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Study on drug prescribing pattern in diabetes mellitus patients in a tertiary care teaching hospital at Dehradun, Uttarakhand

Shaktibala Dutta, Mirza Atif Beg, Mohammad Anjoom, Amit Varma, Shalu Bawa.

Background: Irrational drug prescribing is associated with increased morbidity, mortality and economic burden on the society. Study of prescribing pattern is a component of medical audit that does monitoring and evaluation of the prescribing practice of the prescribers and recommends necessary modifications to achieve rational medical care.

Aims & Objectives: This study was designed to analyze the current prescription patterns of drugs used in the treatment of type 2 diabetes mellitus patients.

Materials and Methods: Present study has been conducted in diabetes mellitus patients by the department of pharmacology in medicine outpatient department at Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun for 6 months. 312 prescriptions were randomly evaluated for prescribing pattern using WHO drug indicators.

Results: A total of 312 prescriptions were analyzed. Mean age was 54.96 0.57 years. Male: Female ratio was 1.04:1. Socio-economic status (SES): Upper 24 (7.69%), Upper Middle 75 (24.04%), Lower Middle 93 (29.81%), Upper Lower 69 (22.11%) and Lower 51 (16.35%). Family history of diabetes mellitus seen in 129 (41.35%) patients and average duration was 7.920.37 years. A total of 1242 drugs were prescribed. 666 (53.62%) antidiabetics, 216 (17.39%) antihypertensives, 159 (12.8%) multivitamins, 90 (7.25%) antiplatelets, 42 (3.38%) statins and 360 (5.56%) in miscellaneous category were prescribed. Amongst antidiabetics, the most frequently prescribed drugs were metformin 273 (40.99%), glimepiride 228 (34.23%) followed by pioglitazone 45 (6.76%), acarbose 33 (4.95%), gliclazide 30 (4.5%), sitagliptin 30 (4.5%), glibenclamide 15 (2.25%) and insulin 12 (1.8%). 99.03% oral drugs were prescribed. Numbers of Fixed dose combinations of antidiabetic drugs were 246 (36.93%). 3.98 drugs per prescription were prescribed. 288 (43.24%) antidiabetics were prescribed from National List of Essential Medicines (NLEM), 2011. 100% drugs were prescribed by brand names.

Conclusion: The most commonly prescribed drugs were Metformin and Glimepiride. Rational prescribing can be improved by sensitizing our physicians and providing them with the feedback of the study.

Key words: Drug Utilization; Irrational Prescribing; Diabetes Mellitus; National List of Essential Medicine

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