Study of drug utilization pattern for acute exacerbation of chronic obstructive pulmonary disease in patients attending a government hospital in Kerala, India

Abstract

Objective:Drug utilization studies are powerful exploratory tools to ascertain the role of drugs in society. This study was conducted to establish the drug utilization pattern and the common adverse drug reactions for the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD) in one of the government hospitals in Kerala, India.Methods:This was a prospective observational study aimed at recognizing the drug utilization pattern for the treatment of acute exacerbation of COPD for 7-day under nonexperimental settings. All information significant to the study was collected from the case records and discussions conducted with the inpatients and bystanders during ward rounds, with the support of a physician. Moreover, daily follow-ups were conducted to assemble data on amendment in therapy, add-on therapy, and clinical improvement until the patient was discharged from the hospital or to an upper limit of 7-day, whichever is earlier.Results:All the patients in this study received combination therapy. Among the inhalational β-agonists, salbutamol accounted for 74% use. Parenteral steroids were used in 78% of the patients and all of them received hydrocortisone. Steroid inhalers were used only in 25% of the patients. Anticholinergics were used in 77.5% of patients. Antibiotics were used in 86.7% patients. The main adverse effects noted were dry mouth (15%) and bad taste (10%) and these adverse effects were highly correlated with the use of anticholinergics (P < 0.05).Conclusions:Despite the use of drugs according to the availability and physician's preference, it was found in the analysis that majority were in accordance with Global Initiative for Chronic Obstructive Lung Disease criteria recommendations.

Study of drug prescription pattern among COPD patients admitted to medicine in-patient department of tertiary care hospital

“…Most of the exacerbations are due to respiratory tract infections. Antibiotics were most commonly prescribed drugs, about 88.7% of study group patients were prescribed with antibiotics, and it is similar to the results of previous studies in India by Unni, A. et al, and Veettil, S et al 7,11 High percentage of prescribing antibiotics would contribute to increase in prevalence of resistance strains of pathogenic organisms. Most commonly used antibiotics were Amoxicillin and Clavulanic acid as FDC, followed by Azithromycin, Ceftriaxone, cefotaxime, Metronidazole.…”

“…A. et al, and Veettil S et al 7,11 Inhaled corticosteroids improve lung function and reduce the frequency of exacerbations.…”

Pharmacoeconomic Evaluation of Acute Exacerbations of Chronic Obstructive Pulmonary Disease at a Tertiary Care Teaching Hospital in North Karnataka, India

“…A study [9] is having total direct cost 36% higher than the present study. The division of the total direct cost in the present study was 79.56% medical and 20.44% non-medical cost which is similar as reported by Kruti et al [1] and Veettil et al [8].…”

“…This study calculated the cost-of-illness of patients, from the day of admission to the day of discharge, with acute The mean cost for the treatment of acute exacerbations of COPD was Rs. 3998.18 which was lower than reported by Veettil et al [8] and Miravitlles et al [9]. A study [9] is having total direct cost 36% higher than the present study.…”

Drug utilization study in patients of COPD in TB and Chest department in a tertiary care teaching hospital

“…These findings were almost similar to the result of previous study in which male patients were 87% and female patients were 12%. 6 A systemic review of RCT found that the ipratropium bromide alone provided small benefit over short acting β2 agonist in terms of lung function, health status and requirement of oral steroids. 7 In present study no patients were prescribed ipratropium alone or in combination.…”