DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20190915

A prospective study on drug utilization pattern of anti-diabetic drugs in a tertiary care teaching hospital of eastern Uttar Pradesh, India

Chaudhary K. Pankaj, Singh P. Satendra, Pandey Dhananjay, Ranjan Kumud, Chaudhary Rajmangal, Pratap Bhanu

Abstract


Background: Diabetes mellitus is a metabolic disorder with common denominator of hyperglycemia, arising from a variety of pathogenic mechanisms. The aim of the study was to evaluate the drug utilization pattern of anti-diabetic drugs in diabetic patients and observe adverse drug events (ADEs) associated with anti-diabetic therapy in a prospective way.

Methods: A prospective study was carried out in diabetic patients visiting the Departments of General Medicine in a tertiary care teaching hospital. Demographic data, drug utilization pattern and ADEs due to Anti-diabetic drugs were summarized.

Results: In the present study, 153 (54%) of the 282 diabetic patients were males and 129 (46%) were females. Majority of patients were in the age group of 51-60 years (31.20%) and most of the patients (31.56%) had a diabetic history of 11-15 years. Metformin was the most commonly prescribed drug (64.89%). Majority of the patients (36.87%) were on multidrug therapy. Co-morbid condition was found in 232 patients (82.26%) where hypertension (22.69%) being the most common co-morbid condition. 32 ADRs were observed with Nausea being the most common ADR reported.

Conclusions: The present study helps to find out current prescribing pattern of oral diabetic medications with different co-morbidities with respect to diagnosis, cost of treatment and it also highlight the need for comprehensive management of diabetic patients, including life style changes, dietary control, hypoglycemic agents, cardiovascular prevention, treatment of complications and co-morbidity. Therefore, through the existing prescribing patterns, attempts can be made to improve the quality and efficiency of drug therapy.

Keywords


Anti-diabetic drug, Adverse drug events, Drug utilization

Full Text:

PDF

References


WHO. The selection of essential drugs. WHO Tech Rep. 1997;615:36. Available at: https://www.jscimedcentral.com/Pharmacology/pharmacology-5-1078.pdf.

Dan LL, Anthony SF, Dennis LK, Stephen LH, Larry JJ, Joseph L. Harrison’s Principles of Internal Medicine. Eighteenth edition, McGraw-Hill Medical, New York, United States of America; 2012:2968.

King H, Aubert RE, Herman WH. Global burden of diabetes, 1995–2025: prevalence, numerical estimates, and projections. Diabetes Care. 1998 Sep 1;21(9):1414-31.

Sierra GN. the global pandemic of diabetes; for American journal of diabetes medicine. 2009. Available at: http://www.ijrpc.com/files/10-01-17/09.pdf

IDF Diabetes Atlas, 6th ed. 2013;1-160. Available at: https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/19-atlas-6th-edition.html.

Bope ET, Kellerman RD. Conn’s Current Therapy 2014. Saunders-Elsevier, Philadelphia, United States of America; 2014;701-704. Available at: http://www.ijopp.org/sites/default/files/10.5530.ijopp_.9.4.3_0.pdf

Richard AH. Diabetes Mellitus/Pathophysiology: Etiologic factors associated with diabetes mellitus. In: Stephen M Setter, John R White. Textbook of Therapeutics: Drug and Disease Management. 8th ed, Lippincott Williams and Wilkins-Wolters Kluwer, Philadelphia, United States of America; 2007.

Baksaas I, Lunde PK. National drug policies: the need for drug utilization studies. Trends Pharmacol Sci. 1986 Jan 1;7:331-4.

Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diab. 2008 Apr 1;26(2):77-82.

Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New Eng J Med. 2002 Feb;346(6):393-403.

Garber AJ, Abrahamson MJ, Barzilay JI, Blonde L, Bloomgarden ZT, Bush MA, et al. AACE/ACE comprehensive diabetes management algorithm 2015. Endocrine Practice. 2015 Apr;21(4):438-47.

American Diabetes Association. Standards of medical care in diabetes-2010. Diab Care. 2010 Jan 1;33(Supplement 1):S11-61.

NICE Clinical guideline-87. Type 2 diabetes. 2014. Available at: http://www.ijopp.org/sites/default/files/10.5530.ijopp_.9.4.3_0.pdf.

Unger J. Current strategies for evaluating, monitoring, and treating type 2 diabetes mellitus. Am J Med. 2008 Jun 1;121(6):S3-8.

Krentz AJ, Bailey CJ. Oral antidiabetic agents: current role in type 2 diabetes mellitus. Drugs. 2005;65(3):385-411.

El-Kaissi S, Sherbeeni S. Pharmacological management of type 2 diabetes mellitus: An update. Curr Diabetes Rev. 2011;7(6):392-405.

Diagnostic Criteria. 2005. ICMR Guidelines for Management of Type 2 Diabetes. Available at: https://www.peertechz.com/articles/assessment-of-prescription-pattern-of-antidiabetic-drugs-in-the-outpatient-department-of-a-tertiary-care-hospital.pdf.

Joshi SR. Management of obese Indian patient. Indian J Obes. 2005;I(1):11-20.

