Assessment of Drug Utilization Pattern in Chronic Kidney Disease Patients in A Tertiary Care Hospital Based on Who Core Drug Use Indicators

Sharad Chand, C. S Shastry

Abstract

Introduction: Chronic kidney disease (CKD) is defined as any decrease in the glomerular filtration rate (GFR) with an abnormality in the kidney structure or its function. CKD patients are presented with multiple co-morbidities and compromised pharmacokinetics resulting in compromised quality of life and considerable economic burden. Aim: To study the drug utilization pattern in Chronic Kidney Disease (CKD) patients by using the World Health Organization (WHO) core drug use indicators. Materials and Method: A prospective observational drug utilization study was carried out in out-patients of Department of Nephrology of Justice K S Hegde Charitable Hospital, Mangaluru, for period of 8 months. CKD patients with an age of 18 years and above were included with consent. Data was collected using data collection forms, patients case notes, prescriptions sheet and personal interviews. Result: A total of 256 patients were recruited. Of which, 192 (75%) patients were males and 64(25%) were females with a mean age of 54.5 years. Average consultation time was 6.5 minutes. A total of 1374 drugs were prescribed to these patients with an average of 5.3 drugs per prescription. The most common prescribed class of drugs were for the cardiovascular system (42.6%) followed by the hematopoietic system (16.7%). Further, 65% of the drugs were prescribed from the National list of essential medicines (NLEM) whereas 8.7% of drugs were prescribed by generic name. Conclusion:  Utilizing the WHO’s core drug use indicators in this special patient population will strengthen the current hospital drug use policies and improve the drug usage pattern, saving the precious life years and monetary resources.

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References

Marriot, J., Cockwell, P., Stringer, S. Chronic kidney disease and end‑stage renal disease. In: Walker R, Whittlesea C, editors. Clinical Pharmacy and therapeutics. UK: Churchill livingstone; 2012. pp.272.

Tsai, W., Wu, H., Peng, Y., Ko, M., Wu, M., Hung, K., et al. Risk factors for development ad progression of chronic kidney disease. Medicine, 2016, 95(11).

Nugent, R. A., Fathima, S. F., Feigel, A. B., Chyung, D. The burden of chronic kidney disease on developing nations: A 21st century challenge in global health. Nephron. Clin. Pract., 2011,118:269-277.

Jha, V., Garcia, c., Iseki, K., Naicker, S., Plattner, B., Saran, R., Wang, A., Yang, C. Chronic kidney disease: global dimension and perspectives. Lancet., 2013, 382:260-272.

Murthy, B., and Satyanarayana, V. Prescribing pattern of drugs in chronic kidney disease patients on hemodialysis at a tertiary care hospital. Int. J Basic. Clin. Pharmacol., 2017, 6(4): 928-932.

Hudson, J. Q., Wazny, L. D. Chronic Kidney Disease. In: DiPiro, J. T., Talbert, R. L., Yee, G. C., et al., eds. Pharmacotherapy: A Pathophysiologic Approach. 7th ed. New York: McGraw-Hill; 2008:pp.634

Roberts, J. A., Lipman, J. Pharmacokinetic issues for antibiotics in the critically ill patient. Crit. Care. Med., 2009, 37: 840-51.

Philips, M., Wilson, J. A., Aly, A., An evaluation of medication reconciliation in an outpatient nephrology clinic. Cannt. J., 2017, 26(2):29-33.

Ahlawat, R., D’cruz, S., and Tiwari, P. Drug utilization pattern in chronic kidney disease patients at a tertiary care public teaching hospital: evidence from a cross-sectional study. J. Pharma. Care. Health. Sys. 2015, 3(1).

WHO. The rational use of drugs. Report of a conference expert, Nairobi, 25-29 November 1985. Geneva: World Health Organization; 1987.

Dheepan, B, N., Sarala, N., and Raghavendra, B, N. Drug utilization study in hemodialysis unit in a tertiary care Centre in kolar. Int. Pharm. Bio. Sci., 2015, 5(1):72-78.

