UTILIZATION OF SELECTED NON STEROIDAL ANTI-INFLAMATORY DRUGS IN RURAL TERTIARY TEACHING HOSPITAL - PowerPoint PPT Presentation

View by Category
About This Presentation
Title:

UTILIZATION OF SELECTED NON STEROIDAL ANTI-INFLAMATORY DRUGS IN RURAL TERTIARY TEACHING HOSPITAL

Description:

To find out the utilisation, seasonal variation of NSAIDs(oral form)& To identify the preferred group of NSAIDs in a rural tertiary teaching hospital – PowerPoint PPT presentation

Number of Views:656

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: UTILIZATION OF SELECTED NON STEROIDAL ANTI-INFLAMATORY DRUGS IN RURAL TERTIARY TEACHING HOSPITAL


1
  • UTILIZATION OF SELECTED NON STEROIDAL
    ANTI-INFLAMATORY DRUGS IN RURAL TERTIARY TEACHING
    HOSPITAL
  • REVATHI P , ARBIND KC,
    BALASARASWATHI T, MANICKAVASAGAM S,

  • THIRUMALAIKOLUNDUSUBRAMANIAN P
  • DEPARTMENT OF PHARMACOLOGY, CHENNAI MEDICAL
    COLLEGE HOSPITAL RESEARCH CENTRE (SRM GROUP),
    IRUNGALUR, TIRUCHIRAPALLI-621 005.
  • Correspondenceltreva1923_at_yahoo.comgt

2
INTRODUCTION
  • The World Health Organization (WHO)
  • addressed drug utilization(DU) as-
  • the marketing, distribution, prescription and
  • use of drugs in a society, considering its
  • consequences, either medical, social, and
  • economic.

3
  • DU- aim to evaluate factors related to the
  • prescribing,
  • dispensing
  • administering
  • taking of medication and
  • its associated events
  • (either beneficial or adverse).
  • DU studies are an evolving area.

4
  • a valuable resource in pharmacoepidemiology
  • builds bridge with other health related areas,
  • such as-4 Ps
  • public health,
  • pharmacovigilance eco-pharmacovigilance
  • pharmacoeconomics,
  • pharmacogenetics.

IMPORTANCE OF DU STUDIES
5
IMPORTANCE OF THIS DU STUDY
  • Health budgeting
  • Purchase of medicine
  • Designing areas for CMEs
  • Monitoring a mean for surveillance activity
  • Improve quality of prescription rational use of
    drugs

6
  • NSAIDs are among the most commonly prescribed
    categories of drugs worldwide in the treatment of
    pain and inflammation in many conditions.
  • Irrational prescriptions availability of the
    NSAIDs as over-the-counter (OTC) products has
    made NSAIDS as a widely misused and abused drug.
  • Moreover, their use is not always without severe
    adverse effects.

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS(NSAIDs)
7
  • To find out the utilisation of NSAIDs(oral form)
    in a rural tertiary teaching hospital
  • To identify the preferred group of NSAIDs
  • To elicit seasonal variation.

OBJECTIVES
8
  • Research Design - A retrospective Study
  • Period of study - September 2009 to August
  • 2010
    (12months)
  • Place of study
  • Department of Pharmacology Pharmacy,
  • Chennai Medical College Hospital Research
    Centre (SRM Group), Irungalur Tiruchirapalli,
    India
  • Institutional ethical clearance obtained

MATERIAL METHODS
9
  • Computer registries are used for collecting
    information on drug utilization.
  • Institutional prescriptions entered in the
    computer over a period of 12 consecutive months
    were retrieved and analysed in relation to NSAIDs
    and season.
  • Limited formulations of NSAIDs (Group I, II and
    IV) were available at the store uninterruptedly

MATERIALS
10
  • INCLUSION CRITERIA
  • Prescriptions of adult Patients of NSAIDs (oral
    forms) were included in this study.
  • EXCLUSION CRITERIA
  • Paediatric preparations were not excluded
  • Statistical analysis Data were analyzed by
    simple descriptive statistics

