Prescribing Patterns in Type 2 Diabetes Mellitus Outpatients at a Tertiary Care Centre in Jaipur, India
Abstract
Background: Over the last few years, an unexpected increase in the prevalence of diabetes in India have been witnessed. The present study was planned to analyse prescribing patterns of anti-hyperglycaemic drugs and assess the influence of Chief Minister’s Free Drug Scheme in Rajasthan, India. It aimed to evaluate, monitor and if possible, suggest modifications in prescribing practices to make medical care rational and also to assist minimising adverse drug reactions (ADRs).
Methods: This was a cross-sectional, observational study carried out for a 12-month period. A total 400 known patients of type 2 diabetes mellitus (T2DM) from endocrinology outdoor of SMS Medical College Hospital (a tertiary care hospital in Jaipur, Rajasthan, India) were recruited and their prescriptions were
analysed using the World Health Organization (WHO) prescribing indicators.
Results: Most commonly observed age group was of 40-50 years (mean age 53.76 ± 8.84), with a male preponderance (57.5 %). Among them, 67.5 % of patients were found to be obese (mean BMI 29.79 ± 3.26). All anti-hyperglycaemic were prescribed in their generic names only. Metformin was the most frequently prescribed anti-hyperglycaemic agent. Among the fixed dose combinations, the most common was that of glimepiride and metformin (40.75 %), while most prescribed add on anti-hyperglycaemic was teneligliptin (51.5 %), followed by pioglitazone (30.5 %). A total of 53.25 % of these patients received insulin along
with oral anti-hyperglycaemic agents.
Conclusion: The anti-hyperglycaemic agent prescribing among endocrinology outpatients at tertiary care hospital in Jaipur was found to be satisfactory.
References
Diabetes [Internet]. Who.int. 2021 [Cited: 2021-Dec-17]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes.
Diabetes [Internet]. World Health Organization; [Cited: 2021-Dec-17]. Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes/ management.
Global Report on Diabetes [Internet]. World Health Organization [Cited: 2021-Dec-17]. Available from: http://www.who.int/diabetes/globalreport/en/.
IDF Diabetes Atlas 9th edition 2019 [Internet]. IDF Diabetes Atlas [Cited: 2021-Dec-17]. Available from: https://www.diabetesatlas.org/.
Grundy SM, Benjamin IJ, Ivor J. Benjamin Search, Burke GL, Burke GL, et al. Diabetes and Cardiovascular Disease [Internet]. Circulation. 1999 [Cited: 2021-Dec-17]. Available from: https://www.ahajournals.org/doi/abs/10.1161 /01.cir.100.10.1134.
Abidi A, Gupta S, Kansal S. Prescription auditing and drug utilization pattern in a tertiary care teaching hospital of western UP. Int J Basic Clin Pharmacol 2012 Dec;1(3):184-90.
Shivhare SC, Kunjwani HK, Manikrao AM , Bondre AV. Drugs hazards and rational use of drugs: a review. J Chem Pharm Res 2010;2:106-12.
Marshner JP, Thurmann P, Harder S. Drug utilisation review on a surgical intensive care unit. Int J Clin Pharmacol Ther 1994;32:447-51.
Mandal S, Maiti T, Das AK, Das A, Mandal A, Sarkar BS, et al. Drug utilization study in patients with type 2 diabetes mellitus diabetes clinic of a tertiary care hospital in rural Bengal. Int J Basic Clin Pharmacol 2016;5:1647-54.
How to investigate drug use in health facilities: selected drug use indicators- EDM Research Series No. 007: Chapter 2: Core drug use indicators [Internet]. Apps.who.int. 2019 [Cited: 2021-Dec-17]. Available from: http://apps.who.int/medicinedocs/en/d/Js2289e/3.html.
Essential Drugs List [Internet]. Rmsc.health.rajasthan.gov.in. 2019 [Cited: 2021-Dec-17]. Available from: http://rmsc.health.rajasthan.gov.in/content/ raj/medical/rajasthan-medical-services-corporation-ltd-/en/library/Essentialdrugs-List.html.
Brahmbhatt SV, Sattigeri BM, Nil AK, Parikh DP, Shah HS. A prospective study on drug utilization pattern & rationality in treatment of type II diabetes mellitus: a population based analysis. Int J Res Med Sci 2014;2:983-7.
Ahmed Z, Hafez MA, Bari MA, Akhter J. Pattern of anti-hyperglycaemic drugs prescribed in a tertiary care hospital of Bangladesh. Int J Basic Clin Pharmacol 2016;5(1):6-12.
Sachdev B. Community based study on incidence of type 2 diabetes and hypertension among nomad tribal population of Rajasthan, India. Inter Jour of Scie and Nat 2011;2(2):296–301.
Iglay K, Hannachi H, Joseph Howie P, Xu J, Li X, Engel SS. Prevalence and co-prevalence of comorbidities among patients with type 2 diabetes mellitus. Curr Med Res Opin 2016;32(7):1243-52.
Agarwal AA, Jadhav PR, Deshmukh YA. Prescribing pattern and efficacy of anti-hyperglycaemic drugs in maintaining optimal glycaemic levels in diabetic patients. J Basic Clin Pharma 2014;5:79-83.
Muhammad Ashar SM, Hanif A, Jadoon A, Mujaddid ur Rehman MU, Ullah N. Assessment of drug use pattern using WHO prescribing indicators in the medication therapy of indoor diabetic patients. IJBMSP 2016;6(1):16-20.
World Health Organization. Lists of Recommended and Proposed INNs [Internet]. World Health Organization; 2019 [Cited: 2021-Dec-17]. Available from: https://www.who.int/medicines/publications/ druginformation /innlists/en/.
Manjusha S, Amit M, Ronak S. A study on prescribing pattern and potential drug-drug interactions in type 2 diabetes mellitus inpatients. IJOPP 2014;7(1):7-12.
Satpathy SV, Datta S, Upreti B. Utilization study of anti-hyperglycaemic agents in a teaching hospital of Sikkim and adherence to current standard treatment guidelines. J Pharm Bioall Sci 2016; 8:223-8.
Desai P, Desai C, Panchal A, Desai S. A drug prescribing pattern study in diabetes mellitus: an outpatient study. J Pharm Sci Bio Scientific Res 2014;5(1):115-8.
Policies & Guidelines [Internet]. Home. [Cited: 2021-Dec-17]. Available from: http://rmsc.health.rajasthan.gov.in/content/raj/medical/rajasthan-medicalservices-corporation-ltd-/en/library/policies,guidelines.html.
ICMR Guidelines for Management of Type 2 Diabetes 2018 [Internet]. [Cited: 2021-Dec-17]. Available from: https://medibulletin.com/wpcontent/uploads/2018/05/ICMR.diabetesGuidelines.2018.pdf.
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