Abstract

DRUG UTILIZATION STUDY AND EVALUATION OF RATIONAL USE OF MEDICINES IN THE MEDICAL EMERGENCY POISON DEPARTMENT AND INTENSIVE CARE UNIT OF A GOVERNMENT HOSPITAL; A PROSPECTIVE STUDY.

Amitha Simon1 Pharm D., Anagha R. Pharm D., Anns Joseph Pharm D., Aswany Mohan Pharm D., R. Senthilselvi. PhD.* and S. E. Bharanidharan MD.

ABSTRACT

Background: The emergency department represents an important platform for conducting drug utilization studies as patients present with a wide range of diseases and the drug use is quite extensive. Therefore, evaluating the drug prescribing behaviour and usage patterns in the emergency settings has the potential of determining the rationality of drug therapy. Drug utilisation studies in poison department is conducted to know the actual magnitude, pattern and profile of poisoning and also to focus on poisoning cases reported in a particular area, to improve the management and thereby prevent deaths. There is a limited data from Indian medical intensive care unit on prescription pattern and patients are rigoursly treated with multiple medications. Aim: To carry out a Drug Utilisation Study and Evaluation of Rational Use of Medicines (RUM) in the medical emergency poison department and intensive care unit of a government hospital using WHO / INRUD prescription indicators. Methods: Prior permission from the institutional ethical committee was obtained, drug utilisation study and evaluation of rational use of medicines in medical emergency poison department and intensive care unit was conducted for duration of 6 months from January to June 2017 of G.H, Tiruppur. Data were entered and analysed using Microsoft excel. Graphical representation is used for visual interpretation of the analysed data. Results and Discussion: A total of 1618 drugs were prescribed from 300 prescriptions. Average number of drugs per prescription was 5.393 which are more than double the average number (i.e,2) recommended by WHO. The percentage of drugs prescribed by generic name is 100% according to WHO standards, but in this study 82.07% of drugs was prescribed in generic name. Percentage of encounters with antibiotics was found to be 14.67% where WHO recommends less than 30%. Number of encounters with injectable was higher (99.33%), which again seems justifiable on account of need of immediate drug action. In this study there is no need for rationalising drug therapy in the emergency settings with regard to increasing adherence to national essential drug list/formulary which is found to be 100%. The mean value of the IRDP was (4.52) very close to the WHO optimal value of 5.The index of poly pharmacy (0.56) shows great variation from the WHO recommended standard which indicated that poly pharmacy. The index of generic name prescribing is found to be (0.82). The index of antibiotic prescribing is found to be (2.04). The index of injection prescribing (0.10) shows great variation from the optimal index value. Conclusion: The findings of the study revealed that drug utilisation pattern were not optimal but found near to standard recommended guidelines. There was a higher tendency of poly pharmacy and over prescription of injectables.

Keywords: Drug utilization, Intensive care unit, Rational use of drugs, Poisoning, Emergency medicine.