A Drug Utilization Study of Psychotropic Drugs Prescribed in the Psychiatry Outpatient Department of a Tertiary Care Hospital
Background: Psychiatric disorders are one of the major causes of morbidity. Development of newer drugs like SSRIs and atypical antipsychotics has altered the treatment paradigms. Various factors like cost of drugs, local paradigms, etc. play a role in the selection of drug therapy and hence, aff...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2013-12-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/3885/29-%206760_E(C)_F(T)_PF1_(VP)_PFA(P).pdf |
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| author | Karan B. Thakkar Mangal M. Jain Gauri Billa Abhijit Joshi Akash A. Khobragade |
| author_facet | Karan B. Thakkar Mangal M. Jain Gauri Billa Abhijit Joshi Akash A. Khobragade |
| author_sort | Karan B. Thakkar |
| collection | DOAJ |
| description | Background: Psychiatric disorders are one of the major causes
of morbidity. Development of newer drugs like SSRIs and atypical
antipsychotics has altered the treatment paradigms. Various
factors like cost of drugs, local paradigms, etc. play a role in
the selection of drug therapy and hence, affect the outcome.
Keeping this in mind, we conducted a study to delineate the
various drugs used in psychiatric disorders, to find discrepancies,
if any, between the actual and the ideal prescribing pattern of
psychotropic drugs and to conduct a cost analysis.
Material and Methods: After our institutional ethics committee
approved, a retrospective cross sectional drug utilization study
of 600 prescriptions was undertaken. Preparation of the protocol
and conduct of the study was as per the WHO – DUS and the
STROBE guidelines.
Results: Drug use indicators – In 600 prescriptions, 1074 (88.25%)
were psychotropic drugs. The utilization from the National and
WHO EML was 100% and 90%, respectively. Average number of
psychotropic drugs per prescription was 1.79 ± 1.02 (SD). 22.5% of
the prescriptions contained psychotropic FDCs. 76.01% of drugs
were prescribed by generic name. Percentage of psychotropic
drugs prescribed from the hospital drug schedule and psychotropic
drugs actually dispensed from the hospital drug store were 73.1%
and 62.3%, respectively.
Drug utilization pattern in different psychiatric disorders –
Most commonly prescribed drugs for schizophrenia, bipolar
disorders, depression and anxiety disorders were trifluoperazine
+ trihexiphenydyl (63.9%), carbamazepine (17.2%), amitriptyline
(34.9%), and diazepam (23.8%), respectively. The least commonly
prescribed drugs were levosulpiride (1.7%), lithium (1.3%),
bupropion (4.7%) and clozapine (1.9%), respectively. The PDD/
DDD ratio of three drugs – haloperidol, pimozide and amitriptyline
– was equal to one. The cost borne by the hospital was 116, i.e.,
65.2% of the total cost. The cost index of clozapine was 11.2.
Conclusion: Overall, the principles of rational prescribing were
followed. The hospital drug schedule should include more SSRIs.
