Title: A Prescription Audit of Drugs Prescribed in Psychiatry OPD in a Tertiary Care Teaching Hospital in North India

Authors: Dr Monica Aggarwal, Dr Ankur Sachdeva, Dr Dwividendra Kumar Nim

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i11.104

Abstract

Background: Although psychotropic medications play a significant role in modern day psychiatric practice, their utilization and consequences on actual clinical practice need continuous study.

Methods: Current prospective cross sectional drug utilization study was carried out in outpatient department of psychiatry, ESIC medical college and hospital, Faridabad, to assess the utilization of psychotropic drugs and their prescribing pattern. The prescribing pattern was analyzed by various WHO drug use indicators.

Results: Among 200 patients included in our study, 84 were males and 116 were females. The most common disorder was depression followed by anxiety, headache, psychosis and seizures. The number of drugs prescribed per patient was 1.9. 85% of drugs were prescribed by generic names, 89% drugs were available in hospital pharmacy. Escitalopram was the most common prescribed antidepressant (30%) and clonazepam was the most commonly prescribed benzodiazepine.

Conclusion: The study advocated on overall rational utilization of psychotropic drugs with a fewer deviation due to socio-economic status of patients and prescription patterns of health care providers.

Keywords: Prescription Audit, Drug Utilization, Psychotropic Drugs.

References

  1. The ESEMeD/ MHEDEA 2000 investigators. Psychotropic drug utilization in Europe: Results from the Europe Study of the Epidemiology of Mental Disorders (ESEMeD) project. Acta Psychiatr Scand. 2004;109:55-64.
  2. WHO International Working Group for Drug Statistics Methodology. Introduction to drug utilization research. Geneva: WHO Collaborating Centre for Drug Utilization Research and Clinical Pharmacology; 2003. Available from: http:// www.whocc.no/filearchive/publications/drug_utilization_research.pdf (cited 2012 Nov 1).
  3. Strom BL. Pharmacoepidemiology. 4th ed. England: John Wiley and Sons; 2005.
  4. Introduction to drug utilization research. Geneva (Switzerland): WHO; 2003. P.611. Available from:URL: http://www.who.int/medicines/areas/quality_safety/safety_efficacy/Drug%20utilization%20research.pdf.
  5. Banerjee I, Roy B, Banerjee I, Sathian B, Mondol M, Saha A.Depression and its cure: a drug utilization study from a tertiary care centre of Western Nepal. Nepal J Epidemiol. 2011; 1(5):144-52.
  6. Pradhan SC, Shewade DG, Tekur U, Zutshi S, Pachiappan D, Dey AK, et al. Changing pattern of antimicrobial utilization in an Indian teaching hospital. Int J Clin Pharmacol Ther Toxicol. 1990; 28(8):339-43.
  7. Fourrier A, Gasquet I, Allicar M, Bouhassira M, Lepine J, Begaud B. Pattern of neuroleptic drug prescription: a national cross sectional survey of a random sample of French psychiatrists. Br J Clin Pharmacol, 2000; 49:80-86.
  8. Hugenholtz GWK, Stolker J, Heerdink E, Nolen W, Leufkens H. Short-acting parenteral antipsychotics drive choice for classical versus atypical agents. Eur J Clin Pharmacol, 2003; 58: 757-760
  9. Jorm A, Christensen H, Griffiths K. Changes in depression awareness and attitudes in Australia: the impact of beyondblue: the national depression initiative. Australian and New Zealand Journal of Psychiatry, 2006; 40:42–46.
  10. Earls F.Sex differences in psychiatric disorders: origins and developmental influences.Psychiatric developments [Inrernet]. 1987 Jan [cited 2012 Nov 2;5:1-23.Available from :http://www.ncbi.nlm.nih.gov/pubmed/3601929.
  11. Patel V.Gender in Mental Health Research.Department of Gender , Women and Health Family and Community Health.[Internet]. World Health Organisation. 2005[cited 2012 Oct 12].Available from : http://www.who.int/gender/documents/MentalHealthlast2.pdf.
  12. Piparva KG,Parmar DM, Singh AP.Drug utilization study drugs in outdoor patients in a teaching hospital.Int J Psychol Med.2011;33(1):54-8.
  13. Avasthi A, Aggarwal M, Grover S, Khan MKR. Research on anti-psychotics in India. Indian journal of psychiatry [Internet]. 2010 Jan;52 (1):317-40. Available from: http:/www.ncbi.nlm.nih.gov/pmc/articles/PMC3146231/.
  14. Loder E.  Fixed drug combinations for the acute treatment of migraine : place in therapy. CNS Drugs 2005; 19(9): 769-784
  15. Sharma K, Sharma A, Singh V, Pilania D, Sharma YK. Irrational Fixed Dose Combinations & Need for Intervention: Understanding of Dental Clinicians and Residents. Journal of Clinical and Diagnostic Research 2014 Dec;8(12): ZC49-ZC52 .
  16. Anxiety (CG22). National Institute for Health and Clinical Excellence. National Collaborating Centre for Mental Health; 2011. Available at http://www.guidance.nice.org.uk/CG113. Cited 14 August 2015.
  17. Furukawa TA, Streiner DL, Young LT, Kinoshita Y. Antidepressants plus benzodiazepines for major depression. (Cochrane Review) in: The Cochrane Library, 2007; Issue 4.
  18. Ashton H. Guidelines for the rational use of Benzodiazepines. Drugs 1994;48:25-40.
  19. Carpenter WT Jr, Buchanan RW, Kirkpatrick B, Breier AF. Diazepam treatment of early signs of exacerbation in schizophrenia. Am J Psychiatry. 1999;156(2):299-303. Introduction to Drug Utilization Research by World Health Organization. Available from: http://www.whocc.no/ filearchive/publications/drug_utilization_research.pdf [Last accessed on 2011 Feb 17].
  20. Dhasmana DC, Rawat Y, Mishra KC. What is so atypical about atypical antipsychotic? Indian J Pharmacol 2003;35:322-4.

Corresponding Author

Dr Dwividendra Kumar Nim

Assistant Professor, Deptt of Pharmacology,

ESIC Medical College and Hospital, NH3 Faridabad.121001

Mobile no.9650612878, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.