Evaluation of prescribing patterns in diabetic and hypertensive patients in a South Delhi Hospital

Background: Drug utilization studies (DUS) defined by World Health Organization as the marketing, distribution, prescription and use of drugs in a society, considering its consequences, either medical, social, and economic. The increasing importance of DUS as a valuable investigation resource in pharmacoepidemiology has been linking it with other health related areas, such as public health, pharmacovigilance, pharmacoeconomics, and pharmacogenetics. Methods: The study was a prospective DUS carried out in medicine OPD of Indian Institute of Technology Hospital, New Delhi, India in which a total of 595 prescriptions of hypertensive and diabetic patients were reviewed. All diabetic and/or hypertensive patients; irrespective of age, gender; who had least one drug in the prescription were included. Data were collected by screening of physician's prescribing record and patient medication profile. Results: A total of 595 prescriptions were recorded. 57.31% were males as compared to 42.69% females. 54.62% patients were hypertensive (325 prescription); 14.78% patients were diabetic (88 prescription) whilst 30.58% had both the diseases. Of 507 prescriptions having antihypertensive drugs, combination therapy was utilized (40.8%) in the prescriptions and out of 270 prescriptions having antidiabetic drugs, 143 (52.96%) prescription were of combination therapy. Among antihypertensive drugs, angiotensin-converting enzyme inhibitors were the most frequently prescribed class of drugs (19.18%). The combination most commonly prescribed was amlodipine and atenolol (14.05%). Antidiabetic drugs made up for 11.05% of the total drugs prescribed. 28.78% of all hypoglycemic agents were sulfonylurea. Glimepiride and metformin combination was the most prescribed anti-diabetic drugs combination (16.16%). Conclusion: Both hypertension and diabetes are considered to be lifestyle diseases. Hence, apart from optimal and appropriate prescribing, there is a need for lifestyle modification to obtain improved outcomes. Combination therapy was observed in a high percentage of prescriptions. Though monotherapy is associated with improved compliance and fewer side effects, combination therapy is desirable for synergistic actions and to overcome complications.