DRUG-RELATED PROBLEMS AND ITS PRESCRIBING INDICATORS IN STROKE PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY

  • DURGA PRASAD THAMMISETTY Research Scholar, Department of Pharmaceutical Sciences, Jawaharlal Nehru Technological University Anantapur, Ananthapuramu, Andhra Pradesh, India.
  • DIVITI RANGANAYAKULU Professor, Department of Pharmacology and Principal, Sri Padmavathi School of Pharmacy, Vaishnavi Nagar, Tiruchanoor, Tirupati, Andhra Pradesh, India.
  • DEVANNA NAYAKANTI Professor, Department of Chemistry and Director, Oil Technological and Pharmaceutical Research Institute, Jawaharlal Nehru Technological University Anantapur, Ananthapuramu, Andhra Pradesh, India.

Abstract

Objective: The objective of the study was to assess the drug-related problems (DRPs) and the World Health Organization (WHO) core prescribing indicators among stroke patients.


Methods: A prospective observational study was conducted among stroke inpatients of Acute Medical Care and General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data about demographics, clinical characteristics, WHO prescribing indicators, and DRPs. Descriptive statistics were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Chi-square test was employed to test the significant association between the demographics and the occurrence of DRPs.


Results: Among 174 patients included in the study, 89 had one or more DRPs. A total of 122 DRPs were identified in the study population. Drug interactions (48.4%) and adverse drug reactions (ADRs) (17.2%) were commonly observed DRPs. A significant direct association was observed between the occurrence of DRPs and number of comorbidities (p<0.001), polypharmacy (p<0.001), and hospital stay (p<0.05). The average number of drugs per prescription was 7.2. Of drugs prescribed, 67.6% were in their generic names. The percentage of encounters in which an antibiotic, injection was prescribed was 65.5% and 89.6% respectively. The percentage of drugs prescribed from an essential drug list was 91.2%.


Conclusion: The rate of drug interactions and ADRs was high in treatment of stroke patients. Patients suffering from comorbidities, polypharmacy, and long hospital stay were positively associated with occurrence of DRPs in stroke. Regular monitoring and screening for drug interactions and ADRs were advised to reduce the burden DRPs in stroke patients admitted in a critical care unit.

Keywords: Stroke, Prescribing pattern, World Health Organization, Drug use indicators, Drug-related problems

Author Biographies

DURGA PRASAD THAMMISETTY, Research Scholar, Department of Pharmaceutical Sciences, Jawaharlal Nehru Technological University Anantapur, Ananthapuramu, Andhra Pradesh, India.

Department of Pharmaceutical Sciences

DIVITI RANGANAYAKULU, Professor, Department of Pharmacology and Principal, Sri Padmavathi School of Pharmacy, Vaishnavi Nagar, Tiruchanoor, Tirupati, Andhra Pradesh, India.

Professor and Principal

DEVANNA NAYAKANTI, Professor, Department of Chemistry and Director, Oil Technological and Pharmaceutical Research Institute, Jawaharlal Nehru Technological University Anantapur, Ananthapuramu, Andhra Pradesh, India.

Director

References

1. Ofori-Asenso R, Agyeman AA. Irrational use of medicines a summary of key concepts. Pharmacy (Basel, Switzerland) 2016;4:35.
2. World Health Organization. Promoting Rational Use of Medicines: Core Components WHO Policy Perspectives on Medicines. Geneva, Switzerland: World Health Organization; 2002. Available from: http:// www.apps.who.int/medicinedocs/en/d/Jh3011e/2.html. [Last accessed on 2020 Dec].
3. Imran A. Irrational Use of Medicine-a Threat to Patient Community. Available from: https://www.ezinearticles.com/?irrational-use-of-medicines---a-threat-to-patient-community&id=3144554. [Last accessed on 2020 Dec].
4. World Health Organization. How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators. Geneva, Switzerland: World Health Organization; 1993. Available from: http://www.apps.who.int/ medicinedocs/en/d/Js2289e/1993. [Last accessed on 2020 Dec].
5. World Health Organization. Operational Package for Assessing, Monitoring and Evaluating Country Pharmaceutical Situations: Guide for Coordinators and Data Collectors. Geneva, Switzerland: World Health Organization; 2007. Available from: https://www.who.int/ medicines/publications/WHO_TCM_2007.2/en. [Last accessed on 2020 Dec].
6. Strand L, Cipolla R, Morley P. Pharmaceutical Care Practice: The Patient-Centered Approach to Medication Management. 3rd ed. New York: McGraw-Hill; 2012. p. 435-44.
7. Semcharoen K, Supornpun S, Nathisuwan S, Kongwatcharapong J. Characteristic of drug-related problems and pharmacists’ interventions in a stroke unit in Thailand. Int J Clin Pharm 2019;41:880-7.
8. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990;47:533-43.
9. Marie A, Chisholm B, Jerryl S, Barbara GW, Dipiro JT. Pharmacotherapy Principles and Practice. 2nd ed. New York: McGraw-Hill; 2010. p. 215-6.
10. Banerjee TK, Roy MK, Bhoi KK. Is stroke increasing in India-- preventive measures that need to be implemented. J Indian Med Assoc 2005;103:162-4, 166 passim.
11. Hanlon JT, Semla TP, Schmader KE. Alternative medications for medications in the use of high-risk medications in the elderly and potentially harmful drug-disease interactions in the elderly quality measures. J Am Geriatr Soc 2015;63:1-11.
12. Ragam A, Acharya S, Holla R. Assessment of drug use pattern using World Health Organization prescribing indicators in a tertiary care hospital in Mangalore: A cross-sectional study. Natl J Physiol Pharm Pharmacol 2017;7:1026-30.
13. Ramanath KV, Nedumballi S. Assessment of medication-related problems in geriatric patients of a rural tertiary care hospital. J Young Pharm 2012;4:273-8.
14. Greeshma M, Lincy S, Maheswari E, Tharanath S, Viswam S. Identification of drug related problems by clinical pharmacist in prescriptions with polypharmacy: A prospective interventional study. J Young Pharm 2018;10:460-5.
15. Ahmad A, Mast MR, Nijpels G, Elders PJ, Dekker JM, Hugtenburg JG. Identification of drug-related problems of elderly patients discharged from hospital. Patient Prefer Adherence 2014;8:155-65.
16. Abdela OA, Bhagavathula AS, Getachew H, Kelifa Y. Risk factors for developing drug-related problems in patients with cardiovascular diseases attending Gondar University Hospital, Ethiopia. J Pharm Bioall Sci 2016;8:289-95.
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THAMMISETTY, D. P., D. RANGANAYAKULU, and D. NAYAKANTI. “DRUG-RELATED PROBLEMS AND ITS PRESCRIBING INDICATORS IN STROKE PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 14, no. 3, Mar. 2021, pp. 141-4, doi:10.22159/ajpcr.2021.v14i3.40529.
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