from the glaucoma clinic of a tertiary care hospital in the same region, Niraj et al 6 had reported that the mean drugs in the prescriptions from their hospital was 2.18 ± 1.68, while the same was 5.04 ± 1.52 in cases referred to their center from other hospitals. While the five drugs to a prescription may be explained by the fact that only those patients who are not controlled on maximal medical therapy (MMT) are referred to a tertiary care center, it may be interesting to compare the prescription patterns of glaucoma specialists with those from general ophthalmologists to better understand drug utilization patterns in the region.…”

“…The irrational and inappropriate use of medication is a major concern worldwide, across disciplines, and glaucoma is no exception. 2 – 6 …”