STUDY OF DRUG PRESCRIPTION PATTERN AND SAFETY OF DIFFERENT DRUGS USED IN ALCOHOL-RELATED CHRONIC LIVER DISEASE IN GSVM COLLEGE, KANPUR: A TERTIARY CARE HOSPITAL

Main Article Content

Dr Vekaria Harsh Mansukhbhai
Dr Virendra Kushwah
Dr Pooja Agrawal
Dr Ajesh Chandra Gupta
Dr Amit Kumar
Dr Himanshu Sharma

Keywords

Drug prescription, Safety, Alcohol-Related Chronic Liver Disease

Abstract

Introduction: Management of alcohol-related chronic liver disease involves a multifaceted approach, including lifestyle modification, abstinence from alcohol, and pharmacotherapy. Despite the availability of various treatments, there is a lack of consensus on the optimal drug regimen and a need for localized data on drug prescription patterns and their safety profiles.


Aims & Objectives: This study was planned to evaluate drug prescription pattern and safety of different drugs used in patients with alcohol-related chronic liver disease.


Materials & Methods:  An observational prospective study was conducted by the Department of Pharmacology, in collaboration with the Department of Medicine, G.S.V.M. Medical College, Kanpur. Prescriptions were collected and further studied. All basic details and prescribed drugs were collected and entered in predesigned proforma.


Results: The gender distribution indicated a significant male predominance (99.45%). The drug prescription pattern revealed an average of 6.67 drugs per prescription.


Antibiotics were prescribed at 1.39 per encounter, with 65.08% prescribed using generic names and 90.14% sourced from government supplies. Number of drugs prescribed by generic name were 779 (65.08%) drugs and most according to essential list of medicines i.e., 80.86% which increases rationality of our prescription. In present study, causality assessment of ADRs according to Naranjo scale suggested that of total 19 patients who had ADRs, 22(43.14%) were probable and 29(56.86%) were possible.


Conclusion: While the study provides a detailed snapshot of current practices and safety issues, ongoing efforts are required to enhance drug prescription practices and ensure the safest and most effective treatment strategies for patients with alcohol-related chronic liver disease.


Further research is needed to refine drug prescription strategies, evaluate long-term outcomes, and explore the efficacy of emerging therapies.

