Evaluation of drug utilization in cardiovascular disease at a teaching and referral hospital in Northern Telangana

Indian J Pharmacol. 2019 Sep-Oct;51(5):323-329. doi: 10.4103/ijp.IJP_743_17. Epub 2019 Nov 26.

Abstract

Objectives: Cardiovascular disease (CVD) is the primary cause of death globally despite the advanced health-care facilities. Extensive disparity exists in pharmacotherapy pattern among CVD patients where rational drug use plays a pivotal role in promoting safety and efficacy. The study focused to evaluate drug utilization using the World Health Organization (WHO) prescribing indicators and defined daily dose (DDD) in patients admitted to a teaching/referral hospital in Northern Telangana.

Materials and methods: A total of 1120 medical records were analyzed for drug utilization for a period of 7 months. Prescription pattern was assessed using the WHO prescribing indicators and DDD to measure individual drug utilization categorized under anatomical-therapeutic-chemical classification.

Results: Of the total admissions, 58.57% (55.19 ± 15.19 years) were male and 41.43% (56.64 ± 15.28 years) were female where coronary artery disease was the most common cause of admission followed by cardiomyopathy. Among prescribing indicators, percentage of drugs with generic names was least accounted with 26.86% and 18.95% during hospitalization and discharge, respectively. A mean of 11.55 (hospitalization) and 6.55 (discharge) drugs were prescribed per prescription. Antiplatelet (72.86%) and statin (80.62%) use was predominate during complete therapy. The DDD of furosemide (109.33) was found to be high, followed by atorvastatin (64.6), enalapril (58.44), aspirin (58.14) and clopidogrel (53.2).

Conclusion: Polypharmacy and least use of generic name were observed in the study which may affect the rationality. The use of antiplatelets, statins, and angiotensin-converting enzyme-inhibitors was appropriate, but furosemide overuse is of major concern. Therefore, appropriate prescription writing improvises treatment compliance in the patients, which results in rationality.

Keywords: Cardiovascular disease; defined daily dose; prescribing indicators; rational drug use.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Cardiovascular Agents / therapeutic use*
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / physiopathology
  • Drugs, Generic / therapeutic use*
  • Female
  • Hospitals, Teaching
  • Humans
  • India
  • Male
  • Middle Aged
  • Polypharmacy*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Prospective Studies

Substances

  • Cardiovascular Agents
  • Drugs, Generic