A Comparative drug utilization study of depression patients between tertiary care teaching hospital and private practitioners of Dehradun city, Uttarakhand
Background: Drug utilization studies are beneficial in clinical practice for rational prescribing, as there is continuous proliferation of new drugs and the increasing recognition of their delayed adverse effects. Depression is an important global public health problem thus making such studies a must for minimizing the medication errors.
Aim and objectives: Present study audits the prescribing pattern of psychiatric private practitioners (PPs) vs psychiatric practitioners of tertiary care teaching hospital (TCTH) at Dehradun, Uttarakhand.
Materials and methods: A total of 371 prescriptions were analysed, 196 were from collected from PPs and 175 from TCTH at Dehradun. They were analysed using WHO drug use indicators and National List of Essential Medicines (NLEM-2013).
Results: Anxiolytics 150(25.25%) were most commonly prescribed by the PPs followed by antidepressants 120(20.20%) and antipsychotics 111(18.48%), whereas antidepressants 105 (27.78%) was the major drug group prescribed by TCTH followed by anxiolytics 102(26.98%) and antipsychotics 37(9.79%). Tricyclic antidepressants(TCAs) were most frequently prescribed antidepressants followed by selective serotonin reuptake inhibitors(SSRIs) at TCTH whereas SSRIs were the major antidepressants prescribed by PPs. Anxiolytics and anticholinergics co-prescription with antidepressants and antipsychotics respectively, was a common observation among PPs and TCTH. Analysis of prescription revealed average number of drugs prescribed per prescription in teaching hospital is 2.16 vs 3.03 among the private practitioners. 18.25% Fixed drug combinations(FDCs) were prescribed by TCTH while 0% were prescribed by PPs. 55.39% and 55.56% drugs were prescribed from the NLEM-2013 by the PPs and the TCTH respectively.
Conclusion: There were lesser number of drugs prescribed per prescription and more frequent use of drug combinations at TCTH while no drug combinations and greater number of drugs per prescription were prescribed by PPs. Newer class of drugs were more frequently prescribed by PPs.
Key words: Drug utilization studies, antidepressants, antipsychotics, anxiolytics, Fixed drug combinations.
1. World Health Organisation. Introduction to drug utilisation research. Oslo: World Health Organisation, 2003.
2. Lahon K, Shetty HM, Paramel A, Sharma G. A Retrospective Drug Utilization Study of Antidepressants in the Psychiatric Unit of a Tertiary Care Hospital. Journal of Clinical and Diagnostic Research 2011;5(5):1069-75.
3. Akiskal, H.S. Mood disorders: Historical introduction and conceptual overview. In: Kaplan and Sadock's comprehensive textbook of psychiatry. 8th edition. Lippincott Williams & Wilkins: Philadelphia; 2005:1559-75.
4. Grover S, Avasth A, Kalita K, Dalal PK, Rao GP, Chadda RK, et al. IPS multicentric study: antidepressant prescription patterns. Indian J Psychiatry 2013;55(1):41-5.
5. Avanthi E, Somashekar HE, Kumar P, Sushma HK, Sudarshan CY et al. Prescribing pattern of antidepressants in psychiatric unit of a tertiary care hospital. Int J Basic Clin Pharmacol 2014;3(4):667-70.
6. Dutta SB, Beg MA, Sindhu S, Singh NK. Role of pharmaco-epidemiology in psychopharmacology: a study in psychiatric out-patient department of a tertiary care teaching hospital at Dehradun, Uttarakhand. Int J Basic Clin Pharmacol 2014;3(4):637-43.
7. Trivedi JK, Dhyani M, Sareen H, Yadav VS, Rai SB. Antidepressant drug prescription pattern for depression at a tertiary health care centre of Northern India. Med Pract Rev 2010;1(2):16-8.
8. Dutta S, Beg MA, Kaul V, Dutta SH, Dhasmana DC. Psychotropic drug utilization study in psychiatric OPD of a tertiary care teaching hospital in Dehradun, Uttarakhand. J Adv Res Biol Sci 2013;5(4):386-91.
9. Piparva KG, Parmar DM, Singh AP, Gajera MV, Trivedi HR. Drug utilization study of psychotropic drugs in outdoor patients in a teaching hospital. Indian J Psychol Med 2011;33(1):54-8.
10. Battista CD. Antidepressant agents. In: Katzung BG, Masters SB, Trevor AJ, editors. Basic and Clinical Pharmacology. 11th Edition. New York: McGraw Hill; 2012:p.509-30.
11. American Psychiatric association (APA). Practice guidelines for the treatment of patients with major depressive disorder. 3rd ed. Arlington (VA): American Psychiatric association (APA) 2010. 152p.(1170 references)
12. Dhasmana DC, Rawat Y, Mishra KC. What is so atypical about atypical antipsychotic? Indian J Pharmacol. 2003;35:322-4.
13. Ren XS, Huang YH, Lee AF, Miller DR, Qian S, Kazis L. Adjunctive use of atypical antipsychotics and anticholinergic drugs among patients with schizophrenia. J Clin Pharm Ther.2005;30(1):65-71.
14. Memom A, Patel K. drug use pattern of antidepressant agents in psychiatric patients-a prospective study. NHL Journal of Medical Sciences 2013;2(2):33-6.
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