A PROSPECTIVE OBSERVATIONAL STUDY ON DRUG UTILIZATION PATTERN AND PHARMACOVIGILANCE OF PATIENTS ATTENDING PSYCHIATRY OPD IN A TERTIARY CARE HOSPITAL
Main Article Content
Keywords
Drug utilization research, Psychiatric disorders, Pharmacovigilance.
Abstract
Background: Drug utilization research (DUR) was defined by WHO as “the marketing, distribution, prescription and the use of drugs in a society, with special emphasis on the resulting social, medical and economic implications”. (1) The main aim of drug utilization research is to facilitate safe and effective use of drugs and to assess whether drug therapy is rational or not. Since there is no sufficient data on the utilization pattern of drugs on psychiatric disorders in Chidambaram area, the present study was conducted to analyse the drug utilization pattern and monitor the adverse effects of drugs used in various psychiatric disorders in a tertiary care hospital.
Materials and Methods: This is an observational study conducted by Department of Pharmacology in the Department of Psychiatry, Rajah Muthiah Medical College and Hospital (RMMCH) for a period of one year from January 2018 to December 2018, in which a total of 80 prescriptions were analysed.
Results: Out of 80 prescriptions ,52.50% were males and 47.50% were females. Majority of the patients were in the age group of 36 – 45 years (32.50%). Regarding the disease distribution pattern, 51(63.75%) anxiety disorder, 11(13.75%) depressive disorder, 10(12.50%) adjustment disorder, 4 (5%) obsessive compulsive disorder and 4(5%) schizophrenia cases. Most commonly encountered adverse effects were drowsiness and headache.
Conclusion: Prescription pattern of drugs used for various psychiatric illness were rational, and were according to the drug use indicators by WHO/INRUD. Majority of the drugs (69.34%) were prescribed in their generic names. However, there remains room for improvement, especially in increasing generic prescribing and adherence to the essential drug list.
References
2. Murthy RS. Mental Health Programme in the 11th Five Year Plan. Indian J Med Res. 2007 Jun;125(6):707-11. PMID: 17704544.
3. GBD 2015 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053):1545-1602. doi: 10.1016/S0140-6736(16)31678-6. Erratum in: Lancet. 2017 Jan 7;389(10064):e1. doi: 10.1016/S0140-6736(16)32606-X. PMID: 27733282; PMCID: PMC5055577.
4. Ritu Parna Maiti. Postgraduate topics in pharmacology.2nd edition: ADR Monitoring and Pharmacovigilance . Hitesh A Kothari 2015:pg 111-125.
5. Tripathi A, Avasthi A, Desousa A, Bhagabati D, Shah N, Kallivayalil RA, Grover S, Trivedi JK, Shinfuku N. Prescription pattern of antidepressants in five tertiary care psychiatric centres of India. Indian J Med Res. 2016 Apr;143(4):507-13. doi: 10.4103/0971-5916.184289. PMID: 27377509; PMCID: PMC4928559.
6. Thakkar KB, Jain MM, Billa G, Joshi A, Khobragade AA. A drug utilization study of psychotropic drugs prescribed in the psychiatry outpatient department of a tertiary care hospital. J Clin Diagn Res. 2013 Dec;7(12):2759-64. doi: 10.7860/JCDR/2013/6760.3885
7. Grover S, Avasthi A, Sinha V, Lakdawala B, Bathla M, Sethi S, Mathur DM, Kathuria P, Shah S, Baalasubramanian DS, Agarwal V, Deka K. Indian Psychiatric Society multicentric study: Prescription patterns of psychotropics in India. Indian J Psychiatry. 2014 Jul;56(3):253-64. doi: 10.4103/0019-5545.140632. PMID: 25316936; PMCID: PMC4181180.
8. Goyal SG, Kurle DG, Samant BD. Observational study to assess prescription cost and its relation to the socioeconomicstatus of the patients in psychiatry outpatient department in a tertiary care hospital. Int J Basic Clin Pharmacol. 2016 Apr;5(2):307-311. DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20160725
9. Nagarkar A, Sharma JP, Tandon SK, Goutam P. The clinical profile of mentally retarded children in India and prevalence of depression in mothers of the mentally retarded. Indian J Psychiatry. 2014 Apr;56(2):165-70. doi: 10.4103/0019-5545.130500. PMID: 24891705; PMCID: PMC4040065.
10. Mengistu G, Misganaw D, Tsehay T, Alemu BK, Bogale K. Assessment of Drug Use Pattern Using WHO Core Prescribing Indicators at Outpatient Settings of Governmental Hospitals in Dessie Town. Drug Healthc Patient Saf. 2020 Nov 27;12:237-244. doi: 10.2147/DHPS.S266749. PMID: 33273863; PMCID: PMC7708261.
11. Lam MK, Lam LT, Butler-Henderson K, King J, Clark T, Slocombe P, Dimarco K, Cockshaw W. Prescribing behavior of antidepressants for depressive disorders: A systematic review. Front Psychiatry. 2022 Sep 9;13:918040. doi: 10.3389/fpsyt.2022.918040. PMID: 36159914; PMCID: PMC9501861.