The practice of using 1st generation/ typical anti–psychotics
as the first line was as per current recommendations. Anti–
cholinergics should be used only in selected cases of patients on
anti–psychotics. The use of diazepam should be curtailed and it
should be used for short term only. |
| first_indexed | 2024-12-18T19:09:43Z |
| format | Article |
| id | doaj.art-0aa3b22a4ab740999a7145294b44bbc8 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-18T19:09:43Z |
| publishDate | 2013-12-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-0aa3b22a4ab740999a7145294b44bbc82022-12-21T20:56:18ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2013-12-017122759276410.7860/JCDR/2013/6760.3885A Drug Utilization Study of Psychotropic Drugs Prescribed in the Psychiatry Outpatient Department of a Tertiary Care HospitalKaran B. Thakkar0Mangal M. Jain1Gauri Billa2Abhijit Joshi3Akash A. Khobragade4Resident Doctor, Department of Pharmacology, Grant Medical College & Sir JJ Group of Hospitals, Mumbai, India.Associate Professor, Department of Pharmacology, Grant Medical College & Sir JJ Group of Hospitals, Mumbai, India.Resident Doctor, Department of Pharmacology, Seth GS Medical College & KEM hospital, Mumbai, India.Assistant Professor, Department of Pharmacology, Grant Medical College & Sir JJ Group of Hospitals, Mumbai, India.Assistant Professor, Department of Pharmacology, Grant Medical College & Sir JJ Group of Hospitals, Mumbai, India.Background: Psychiatric disorders are one of the major causes of morbidity. Development of newer drugs like SSRIs and atypical antipsychotics has altered the treatment paradigms. Various factors like cost of drugs, local paradigms, etc. play a role in the selection of drug therapy and hence, affect the outcome. Keeping this in mind, we conducted a study to delineate the various drugs used in psychiatric disorders, to find discrepancies, if any, between the actual and the ideal prescribing pattern of psychotropic drugs and to conduct a cost analysis. Material and Methods: After our institutional ethics committee approved, a retrospective cross sectional drug utilization study of 600 prescriptions was undertaken. Preparation of the protocol and conduct of the study was as per the WHO – DUS and the STROBE guidelines. Results: Drug use indicators – In 600 prescriptions, 1074 (88.25%) were psychotropic drugs. The utilization from the National and WHO EML was 100% and 90%, respectively. Average number of psychotropic drugs per prescription was 1.79 ± 1.02 (SD). 22.5% of the prescriptions contained psychotropic FDCs. 76.01% of drugs were prescribed by generic name. Percentage of psychotropic drugs prescribed from the hospital drug schedule and psychotropic drugs actually dispensed from the hospital drug store were 73.1% and 62.3%, respectively. Drug utilization pattern in different psychiatric disorders – Most commonly prescribed drugs for schizophrenia, bipolar disorders, depression and anxiety disorders were trifluoperazine + trihexiphenydyl (63.9%), carbamazepine (17.2%), amitriptyline (34.9%), and diazepam (23.8%), respectively. The least commonly prescribed drugs were levosulpiride (1.7%), lithium (1.3%), bupropion (4.7%) and clozapine (1.9%), respectively. The PDD/ DDD ratio of three drugs – haloperidol, pimozide and amitriptyline – was equal to one. The cost borne by the hospital was 116, i.e., 65.2% of the total cost. The cost index of clozapine was 11.2. Conclusion: Overall, the principles of rational prescribing were followed. The hospital drug schedule should include more SSRIs. The practice of using 1st generation/ typical anti–psychotics as the first line was as per current recommendations. Anti– cholinergics should be used only in selected cases of patients on anti–psychotics. The use of diazepam should be curtailed and it should be used for short term only.https://jcdr.net/articles/PDF/3885/29-%206760_E(C)_F(T)_PF1_(VP)_PFA(P).pdfdrug utilizationpsychopharmacologyatcdddpdd |
| spellingShingle | Karan B. Thakkar Mangal M. Jain Gauri Billa Abhijit Joshi Akash A. Khobragade A Drug Utilization Study of Psychotropic Drugs Prescribed in the Psychiatry Outpatient Department of a Tertiary Care Hospital Journal of Clinical and Diagnostic Research drug utilization psychopharmacology atc ddd pdd |
| title | A Drug Utilization Study of Psychotropic Drugs Prescribed in the Psychiatry Outpatient Department of a Tertiary Care Hospital |
| title_full | A Drug Utilization Study of Psychotropic Drugs Prescribed in the Psychiatry Outpatient Department of a Tertiary Care Hospital |
| title_fullStr | A Drug Utilization Study of Psychotropic Drugs Prescribed in the Psychiatry Outpatient Department of a Tertiary Care Hospital |
| title_full_unstemmed | A Drug Utilization Study of Psychotropic Drugs Prescribed in the Psychiatry Outpatient Department of a Tertiary Care Hospital |
| title_short | A Drug Utilization Study of Psychotropic Drugs Prescribed in the Psychiatry Outpatient Department of a Tertiary Care Hospital |
| title_sort | drug utilization study of psychotropic drugs prescribed in the psychiatry outpatient department of a tertiary care hospital |
| topic | drug utilization psychopharmacology atc ddd pdd |
| url | https://jcdr.net/articles/PDF/3885/29-%206760_E(C)_F(T)_PF1_(VP)_PFA(P).pdf |
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