Drug Utilization Study In Intensive Coronary Care Unit of A Tertiary Care Teaching Hospital
Drug utilization study
Keywords:
Intensive Coronary Care Unit, Streptokinase, Myocardial Infarction, Drug Utilization studyAbstract
Background: Critically ill patients are admitted in Intensive coronary care unit. The intensive coronary care unit (ICCU) is a setting where a large number of drugs are administered to patients. Information on drug utilization in intensive coronary care units (ICUs) are lacking in India. Objectives: To identify pattern of drug use and suggest measures. Methods: Prospective drug utilization study was conducted in patients admitted in ICCU for six months. Data was collected in previously prepared case record form. Data was recorded from the admission of patient in ICCU to discharge from ICCU. Analysis was done by using drug use indicators, age and sex wise distribution, morbidity pattern of disease, frequency of drug use, cost of drug therapy and length of stay. Data analysed using Microsoft Excel. Total 605 cases were analysed. Results and Interpretation: Mean ± SD6 of age of all patients being admitted in ICCU is 57.05 ± 11.92 years. Most frequent morbidity found is myocardial infarction. Average number of drugs per encounter is 14.85. Percentage of encounters with an antibiotic and injection prescribed is 27.44% and 98.68% respectively. 34.46% drugs are prescribed by generic name and 43.75% drugs were prescribed from WHO essential drug list. Most commonly prescribed drug is Tablet Aspirin. Frequent injections used are promethazine, heparin, hydrocortisone, buprenorphine, streptokinase, metoprolol, Pentazocin and frusemide. Average drug cost per encounter is 867.84 Rs. 65.38% cost is spent on fibrinolytics. Conclusion: Average number of drugs per encounter is high it should be kept low whenever possible. From all drugs prescribed 42.66% drugs were parenteral. Percentage of drug prescribed by generic name is less. Drugs should be prescribed by generic name. Cost of drugs spend by patient is high. Antibiotics are less frequently prescribed. The mortality rate is low. Essential drug list for ICCU should be prepared. Seminar or group discussion can be done with health professionals working in ICCU to discuss drug utilization pattern for further improving prescribing pattern
References
2. Krishnaswamy K. Dinesh Kumar B, Radhaiah G; A drug survey- percepts and practices. Eur J Clin Pharmacol. 1985; 29: 363-70.3. 4th report of WHO expert committee: The use of essential drug, WHO TRS 796. World Health Organization; 1990.
4. Maini Rajiv,Verma KK, Biswas NR et al. Drug utilization study in Dermatology in a tertiary hospital in Delhi .Ind J Physiol Pharmacol 2002; 46: 107-10.
5. WHO how to investigate drug use in health facilities: selected drug use indicators. Geneva: World Health Organization; 1993. (WHO/DAP/93.1).
6. Mahajan BK. Methods in biostatistics for medical students and research workers. New Delhi: Jaypee Brothers. 2006.
7. Moran JL, Peisach AR, Soloman PJ, Martin J. Cost calculation and prediction in adult intensive care: a ground up utilization study. Anaesth Intensive Care. 2004 Dec; 32:787-97.
8. Toh CC ,Low L P, Khoo O T,.Intensive care of acute myocardial infarction in coronary care unit. Singapore Med J. 1970 march;11(1):38-45.
9. Shankar PR, Partha P, Dubey AK, Mishra P, Deshpande VY. Intensive care unit drug utilization in a teaching hospital in Nepal. Kathmandu Univ Med J. 2005 Apr-Jun; 3:130-7.
10. Williams A, Mathai A, and Phillips A Antibiotic prescription patterns at admission into a tertiary level intensive care unit in Northern India.J Pharm Bioallied Sci. 2011 Oct-Dec; 3(4): 531–536.
11. Badar V A, Navale S B. Study of Prescribing Pattern of Antimicrobial Agents in medicine Intensive Care Unit of a Teaching Hospital in Central India. JAPI . 2012 april; 60:20-23.
12. Smythe MA, Melendy S, Jahns B, Dmuchowski C. An exploratory analysis of medication utilization in a medical intensive care unit. Crit Care Med. 1993; 21:1319-23.
13. Stratton CW 4th, Ratner H, Johnston PE, Schaffner W. Focused microbiological surveillance by specific hospital unit: practical application and clinical utility. Clin Ther. 1993; 15 suppl A: 12-20.
14. Buchanan N, Cane RD. Drug utilization in a general intensive care unit. Intens care med.1978; 4:75-7.
15. Quick JD, Hogerzeil HV, Velasquez G, Rago L. Twenty-five years of essential medicines. Bull: WHO 2002; 80: 913-14.
16. Selles M, Datino T, Bueno H. Coronary care unit admission of very old patients with acute myocardial infarction. Heart. 2006; 92:549-50.
17. Tripathi K D. Opioid analgesics and antagonists. In: Essentials of medical pharmacology. New Delhi: Jaypee Brothers. 2008.
18. Venturini F, Romero M, Tognomi G. Acute myocardial infarction treatment in 58 Italian hospitals: A drug utilization survey. Ann Pharmacother.1995; 29:1100-05.
19. Selles M, Datino T, Bueno H. Coronary care unit admission of very old patients with acute myocardial infarction. Heart. 2006; 92:549-50.
