Title: Evaluation of Prescribing Pattern of Corticosteroids in Dermatology OPD in Tertiary Care Hospital
Authors: Dr Laxmi Bhagunde, Dr S.B Tamboli, Dr Rajat Chhabra
DOI: https://dx.doi.org/10.18535/jmscr/v7i6.71
Abstract
Background: Dermatological problems manifest as primary and secondary cutaneous complaints, which are particularly more common in India. The skin problems that are commonly found are acne, burn scars, dermatitis, psoriasis, scabies, vitiligo, pediculosis, herpes simplex infection, varicella, herpes zoster, erythema, urticaria, and so on. Skin diseases amenable to the effects of topical corticosteroids are usually characterized by inflammation, hyperproliferation, and/or immunologic phenomenon. Topical corticosteroids may also be effective in the treatment of skin symptoms, such as burning and pruritus. Successful treatment depends on an accurate diagnosis and consideration of the steroid’s delivery vehicle, potency, frequency of application, duration of treatment, and side effects. Prescribing of drugs is an important skill, which needs to be continuously assessed and refined suitably and it reflects the physician's skill in diagnosis and attitude towards selecting the most appropriate cost-effective treatment. Contemplating the financial affliction of the treatment on the patients and government, prevailing disease prevalence, it is imperative to study the prescribing pattern of corticosteroids in dermatological OPD.
Objectives: To assess the prescribing pattern of corticosteroids and evaluate the monotherapy and utilization of co-administered drugs along with corticosteroids in skin conditions.
Material & Methods: The study design was prospective, single centred, cross sectional observational study. Out of 1410 subjects studied, a sample size of 311.60 was calculated. 312 properly selected subjects with diagnosis made by the treating dermatologist for Skin related ailments requiring Corticosteroids prescription were recruited as study subjects. An initial preparatory phase was followed by data collection phase in Case record forms. The collected data was numerically coded and entered in Microsoft Excel 2007 and analysed and prescribing indicators were calculated by maintaining anonymity and privacy of respondents.
Results: In our findings, in a sample size of 312, it was seen that a total of 365 glucocorticoids were prescribed. The prescriptions showed generic name in 193 (52.9%) cases as compared to 172 (47.1%) prescriptions were done with trade/ brand names. Foremost route used was topical application (76%), whereas 24% of all corticosteroids prescribed were by oral/ parental route. The average number of drugs prescribed per prescriptions were 3.68, whilst the average corticosteroid prescribed was 1.17.
Conclusion: Prescribing by generic name should be encouraged. Prescribers should be encouraged for undertaking correct diagnosis, providing treatment following STGs (Standard Treatment Guidelines) and protocols. This will aid in improving the prescribing of corticosteroid drugs to a large extent.
Keywords: Corticosteroids, prescribing indicators, dermatological diseases.