Shalini, S., Ravichandran, V., Mohanty, B. K., Dhanaraj, S. K., Saraswathi, R. Drug utilization studies- An overview. International Journal of pharmaceutical sciences and Nanotechnology. 2010, 3(1): 803-810.

How to Investigate Drug Use in Health Facilities: Selected Drug Use Indicators - EDM Research Series No. 007: Chapter 2: Core Drug Use Indicators: Prescribing Indicators [Internet]. World health organization.1993 [ cited 5 feb 2019]. Available from http://apps.who.int/medicinedocs/en/d/Js2289e/.

Bharani, K., Bharani, R., Vohra, R., and Goyal, C. Drug utilization pattern of antihypertensive drugs in chronic kidney disease stage 5 patients in a tertiary care hospital of central India. International journal for basic & clinical pharmacology, 2003,7(7):1411-1414.

Abhisek, p., Panda, R., Samal, R.,Mohapatra, N., and Mohanty, S. Dtug utilization pattern and adverse events in patients with chronic kidney disease undergoing maintaenance haemodialysis at a tertiary care hospital of Odisha. Journal of clinical and diagnostic research. 2017,11(10):11-16 .

Bajait, C., Pimpalkhute, S., Sontakke, S., jaiswal, K., and Dawrl, A. Prescribing pattern of medicines in chronic kidney disease with emphasis on phosphate binders. Indian journal of pharmacology, 2014, 46(1): 35-39.

Goldberg, I., Krause, I. The role of gender in chronic kidney disease. Eur. Med. J, 2015,1(2):58-64.

Fesipe, O., Akhideno, P., Nwaiwu, O., and Adelosye, A. Assessment of prescribed medications ans pattern of distribution for potential drug-drug interactions among chronic kidney disease patients attending the Nephrology clinic of Lagos university teaching hospital in sub-Saharan west Africa. Clinical pharmacology: Advances and applications, 2017,9: 125-132.

Cohen, E., Nardi, Y., Krause, I., Goldberg, E., Milo, G., Garty, M., et al.A longitudinal assessment of the natural rate of decline in renal function with age. J Nephrol, 2014,27(6):635-41.

Santra, S., Agrawal, D., Kumar, S., and Mishra, S. A study on the drug utilization pattern in patients with chronic kidney disease with emphasis on antibiotics. J. Nephrol. Androl., 2015, 2(3):85-89.

Kantanavar, K., Holla, R., and Rao, S. A study of prescription pattern in the drug therapy of chronic kidney disease. International journal of pharmacological research., 2017, 7(04): 81-87.

Chakraborty, S., Ghosh, S., Banerjea, A., Raman, R., Hazra, A., and Mandal, S. Prescribing patterns of medicines in chronic kidney disease patients on maintainance hemodialysis. Indian journal of Pharmacology. 2016, 48(5): 586-590.

Swamy, N., Mateti, U., Bairi, R., Sivva, D., ans Martha, S. Drug utilization pattern in south Indian pediatric population: A prospective study. Perspective in clinical research, 2014,5(4):178-183.

Chawla, S., Ranjan, A., Singh, N., Garg, N., and Kumar, A. Assessment of drug utilization and quality of life in patients of chronic kidney disease in a tertiary care hospital. World journal of pharmacy and pharmaceutical scinces., 2016, 5(9): 1214-1226.

National List of Essential Medicines (NLEM) 2015 – India [Internet]. World health organization. 2015 [cited in 21st March 2019]. Available from: http://apps.who.int/medicinedocs/en/m/abstract/Js23088en/.

Kumar, V., Nagesh., and Kumar, G. A prospective study on prevalence, dialysis, and drug utilization of chronic renal failure patients. International Journal of pharmacology research. 2013, 3(2):45-52.

Ahlawat, R., Tiwari, P., and D’Cruz, S. Direct cost for treating chronic kidney disease at an outpatient setting of a tertiary hospital: Evidence from a cross-sectional study. Value in health regional issues. 2017, 12: 36-40.

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