Abstract

ASSESSMENT OF ANTICOAGULANT DRUG UTILIZATION PATTERN AMONG PATIENTS THOSE UNDERWENT ORTHOPAEDIC AND SPINE SURGERIES AT TERTIARY CARE HOSPITAL

Shaziya Parveen*, Kanchana N. Dussa and Armana Saher

ABSTRACT

Aim of the study was to assess drug utilization pattern among patients underwent orthopaedic and spine surgeries. Design of study was prospective observational carried out for six months after obtaining ethics committee approval. Collected data was documented and statistical analysis was done. Total 200 patients were included after obtaining consent. Majority, 40% followed by 36% of patients were diagnosed with bone fractures and osteoarthritis respectively. Common comorbidity noticed in 41.74% and 28.26% of patients was hypertension (HTN) and type 2 diabetes mellitus (DM) respectively. Total 2018 number of drugs were prescribed. However, 214 anticoagulants drugs were prescribed. Out of 214 anticoagulants drugs prescribed 92.06% Enoxaparin and 7.01% Apixaban. Majority 93% and 56.50% of patients were prescribed with single anticoagulanttherapy during hospital stay and at the time of discharge from hospital respectively. However, most commonly 6.5% of patients were prescribed with combination anticoagulant therapy of Enoxaparin with Apixaban. International normalized ratio laboratory investigations were done in 97% of patients. It was found that selection and time of administration of anticoagulants were rational in all patients. Dosage based on body mass index (BMI) prescribed were rational in 93% of patients as per American society of Hematology (ASH) guidelines (David R. Anderson, et.al.2019). Drug-drug interactions (DDIs) were assessed by using Clinirex. Majority 76.97% and 22.73% DDIs were from the monitor closely and generally avoid category respectively. Active participation of pharmacist can promote rational utilization of drugs by collaborating with orthopaedist to identify DDI and in turn reduce adverse drug reaction (ADR).

Keywords: Adverse drug reaction, Combination therapy, Comorbidity, Collaboration, Pharmacist, Rational.