A PROSPECTIVE STUDY ON PRESCRIBING PATTERN IN TYPE 2 DIABETES MELLITUS OUTPATIENTS IN A TERTIARY CARE INSTITUTION

Abstract

Introduction

Study  of  prescribing  pattern  is  a  component  of  medical  audit  that  does  monitoring  and  evaluation  of  the  prescribing  practice  of  the  prescribers.  Glycemic  control  remains  the  major  therapeutic  objective  for  prevention  of  target  organ  damage  and  other  complications  arising  from  diabetes.  Poor  glycemic  control  in  diabetes  mellitus  can  be  prevented  by   rational  use  of  anti-diabetic  drugs.

Material and methods

The study was conducted in the medicine outpatient department at Guru Nanak Dev hospital attached to Government Medical College, Amritsar for three months. Two hundred type 2 diabetes mellitus patients were enrolled in the study according to the specific inclusion and exclusion criteria after taking informed consent.  Prescription of  these patients  were  analyzed  for  age of patients, percentage of  males  and  females,  percentage of   patients  with or without family  history  of   diabetes,  percentage of  one/two/three  drug  combination   and   most  frequently  prescribed  anti-diabetic drug. Also, prescriptions were audited for irrational Fixed Dose Combinations (FDCs) as per American Diabetes Association 2019 recommendations for combination therapy and whether the drugs were prescribed with generic nomenclature.

Results

Average  number  of  drugs  per  prescription  was  found  to  be  2.03.   Majority (70%) of the patients were on combinationtherapy. Asmonotherapy, metformin constituted 60%, glimepiride 20%, teneligliptin 15 % and insulin 5% of prescriptions. In two drug combination, metformin and glimepride was most (53.3%) prescribed whereas metformin and insulin combination was least (6.6%) prescribed. In triple drug combination, metformin, glimepiride and teneligliptin combination was used in 80% patients and metformin, glimepiride and pioglitazone combination was given to 20% of patients. All drugs were prescribed by trade names and 15% FDCs used were irrational.

Conclusion

Metformin was the most prescribed drug. In combination, majority of patients received metformin and glimepride. Prescribing by trade names and using irrational FDCs should be discouraged to improve the overall health care.

Key words: anti-diabetic drugs, diabetes mellitus, drug utilization, prescribing pattern, rational use