Drug Prescribing Pattern in Dental Teaching Hospital

MT Salman, FA Khan, SZ Rahman, M Makhdoom. JK Science, Vol. 11 No. 2. 107, April-June 2009

Objective: To study drug prescribing pattern in the Dental OPD.
Methods: 50 prescriptions were collected from Ziauddin Ahmad Dental College, AMU, Aligarh, and analyzed for percentage of drugs prescribed as per VEN Method. We also looked into the percentage of drugs prescribed with generic name, groups of drugs commonly prescribed, antibiotics’ prescription pattern, number of injections and cost per prescription as per WHO basic drug indicators.
Results: The percentage of drugs from Essential Medicines List (EML) was 25%, while percentage of drugs prescribed by Generic Name was only 4%. Most common groups of drugs prescribed by Dental Physicians were Antiseptics (40%), NSAIDs (34%), Antibiotics (30%) and Vitamins (4%). The most extensively prescribed drug from each group was Betadine Gargle, Tablets Voveron, Novaclox and Basiton Forte respectively. The average number of drugs prescribed, number antibiotics prescribed and cost per day per prescription were 3, 1 and Rs. 24.2 respectively.. Average number of antibiotics prescribed per prescription was 1.0. No injection was prescribed to any patient.
Discussion: After reviewing the above prescriptions, the pattern of drug prescribing is not based on WHO criteria for rational use of drugs. The system is not at all evidence based. It is thus necessary to make physicians of Dental College aware about the use of drugs from EMLs, importance of prescribing drugs with generic names and, for patients’ point of view, the factor of cost-effectiveness. There is need of CMEs based on GCP and Standard Treatment Guidelines. Every institution must have Drugs and Therapeutic Committees.

Conclusion: For rational prescribing of drugs, there is a need of mass awareness amongst surgeons about good prescribing habit by following five steps of WHO Program on Rational Use of Drugs (RUD).

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"High Alert" Medications

High Alert Medications are those drugs which bear aheightened risk of significant patient harm if used in error, according to The Institute for Safe Medication Practices. To access the list of 'high alert medications' click here.

Impact of JUPITER

In the newest analysis, investigators used data from the National Health and Nutrition Examination Survey (NHANES 1999–2004) to estimate the size of the population that would be affected by the JUPITER findings as well as to describe the population for whom statin therapy might now be indicated.
The group identified 2322 individuals with complete data to determine statin eligibility. More than half, 57.9%, and representing more than 33 million US adults, had a National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) indication for statin therapy. Of these, only 42% were currently taking a statin.
Of the remaining 976 subjects, 13.9%, representing eight million US adults, met the strict JUPITER criteria of hs-CRP >2.0 mg/L and LDL cholesterol <130 mg/dL. Another 5.3%, representing three million adults, had an extended JUPITER indication--elevated CRP and LDL-cholesterol levels between 130 and 160 mg/dL--for statin therapy.
"In the middle-aged and older population, there are already a huge number of people--58%, or 33 million Americans--who meet the current recommendations to take a statin," Spatz told heartwire. "If we are to adopt JUPITER to clinical practice, this would add an additional 11 million people, or another 20% of the population."
As noted, the secondary analysis of the NHANES data revealed that less than half of patients currently meeting the existing recommendations for statin therapy are receiving the lipid-lowering drugs.
In looking at patient characteristics, the researchers noted that compared with individuals in whom statins would not be indicated, the JUPITER patients were more likely to be female and older. There were also more likely to be obese, hypertensive, and have the metabolic syndrome. They also noted that many of JUPITER patients shared similar characteristics, including sociodemographic factors, abdominal obesity, and hypertension, as those who qualified for statin therapy based on the NCEP ATP III guidelines.
An analysis of cardiovascular risk scores showed that Framingham risk score (FRS) was higher in patients who met the NCEP ATP III guidelines for statin therapy but similar in the JUPITER patients and patients without an indication for statin therapy. The Reynolds risk score, which includes additional risk factors beyond the FRS, including hs-CRP, was able to differentiate risk between those who met the criteria for statins based on JUPITER patients and those without an indication for the drugs, said Spatz

New guidelines for management of IBS

The American College of Gastroenterology (ACG) has updated its 2002 evidence-based position statement on the Management of IBS in North America.
Irritable Bowel Syndrome is one of the most common disorders managed by gastroenterologists and primary care physicians, and in light of the changes in the clinical landscape relating to IBS therapy in recent years the ACG has decided to update its position statement.
NEW TREATMENTSThe ACG’s updated evidence-based review analyzes multiple new treatments for IBS, including:
Probiotics
Antibiotics including rifaximin
Lubiprostone, and
Emerging therapies for IBS
For the clinical gastroenterologist, the new ACG recommendations specify whether or not these agents are better than placebo for constipation-predominant IBS or diarrhea-predominant IBS.
NEW GRADED RECOMMENDATIONSRecommendations are now made using the GRADE system where graded recommendations take into account:
Strength of study design
Magnitude of benefit of different treatments, and
Balancing the benefits of treatment with the potential risks
NEW RECOMMENDATIONS ON DIAGNOSTIC TESTINGAlso, the evidence-based review includes new recommendations about the use of diagnostic tests for patients who present with IBS symptoms.

Drug Prescribing Pattern in Surgical Wards of a Teaching Hospital in North India

Drug Prescribing Pattern in Surgical Wards of a Teaching Hospital in North India

Author(s): Salman MT, Akram MF, Rahman S, Khan FA, Haseen MA, Khan SW
Indian Journal for the Practising Doctor. Vol. 5, No. 2 (2008-05 - 2008-06)

ISSN : 0973-516X
Dr MT Salman, Dr SZ Rahman and Dr FA Khan are from the Department of Pharmacology; and Dr MA Haseen and Dr SW Khan from the Department of Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India – 202002.

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Abstract
Irrational use of medicines is widespread throughout the world. The main problems include the unnecessary prescription of drugs, particularly antimicrobials and injections. To investigate the situation in surgery wards, the present study was undertaken. Ninety six prescriptions were collected prospectively from post-operative patients admitted in surgery wards of the JN Medical College Hospital, AMU, Aligarh, and subjected for analysis according to the WHO/INRUD Indicators. VEN method was also applied to ascertain quality of drug procurement. It was revealed that the proportion of drugs from Essential Medicines List (EML) was 61.4%, while no drug was prescribed by generic name. Groups of drugs most commonly prescribed by general surgeons were antibiotics (93%), analgesics (60%), antacids (43%) and antiemetics (10%). The most extensively prescribed drugs from each of the above groups were injections Ceftriaxone and Amikacin, tablets Voveron, Pantoprazole and Metoclopromide, respectively. The average number of drugs prescribed per patient and cost per day per prescription was 4.8 and 246.1 INR, respectively. Average number of antibiotics prescribed per prescription was 2.2 and the average number of injections per prescriptions was 2.3. The results showed that the pattern of drug prescribing is not based on WHO criteria for rational use of drugs. The system is not at all evidence-based. It is thus necessary to make surgeons aware about good prescribing habit by following 5 steps of the WHO Program on Rational use of Drugs (RUD).