Abstract
Anti-peptic ulcer drugs (APUDs) such as proton pump inhibitors (PPI), H2 receptor antagonists (H2A), antacids are widely prescribed. This study is aimed to describe the utilisation pattern of APUDs based on WHO Defined Daily Dose (DDD) and identify most commonly used APUD in the selected hospital. A retrospective study was carried out in outpatient of the selected hospital for year 2017. Sample size was calculated using Raosoft. DDD of APUDs and direct drug cost were calculated. Data were collected through electronic medical record by retrieving patients’ registration number. Inclusion criteria were patients above 18 years old and APUDs prescribed for gastrointestinal related indications. A total of 160 prescriptions were randomly selected for data analysis. Based on the DDD calculated, Rabeprazole 20mg was most prescribed drug among PPI (n=33), while Maalox is most prescribed drug among the antacids (n=23). Based on the DDD calculated, Pantoprazole 20mg recorded highest rates per user per day about 1.26 DDD / user / day while antacids, Actal reported highest usage rate with 7.11 DDD / user / day. Besides, there are 5.4 days supplied per user for this drug. Dexlansoprazole 60mg is the most expensive drug among all the PPI listed in hospital formulary. It has 18.5 days supplied/user, which is the second shortest duration of treatment among all the other PPIs. In contrast, omeprazole 20mg is the lowest cost PPI but the duration supplied per user is longer resulting in higher total cost of therapy. In conclusion, PPIs were the most commonly prescribed.
Abstract
Introduction: Lipid-modifying drugs have been used to treat dyslipidemia as well as for the primary and secondary prevention of CVDs and stroke. Objectives: This study aims to describe the drug utilization pattern of lipid-modifying drugs in a private hospital. Method: A retrospective study was carried out in outpatient of the selected hospital. Patients were selected based on inclusion and exclusion criteria by using convenience sampling. Data were collected through KCIS by retrieving patients’ registration number. Defined daily dose (DDD) was calculated and compared to World Health Organization DDD. Medicine prices were also analysed. Results: A total of 180 patients’ record were analysed, 70% of them were male; 40.6% of the patients were from the age range of 50 to 59 years old; ethnicity breakdown was Malay (69.4%), Indian (18.3%) and Chinese (12.2%). Among all lipid-modifying drugs, utilization of statins was the highest as statins are the preferred line in the treatment of dyslipidemia. Innovator brands were more preferred where most of the lipid-modifying drugs used in the selected hospital are innovator brand drugs. In terms of cost, lipid-modifying drugs contributes to about 27% of the total cost of prescription in average. Conclusion: The utilization of all lipid-modifying drugs in the selected hospital was lower as compared to WHO DDD. As compared to combination therapy, monotherapy with atorvastatin was generally preferred in the selected hospital. The utilization of atorvastatin was found to be the highest in the OPD of the selected hospital.
Abstract
Essential medicines have become indispensable to maintain and to improve our lives and health. Latest literature again reiterated that inappropriate use of medicine is a global phenomenon in both developed and developing countries still prevail. Poor adherence is associated with negative clinical outcome of the disease. It is important to note that about 50% of treatment failures are due to poor medication adherence and this results in substantial morbidity and mortality. Patient’s belief and perception have been reported to influence medication adherence. Low rate of adherence was found strongly associated with patient’s belief across the studies with chronic diseases with hypertension, coronary heart disease, diabetes, asthma and renal disease. Exploring the health beliefs of patients is vital to improve adherence and thereby blood pressure among the patients with hypertension. Lack of knowledge about usage of medication and various misleading perceptions of hypertension management have resulted inappropriate use of medication especially medication adherence among community-dwelling patients with hypertension. Literatures classified non-adherence into primary and secondary. Primary non-adherence refers to medication is purposefully never filled or taken; Secondary non-adherence is defined as medication is not taken properly or continued as prescribed and further classified into intentionally and unintentionally. Patient education aims to train patient in the skill and self-management of their chronic disease by adapting to the treatment or lifestyle changes. Despite improving in patients’ skill and self-care by providing information about the treatment, patient education could enhance their empowerment and medication adherence. Patient education is a basic right of the patients and healthcare members have responsible to provide such information. However, the authenticity of the available information is yet to be verified. Therefore, healthcare professional could play a vital role here to educate their patients about the appropriate information.