Pharmacoepidemiology of drugs utilized in ophthalmic inpatient and outpatient department of a tertiary care hospital.

Rathnakar U.P, Kashvi Gupta, Akash Gadgade, Sarah Naushad, Faheem Kotekar, Vignesh Shenoy. Kasturba Medical College, Mangalore, Karnataka, India

The role of drugs in the society which refers to the marketing, distribution, prescription and use of drugs are ascertained by periodical drug utilization studies, which for the individual patient implies, rational drug use through prescription of a well-documented drug at an optimal dosage and at an affordable price (1). Therefore the study serves as a vital exploratory tool to determine the safety and effectiveness of drugs along with improving the quality of drug therapy thus avoiding prolonged irrational use of drugs (2). The aim of this study was to define the pattern of drug utilization among ophthalmology patients and provide information about the cost of medications in different disease conditions.

The present study was conducted in the Department of Ophthalmology after obtaining the institutional ethics committee approval. The required data was collected for a period of six months from the record section using appropriately designed Performa’s. The data obtained from all the prescriptions was tabulated and statistical analysis were made using SPSS software version 11.5. The variables assessed included the demographic profile of patients, indications for prescription of drug or (if any) surgery performed, details of drugs prescribed by generic or brand name, doses prescribed, dosage forms, frequency and routes of administration, average number of drugs prescribed per prescription , number of fixed-dose combination versus single agents and cost analysis per prescription.(2)

At the end of 6 months it was found that a total of 810 prescriptions were screened of which 587 were outpatients and 223 were inpatients. The maximum number of prescriptions (300) was for cataract in both the inpatient (38.7%) and out-patient department (61.3%) followed by corneal ulcers, FB and trauma cases (190) accounting for 42.1% prescriptions in the inpatient department and 57.9% prescriptions in the outpatient department. The most frequently prescribed form of drugs is depicted in Fig 1. On classification of the drugs it was found that eye anti-invective’s and anti-septic’s were most commonly prescribed (24.07%) followed closely by mydriatic drugs (22.89%), eye anti-septic’s with corticosteroids (11.23%) and ophthalmic decongestants, anesthetics and anti-inflammatories (9.9%). The number of drugs per prescription is listed in Table 1. The average cost per prescription for an outpatient diagnosis was found to be most for glaucoma, ` 210.3 while for an inpatient diagnosis it was cataract, ` 165.

Table 1 Number of drugs per prescription

Type of preparation Fig. 1

To summarize, rational drug usage has been observed. With audits of bigger sample sizes and drug prescription guidelines, cost effectiveness and appropriateness of drug prescription can be increased.

(1) World Health Organization-Introduction to Drug Utilization Research. Geneva: WHO 6-48, 2003

(2) Nehru M. et al, JK Science 7(3): 149, 2005