Drug utilization study in patients visiting psychiatric OPD in tertiary care hospital

U. Gawali, P. Mishra, Salman H. Rizvi, S. Kaur
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Abstract

Background: The illness due to psychiatric diseases and behavioral disorders is enormous, but it remains under represented by conventional public health statistics; which mainly targets mortality more than morbidity or dysfunction. The drug utilization study was conducted to find out problems and provide feedback to prescribers so as to create awareness about irrational use of drugs. This study was conducted in psychiatry outpatient department (OPD) of a tertiary care hospital. Methods: A prospective, observational and cross-sectional study was conducted in Department of Pharmacology in collaboration with department of psychiatry in a tertiary care hospital. Patients fulfilling the inclusion criteria visiting psychiatric OPD from 01 October 2018 to 31 December 2018 period of 3 months were enrolled in the study. Assessment of the prescriptions was done as per the ICD-10 criteria and World Health Organization-indicators for rational use of drugs (WHO-INRUD). Results: Among total 390 prescriptions; 71.54% was males and 28.46% were females. All the drugs were oral formulations. The burden of diseases are depression 35.89%, anxiety 20.51%, schizophrenia 18.97% and bipolar disorder 11.28% and other psychiatric diseases were 13.33%. Olanzapine was the most common drug which was prescribed followed by alprazolam. Total 1,140 drugs were prescribed out of which 86.32% was psychotropic drug and 13.68% were other like vitamin B-complex, analgesics, anta-acids, antibiotics and NSAIDS. The Most common prescribed class was atypical antipsychotics 26.31% followed by benzodiazepines 20.26%, antipsychotics 19.74%, tricyclic antidepressants 8.16%, anticonvulsants 9.21%, antiepileptics 2.37% and lastly selective serotonin reuptake inhibitors. Conclusions: Atypical antipsychotics was most commonly prescribed drug followed by benzodiazepines. All the drugs were prescribed by their generic names which suggests awareness among prescribers regarding WHO policies for generic prescribing.
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三级医院精神科门诊患者药物利用研究
背景:由精神疾病和行为障碍引起的疾病数量庞大,但传统的公共卫生统计仍未充分反映;主要针对死亡率,而不是发病率或功能障碍。开展药物利用调查,发现问题并反馈给处方医师,提高对不合理用药的认识。本研究在某三级医院精神科门诊部进行。方法:采用前瞻性、观察性、横断面研究方法,在某三级医院精神科与药理学合作进行。符合纳入标准的患者于2018年10月1日至2018年12月31日期间访问精神科门诊,为期3个月。按照ICD-10标准和世界卫生组织合理用药指标(WHO-INRUD)对处方进行评估。结果:390张处方中;男性占71.54%,女性占28.46%。所有的药物都是口服制剂。疾病负担为抑郁症35.89%,焦虑症20.51%,精神分裂症18.97%,双相情感障碍11.28%,其他精神疾病13.33%。奥氮平是最常见的药物,其次是阿普唑仑。处方药物1140种,其中精神药物占86.32%,其他药物占13.68%,如复合维生素b、镇痛药、抗酸药、抗生素和非甾体抗炎药。非典型抗精神病药物占26.31%,其次为苯二氮卓类药物20.26%、抗精神病药物19.74%、三环类抗抑郁药物8.16%、抗惊厥药物9.21%、抗癫痫药物2.37%,最后为选择性5 -羟色胺再摄取抑制剂。结论:非典型抗精神病药物是最常用的处方药物,其次是苯二氮卓类药物。所有药物均以其通用名称开具处方,这表明开处方者对世卫组织通用处方政策有所了解。
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