Abstract 0 | pdf Downloads 0

References

1. World Health Organization (WHO). (2020). Global Status Report on Noncommunicable Diseases 2020. Geneva: World Health Organization. Available at: https://www.who.int/publications/i/item/9789240062996
2. Garg, H., Sharma, B., & Kumar, R.. Prevalence and Management of Alcohol-Related Liver Disease in India: A Review. Journal of Clinical and Experimental Hepatology, (2021);11(2):168-176.
3. National Institute on Alcohol Abuse and Alcoholism. Rethinking Drinking: Alcohol and Your Health; 2010. Available from: http://www.rethinkingdrinking.niaaa.nih.gov. [Last accessed on 2024 Aug 23].
4. Bellentani S, Saccoccio G, Costa G, Tiribelli C, Manenti F, Sodde M, et al. Drinking habits as cofactors of risk for alcohol-induced liver damage. The Dionysos Study GroupGut. 1997;41(6):845-50.
5. Kim, H. I., Park, S. Y., & Shin, H. P.. Incidence and management patterns of alcohol related liver disease in Korea: A nationwide standard cohort study. Scientific Reports. (2021);11(1): 1-11. https://doi.org/10.1038/s41598-021-86197-z
6. World Health Organization (WHO). (2014). Global Status Report on Alcohol and Health 2014. Geneva: World Health Organization. Available at: https://www.who.int/publications/i/item/9789241564745
7. Becker U, Deis A, Sørensen TI, Grønbaek M, Borch-Johnsen K, Müller CF, et al. Prediction of risk of liver disease by alcohol intake, sex, and age: A prospective population study. Hepatology.1996;23(5):1025-9.
8. Parthasarathi G, Nyfort-Hansen K, Nahata MC, The textbook of Clinical Pharmacy Practice, Second edition.2012;447-64.
9. Orman ES, Odena G, Bataller R. Alcoholic liver disease: Pathogenesis, management, and novel targets for therapy. J Gastroenterol Hepatol.2013;28 Suppl 1:77-84.
10. Hussen N, Zhu L, Tetangco E, Ellison S. Hepatoptosis in a Patient with Alcoholic Hepatitis. Am J Gastroenterol.2018 Nov;113(11):1581. [PubMed]
11. Arathy PC, Mohan V, Al-Muneer S, Dhanya H. A prospective observational study on pattern of comorbid conditions in CLD patients with drug use pattern, and assessment of severity using meld score. Indian res j pharmacy res.2016;11:861-7.
12. Jamdadea, V. S., Malikb, A., Kolatia, S. R., Reddyc, D., Lahkaracd, M. Prescription pattern of drugs WHO prescribing indicators used in alcoholic liver disease patients in a tertiary care teaching hospital in Northeastern India. International Journal of Pharma and BioSciences.2015; 6(1): 503-510.
13. Vijayan, M., Anisha, K. A., Selina, A. S. K., Roshni, P. R. Clinical Profile and Prescribing Pattern of Cirrhosis in a Tertiary Care Hospital. Indian Journal of Pharmacy Practice.2014; 7(3): 69-74.
14. Huma S, Fatima ON, Ayesha I, Moiz JM, Mohiuddin SM, Prescribing Pattern of Drugs Used in Chronic Liver Disease with Co Morbid Conditions and Assessment of Severity using MELD Score: A Prospective Observational Study, Journal of Drug Delivery and Therapeutics.2020; 10(5-s):19-24.
15. Patil, A. M., & Ma, K. (n.d.). Study of Alcoholic liver cirrhosis in hospital based patients. International Journal of Current Medical And Applied Sciences, 2015, June, 7(1),16-20.
16. Becker U, Deis A, Sørensen TI, Grønbaek M, Borch-Johnsen K, Müller CF, et al. Prediction of risk of liver disease by alcohol intake, sex, and age: A prospective population study. Hepatology.1996;23(5):1025-9.
17. Fuchs CS, Stampfer MJ, Colditz GA, Giovannucci EL, Manson JE, Kawachi I, Hunter DJ, Hankinson SE, Hennekens CH, Rosner B. Alcohol consumption and mortality among women. N Engl J Med.1995;332(19):1245-50. doi: 10.1056/NEJM199505113321901.
18. Kolasani, B., Sasidharan, P., CM, D., Jayabal, P. and Rajaseharan, A., Prescribing pattern of drugs in patients with alcoholic liver disease in a tertiary care teaching hospital. National Journal of Physiology, Pharmacy and Pharmacology
https://doi.org/10.5455/njppp.2017.7.1233027012017
19. Sathish Kumar V, Bhavana P, Supriya.CH, Abdul Rahaman.SK, ‘Prevalence and Drug Utilization Pattern in Hepatic Impairment Patients at a Tertiary Care Hospital”. International Journal of Science and Research (IJSR), 2017.
20. Bajaj, J.S.; Rodriguez, M.P.; Fagan, A.; McGeorge, S.; Sterling, R.K.; Lee, H.; Luketic, V.; Fuchs, M.; Davis, B.C.; Sikaroodi, M.; et al. Impact of bacterial infections and spontaneous bacterial peritonitis prophylaxis on phage-bacterial dynamics in cirrhosis. Hepatology.2022, 76, 1723–1734. [CrossRef] [PubMed]
21. Franz CC, Hildbrand C, Born C, et al. Dose adjustment in patients with liver cirrhosis: impact on adverse drug reactions and hospitalizations. Eur J Clin Pharmacol.2013;69:1565–7.
22. Verbeeck RK. Pharmacokinetics and dosage adjustment in patients with hepatic dysfunction. Eur J Clin Pharmacol.2008;64: 1147–6
23. Delco F, Tchambaz L, Schlienger R, et al. Dose adjustment in patients with liver disease. Drug Saf.2005;28:529–45.
24. National Health Portal India. National Viral Hepatitis Control Program (NVHCP). Available at: https://www.nhp.gov.in/natio nal-viral-hepatitis-control-program-(nvhcp )_pg. Accessed February 24, 2024.