11
  • Group1 Selective COX1 inhibitors Low dose
    aspirin
  • Group2 Non-selective COX inhibitors High
    dose aspirin,
  • diclofenac, ibuprofen,
    Indomethacin , Mefenamic
  • acid, naproxen,
    paracetamol, piroxicam
  • Group3 Selective COX2 inhibitors Ketorolac,
  • meloxicam, nabumetone,
    nimuselide
  • Group4 Highly Selective COX2 inhibitors
    Celicoxib,
  • rofecoxib
  • - Group III were not used in this
    hospital

CLASSIFICATION OF NSAIDs
12
DISTRIBUTION OF PATIENTS PRESCRIPTION ON
NSAIDs
RESULTS
.
. .
s
S
used
used
.
13
Fig.1- UTILIZATION OF NSAIDs IN
Group1-COX1 selective, Group3-
Selective COX2,
Group2-Non-selective, Group4 -
Highly selective COX2 agents.
14
SEASONALITY USE OF NSAIDS
15
Utilization of NSAIDs in a tertiary care hospital
. .
.
.
16
Fig-2 UTILIZATION OF NSAIDs IN GROUP II()
17
DISCUSSION
  • Tertiary level hospitals are chosen in general
    for DU studies, because the prescribing pattern
    of the outpatient departments of tertiary level
    hospitals are often copied by community
    practitioners and health workers.
  • However overall DU of NSAIDs among all the
    departments of hospitals can not be considered as
    rational, though we recommend and insist on RUDs.
  • Analysis of feedback from prescribers are
    essential for proper utilization of NSAIDs

18
  • In our hospital generic formulations were
    purchased provided. However, doctors continue
    to write brand name, hence there is a need to
    reorient prescribers.
  • 60 of prescriptions were made during winter and
    late winter months (September to March) and the
    rest were distributed almost equally in the
    remaining of 6 months.

19
STRENTHS LIMITATIONS OF THE STUDY
  • STRENGTHS Computer based data and hence no
    missing of data.
  • LIMITATIONS
  • Non inclusion of injectable formulations
  • Non inclusion of paracetamol syrup
  • Analysis in relation of Departments, individuals,
    disease/ illness, age group and institutional
    policies for purchase were not made
  • Adverse effects of NSAIDs were not studied

20
  • 2 out of 3 prescription carried one or other
    NSAIDs
  • Group II drugs were most frequently prescribed
    and were in the order of paracetamol, diclofenac
    and ibubrufen
  • 60 of prescriptions were made during rainy
    seasons, winter and late winter months (September
    to March) More preferred combination is
    paracetamol ibubrufen
  • Seasonal variation correlated with morbidity
    pattern observed in this institution.

CONCLUSIONS
21
RECOMMENDATIONS
  • Orientation programmes to prescribers on the
    cautious aspects of NSAIDs as many patients had
    comorbid illness.
  • Awareness programmes to patients care givers
    on adverse effects

22
AREAS FOR WORK
  • Analysis with references to patients, illnesses,
    prescribers formulations
  • Questionnaire survey to elicit preferences and
    knowledge improvement programmes
  • ADR monitoring among those received NSAIDs
  • Analysis of NSAIDs self medicated
  • Interdepartmental programmes for RUD

23
  • REFERENCES
  • 1.WHO Expert Committee. The Selection of
    Essential Drugs, Technical Report Series no.615.
    Geneva World Health Organization, 1977.
  • Lunde PK, Baksaas I. Epidemiology of drug
    utilizationbasic concepts and methodology. Acta
    Med Scand Suppl 19887217-11.
  • Strom BL. Pharmacoepidemiology. Fourth ed John
    Wiley Sons, Ltd 2005.
  • Md. Shamsur Rahman, Zinnat Ara Begum and Md.
    Khoshroz Samad
  • Prescribing pattern of non-steroidal
    anti-inflammatory drugs at outpatient departments
    of teaching hospitals. Bangladesh J Pharmacol
    2007 2 1-6
  • Frolich JC. A classification of NSAIDs according
    to the relative inhibition of cyclooxygenase
    isoenzymes. Trends Pharmacol Sci 19971830-4.
About PowerShow.com