Jul-Sep, 2012 - Indian Journal of Pharmacy Practice

More documents

Recommendations

Info

Mohammed S.S - The Prevalence of Polypharmacy in South Indian Patients: A Pharmacoepidemiological Approach.considerablepart of hospital admissions is precipitated by14drug-related problems and iatrogenic illness. Polypharmacymay be responsible for unnecessary health expendituresdirectly due to the cost of superfluous medication, but alsoindirectly due to the increased number of hospitalizations15caused by drug-related complications. The beneficial effectof reducing the occurrence of polypharmacy in the populationhas been addressed in order to cut down on expenditures forboth physician and hospital services. A study examining thefactors associated with variations in general practitionerprescribing costs showed that diagnoses associated withmultiple drug use (cardiovascular diseases, diabetes mellitus,psychiatric disorders) were strongly related to high drugexpenditures. The occurrence of multi-morbidity predictedhigh prescribing costs. A considerable part of the health careresources is thus used for costs due to expensive multiple drugregimens and expenditures caused by drug-related morbidity16attributable to polypharmacy.The present study was aimed to identify the prevalence andthe associated risk factors of polypharmacy in our hospitalsettings.The main purpose of this study was to develop aprescription database and to compare different methods ofidentifying drug users exposed to polypharmacy.MATERIALS AND METHODSThe study was conductedinGovernment District HeadQuarters Hospital, Ooty for a period of one year (August 2009to April 2010). The study involved collection of data bothprospectively and retrospectively. All prescriptions whichcontain more than one drug and of age between 2-70 yearswere included in the study. Patients with age less than 2 yearsand with conditions like psychiatric & cancer disorders wereexcluded from the study. Polypharmacy was classifiedaccording to British National Formulary (BNF)i.e. theconcurrent use of 2 to 4 drugs are classified as minorpolypharmacy and of five or more drugs as majorpolypharmacy.The study protocol was approved by the Institutional ReviewBoard of JSS College of Pharmacy, Ooty, India. Theprescriptions were collected from patient's hospital recordsand patient counseling center after getting consent from thepatients.The collected prescriptions were entered intoMicrosoft Office Excel sheet according to their age, gender,therapeutic category; number of prescription, length ofhospital stay etc. and a prescription database was generated.All collected prescription details were scrutinized and wereclassified as major or minor polypharmacy.RESULTSA total of 1003 prescriptions were collected from theGovernment District Head Quarters Hospital. Out of 1003prescriptions 600 prescriptions found with majorpolypharmacy and 403 prescriptions with minorpolypharmacy.In our total study population 670 (66.80%) cases were malesand 333 (33.20%) were females.The total populations wereclassified into three major age groups and patient in eachgroup were recorded. The data from our study represent that;up to 18 years 4.39% (N=44), 19-60 years 83.75% (N=840)and above 60 years 11.86% (N=119). Graphicalrepresentation of age distribution in the study population isgiven in Figure1.Fig. 1: Age Vs Total number of prescriptionQuantitative Estimation of PolypharmacyOut of 1003 prescriptions 403 (40.18%) prescriptions werefound to be of minor polypharmacy and 600 (59.82%)prescriptions were of major polypharmacy.a) Polypharmacy Vs Gender: In minor Polypharmacy(N=403), 227 were males and 176 were females. Out of 600major Polypharmacy, 443 were males and 157 werefemales.Table 1 explains the prevalence of Polypharmacy inboth genders in the study population.Table 1: Polypharmacy Vs GenderNumber of drugs Male Female Total Percentage2-4 227 176 403 40.18%≥5 443 157 600 59.82%b) Polypharmacy Vs Age: The numbers of drugs prescribedto the various age groups were analyzed and are presented inTable 2.Table 2: Polypharmacy Vs AgeNumber of drug Age Group Number of Percentageprescribedprescription2-4 ≤18 24 5.96%19-60 316 78.41%≥6 163 15.63%≥5 ≤18 20 3.33%19-60 524 87.33%≥61 56 9.33%Indian Journal of Pharmacy Practice Volume 5 Issue 3 Jul - Sep, 2012 41