Kumar P, Mallik D, Mukhopadhyay DK, Sinhababu A, Mahapatra BS, Chakrabarti P. Prevalence of diabetes mellitus, impaired fasting glucose, impaired glucose tolerance, and its correlates among police personnel in Bankura District of West Bengal. Indian J Public Health. 2013 Jan 1;57(1):24.

Vengurlekar S, Shukla P, Patidar P, Bafna R, Jain S. Prescribing pattern of antidiabetic drugs in Indore city hospital. Indian J Pharmaceut Sci. 2008;70(5):637-40.

Boccuzzi SJ, Wogen J, Fox J, Sung JC, Shah AB, Kim J. Utilization of oral hypoglycemic agents in a drug-insured U.S. Population. Diab Care. 2004;24(8):1411-5.

Johnson JA, Pohar SL, Secnik K, Yurgin N, Hirji Z. Utilization of diabetes medication and cost of testing supplies in Saskatchewan, 2001. BMC Health Services Res. 2006 Dec;6(1):159.

Yurgin N, Secnik K, Lage MJ. Antidiabetic prescriptions and glycemic control in German patients with type 2 diabetes mellitus: a retrospective database study. Clin Ther. 2007;29(2):316-25.

John L, Arifulla M, Sreedharan J, Muttappallymyalil J, Das R, John J, Basha A. Age and gender based utilisation pattern of antidiabetic drugs in Ajman, United Arab Emirates. Malaysian J Pharma Sci. 2012;10(1):79-85.

Sutharson L, Hariharan RS, Vamsadhara C. Drug utilization study in diabetology outpatient setting of a tertiary hospital. Indian J Pharmacol. 2003 Jul 1;35(4):237-40.

Meneilly GS, Elliott T, Tessier D, Hards L, Tildesley H. NIDDM in the elderly. Diab Care. 1996 Dec 1;19(12):1320-5.

Rizvi AA. Management of diabetes in older adults. Am J Med Sci. 2007 Jan 1;333(1):35-47.

Upadhyay DK, Palaian S, Ravi Shankar P, Mishra P, Sah AK. Prescribing pattern in diabetic outpatients in a tertiary care teaching hospital in Nepal. J Clin Diagn Res. 2007 Aug 1;1(4):248-55.

Kannan, Arshad, Kumar S. A study on drug utilization of oral hypoglycemic agents in type-2 diabetic patients. Asian J Pharm Clin Res. 2011;4:60-4.

Sutharson L, Hariharan RS, Vamsadhara C. Drug utilization study in diabetology outpatient setting of a tertiary hospital. Indian J Pharmacol. 2003 Jul 1;35(4):237-40.

Karthikeyan V, Maadhusudhan S, Selvamuthukumran S. Studies on Prescribing Pattern in the Management of Diabetes Mellitus in Rural Teaching Hospital. Saudi J Med Pharm Sci. 2016;2(5):100-7.

Priya D, Purohit S, Pandey BL, Mishra S. Evaluation of antidiabetic prescriptions from medical reimbursement applications at Banaras Hindu University health care facility. J Pharmaceut Care. 2014:49-54.

Sivasankari V, Manivannan E, Priyadarsini SP. Drug utilization pattern of anti-diabetic drugs in a rural area of Tamilnadu, South India–A prospective, observational study. Int J Pharm Biol Sci. 2013 Jan;4:514-9.

Alex SM, Sreelekshmi BS, Smitha S, JijiKn MA, Devi PU. Drug Utilization Pattern of Anti-Diabetic Drugs Among Diabetic Outpatients in a Tertiary Care Hospital. Asian J Pharmaceut Clin Res. 2015;8(2).

Truter I. An investigation into antidiabetic medication prescribing in South Africa. J Clin Pharma Therapeutics. 1998 Dec;23(6):417-22.

Boccuzzi SJ, Wogen J, Fox J, Sung JC, Shah AB, Kim J. Utilization of oral hypoglycemic agents in a drug-insured US population. Diab Care. 2001 Aug 1;24(8):1411-5.

Patel B, Oza B, Patel KP, Malhotra SD, Patel VJ. Pattern of antidiabetic drugs use in type 2 diabetic patients in a medicine outpatient clinic of a tertiary care teaching hospital. Int J Basic Clin Pharmacol 2013;2:485 91.

Alam MS, Aqil M, Qadry SA, Kapur P, Pillai KK. Utilization pattern of oral hypoglycemic agents for diabetes mellitus type 2 patients attending out-patient department at a University hospital in New Delhi. Pharmacol Pharm. 2014;5:636-45.

Acharya KG, Shah KN, Solanki ND, Rana DA. Evaluation of antidiabetic prescription cost and adherence to treatment guidelines: a prospective, cross-sectional study at a tertiary care teaching hospital. J Basic Clin Pharm. 2013;4(4):82-8.

Agrawal R, Rath B, Saha K, Mohapatra S. Drug utilization pattern of antidiabetic agents in a tertiary care hospital of western Odisha, India Int J Basic Clin Pharmacol. 2016 Oct;5(5):2222-6.