12. Davidson JR, Ford SM, Smith RD, Potts NL. Long-term treatment of social phobia with clonazepam. J Clin Psychiatry. 1991 Nov;52 Suppl:16-20. PMID: 1757453.
13. Harnod T, Wang YC, Lin CL, Tseng CH. Association between use of short-acting benzodiazepines and migraine occurrence: a nationwide population-based case-control study. Curr Med Res Opin. 2017 Mar;33(3):511-517. doi: 10.1080/03007995.2016.1266313. Epub 2017 Jan 4. PMID: 27893291.
14. Banerjee I, Roy B, Sathian B, Banerjee I, Kumar SS, Saha A. Medications for Anxiety: A Drug utilization study in Psychiatry Inpatients from a Tertiary Care Centre of Western Nepal. Nepal J Epidemiology [Internet]. 2011 Sep. 30 [cited 2025 Jul. 23];1(4):119-25. Available from: https://www.nepjol.info/index.php/NJE/article/view/5753
15. Jacobson GA, Friesen WT, Peterson GM, Rumble RH, Polack AE. Psychoactive drug prescribing in the Tasmanian community. Med J Aust. 1992 Jul 6;157(1):20-4. PMID: 1353603.
16. Dutta, S. B., Beg, M. A., Bawa, S., Kaur, A., Vishal, S., & Singh, N. K. (2017). Study on drug usage pattern of anxiolytics in psychiatric department in a tertiary care teaching hospital at Dehradun, Uttarakhand, India. International Journal of Basic & Clinical Pharmacology, 6(7), 1661–1665. https://doi.org/10.18203/2319-2003.ijbcp20172726
17. Olfson M, King M, Schoenbaum M. Benzodiazepine use in the United States. JAMA Psychiatry. 2015 Feb;72(2):136-42. doi: 10.1001/jamapsychiatry.2014.1763. PMID: 25517224.
18. Lader MH, Bond AJ, James DC. Clinical comparison of anxiolytic drug therapy. Psychol Med. 1974 Nov;4(4):381-7. doi: 10.1017/s0033291700045827. PMID: 4156411.
19. Sultana J, Italiano D, Spina E, Cricelli C, Lapi F, Pecchioli S, Gambassi G, Trifirò G. Changes in the prescribing pattern of antidepressant drugs in elderly patients: an Italian, nationwide, population-based study. Eur J Clin Pharmacol. 2014 Apr;70(4):469-78. doi: 10.1007/s00228-013-1636-z. Epub 2014 Jan 15. PMID: 24425146.
20. Avasthi A, Grover S, Aggarwal M. Research on antidepressants in India. Indian J Psychiatry. 2010 Jan;52(Suppl 1):S341-54. doi: 10.4103/0019-5545.69263. PMID: 21836704; PMCID: PMC3146188.
21. Winkler D, Willeit M, Wolf R, Stamenkovic M, Tauscher J, Pjrek E, Konstantinidis A, Schindler S, Barnas C, Kasper S. Clonazepam in the long-term treatment of patients with unipolar depression, bipolar and schizoaffective disorder. Eur Neuropsychopharmacol. 2003 Mar;13(2):129-34. doi: 10.1016/s0924-977x(02)00174-8. PMID: 12650958.
22. Victor BS, Link NA, Binder RL, Bell IR. Use of clonazepam in mania and schizoaffective disorders. Am J Psychiatry. 1984 Sep;141(9):1111-2. doi: 10.1176/ajp.141.9.1111. PMID: 6465393.
23. Buckley PF. Efficacy of quetiapine for the treatment of schizophrenia: a combined analysis of three placebo-controlled trials. Curr Med Res Opin. 2004 Sep;20(9):1357-63. doi: 10.1185/030079904125004510. PMID: 15383183.
24. Jenike MA, Baer L, Minichiello WE, Rauch SL, Buttolph ML. Placebo-controlled trial of fluoxetine and phenelzine for obsessive-compulsive disorder. Am J Psychiatry. 1997 Sep;154(9):1261-4. doi: 10.1176/ajp.154.9.1261. PMID: 9286186.
25. Tollefson GD, Rampey AH Jr, Potvin JH, Jenike MA, Rush AJ, kominguez RA, Koran LM, Shear MK, Goodman W, Genduso LA. A multicenter investigation of fixed-dose fluoxetine in the treatment of obsessive-compulsive disorder. Arch Gen Psychiatry. 1994 Jul;51(7):559-67. doi: 10.1001/archpsyc.1994.03950070051010. Erratum in: Arch Gen Psychiatry 1994 Nov;51(11):864. PMID: 8031229.
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Nivetha D
Assistant Professor, Department of Pharmacology, Government Thoothukudi Medical College, Thoothukudi, Tamil Nadu.
A Hussain
Assistant Professor, Department of Pharmacology, Jaipur National University Institute for Medical Sciences and Research Centre, Jaipur, Rajasthan.
Arthi S
Assistant Professor, Department of Pharmacology, Government Medical College, The Nilgiris.