A PROSPECTIVE OBSERVATIONAL STUDY ON PRESCRIPTION PATTERN DRUG UTILIZATION AND AUDIT FOR THE TREATMENT OF DIABETIES MELLITUS IN A TERTIARY CARE HOSPITAL IN ANDHRA PRADESH

Introduction: Diabetes is the most common metabolic disorder in Indian community. It is a silent disease that has become more prevalent with increased age. Despite the advances in understanding the disease and its management, the mortality and morbidity of the disease is increasing.Objective: The objective of the study is to evaluate the prescription pattern, drug utilization and audit for the treatment of diabetes mellitus in a tertiary care hospital in Rajahmundry. Methodology: The study design is a prospective observational study. A total of 150 cases related to anti diabetic treatment were investigated in a tertiary care hospital in Rajahmundry, Andhra Pradesh. Inclusion and Exclusion Criteria include patients with diabetes mellitus admitted as in- patients in the hospital and Patients with age group 20-70 years of both men and women are included. Pregnant and lactating women are excluded from the study and Patients who are unconscious/mentally retarded and who were suffering with psychiatric diseases are excluded from the study.The data sources include patient case sheets, prescriptions issued and discharge medication sheet, WHO guidance on essential drugs and by interacting with physicians and patients. Results and Conclusions: The diabetes is more prevalent among women than in men. Patients in the age group 51-60 years are more prone to diabetes than other age groups. The comorbid diseases in diabetic patients majorly include Hypertension, Hyperlipidemias, Thyroid, and Obesity. Cataract, Chronic foot ulcer, Neuropathy and Mild hypoglycemia are the major clinical manifestations in diabetic patients. Mono drug therapy in 36.6% cases, two drug therapies in 44.6%cases and three drug therapies in 18.6% cases is followed for the treatment of diabetes in the hospital. WHO suggested 18 drugs for mono therapy and 6 two drug combinations for diabetes . Only three drugs(Insulin, Metformin, Glimepiride) out of 18 suggested were used in mono therapy and only one 2 drug combination was used among the 6 suggested by WHO. Three 2 drug combinations other than those suggested by WHO are also used in the hospital. Anti diabetic drugs other than those suggested by WHO are also used to a large extent in the hospital. Hence, it is suggested that the WHO suggested Essential drugs be prescribed in the hospital for better patient care, safety and efficacy. Key words: Prospective observational study, Prescription pattern, Drug utilization, Prescription audit, Anti-diabetic drugs.