Mohammed S.S - The Prevalence of Polypharmacy in South Indian Patients: A Pharmacoepidemiological Approach.c) Polypharmacy Vs Hospital stays: The association ofpolypharmacy and hospital stay was analyzed and the resultsare given in Table 3. In both minor and major polypharmacyhospital stay less than one week found. In majorpolypharmacy about 45.50% had one to two weeks of hospitalstay.Quantitative Estimation of Therapeutic Categories ofPrescriptions: The collected prescriptions were classifiedaccording to the British National Formulary and the numberof prescriptions in each category is given in Table 4. Out of thetotal prescriptions cardiovascular, infections andgastrointestinal system accounted for major cases.Thepercentage of therapeutic categories of all prescribed drugs inthe study population is graphically represented in Figure 2.d) Therapeutic class Vs Polypharmacy: The assessment ofpolypharmacy in each therapeutic class was carried out andthe prevalence of polypharmacy was estimated. The resultsare presented in Table 5. The results shows that majorpolypharmacy is more prevalent in cardiovascular systemdiseases (31.5%) followed by infectious diseases (23.67%).e) Therapeutic class Vs Age group: The patient prescribedwith cardiovascular drugs and gastrointestinal drugs weremore often involved in the polypharmacy among the elderlypopulation, while infectious and cardiovascular drugs wereprominent among young individuals exposed topolypharmacy. The table 6 represents the conception oftherapeutic class of drug by different age group.f) Therapeutic class Vs Hospital stays: The duration oftreatment varies with severity of disease. Our result shows theheterogeneous data with respect to duration of therapy andFig. 2: Percentage of therapeutic categories of allprescribed drugs.Table 4: Quantitative Estimation of Therapeutic Categoriesof PrescriptionsTherapeutic class Number of prescription PercentagecollectedCardiovascular System 267 26.62%Infections 223 22.23%Gastrointestinal System 178 17.75%Respiratory System 144 14.36%Central Nervous System 120 11.96%Endocrine System 23 2.29%Musculoskeletal System 21 2.09%Dermatology 11 1.10%Obstetrics and Gynecology 16 1.60%Table 3: Polypharmacy Vs Hospital stayNumber of drugs 1 week 1-2 week >2 week Total Percentage oftotal prescription2-4 258 (64.02%) 117(29.03%) 28(6.95%) 403 40.18%≥5 296 (49.33%) 273(45.50%) 31(5.17%) 600 59.82%Table 5: Therapeutic class Vs PolypharmacyTherapeutic class Minor Polypharmacy Percentage Major Polypharmacy Percentage(2-4 drugs) (%) (≥5) (%)Cardiovascular System 78 19.35 189 31.50Infections 81 20.10 142 23.67Gastrointestinal System 97 24.07 81 13.50Respiratory System 73 18.11 71 11.83Central Nervous System 44 10.92 76 12.67Endocrine System 11 2.73 12 2.00Musculoskeletal System 12 2.98 9 1.50Dermatology 7 1.74 4 0.67Obstetrics and Gynecology Nil Nil 16 2.67Indian Journal of Pharmacy Practice Volume 5 Issue 3 Jul - Sep, 2012 42
Page 7: Chang J - India's Progress towards
Page 10 and 11: Ingle P.V - Sociocultural, Healthy
Page 16 and 17: Indian Journal of Pharmacy Practice
Page 18 and 19: Mahendra Kumar BJ - Drug Induced Sy
Page 20 and 21: Mahendra Kumar BJ - Drug Induced Sy
Page 25 and 26: Ramesh A - Prospective Monitoring a
Page 27 and 28: Ramesh A - Prospective Monitoring a
Page 29 and 30: Stejin J - Pharmacoeconomic Analysi
Page 31 and 32: Stejin J - Pharmacoeconomic Analysi
Page 35 and 36: Smitha F - A Retrospective Evaluati
Page 37 and 38: Smitha F - A Retrospective Evaluati
Page 41 and 42: Thomas D - Comparison of days lost
Page 43: Indian Journal of Pharmacy Practice
Page 47 and 48: Mohammed S.S - The Prevalence of Po
Page 49 and 50: Munsab Ali - Associated socioeconom
Page 51 and 52: Munsab Ali - Associated socioeconom
Page 53 and 54: Dilip .C - Prescription Monitoring
Page 55 and 56: Dilip .C - Prescription Monitoring
Page 57 and 58: Vijayakumar S - A Hospital Based Cr
Page 59 and 60: Vijayakumar S - A Hospital Based Cr
Page 61 and 62: Linu Mohan - Prevalence of Metaboli
Page 63 and 64: Linu Mohan - Prevalence of Metaboli
Page 67 and 68: Mohammed Saleem TK - Assessment of
Page 73 and 74: Rao JR - Development and Validation
Page 79 and 80: Aishwaryalakshmi K - Assessment of
Page 81 and 82: Aishwaryalakshmi K - Assessment of
Page 83 and 84: Pawar V - A Possible Case of Filgra
Page 85 and 86: Instructions to AuthorsIntroduction
Page 87: Instructions to AuthorsElectronic j

Jul-Sep, 2012 - Indian Journal of Pharmacy Practice

Create successful ePaper yourself

Delete template?

Save as template?