Original Article

Study of Drug Utilization Pattern during Second Wave of Covid-19 in a Tertiary Care Centre: A Retrospective Cross Sectional Study

Abstract

Background: To study the drug utilization trends among patients with COVID-19 disease during the second wave in a tertiary care hospital.

 Methods: A retrospective cross-sectional study was conducted in patients admitted in COVID-19 wards during second wave of SARS – COVID-19 pandemic from 1st March 2021 to 30th June 2021. A total of 300 prescriptions were analysed. Assessment of prescription patterns were done as per the WHO-The International Network for Rational Use of Drugs (INRUD)drug use indicators. 

Results: A total of 3106 drugs were analysed.The average number of drugs prescribed was 11±5.1. The most frequent prescription was that of analgesic and antipyretic drug   Paracetamol (95.26%) followed by vitamin C (94.74%) and multivitamins(87.89%) . Nearly all patients in this study received antibacterials, 68% received antivirals. Antibacterials commonly used were cephalosporins, amoxicillin- clavulanic acid combination and pipercillin –tazobactam combination. Antiviral drug Remdesivir was also used extensively in our study (54.21%). Other class of drugs which were commonly prescribed to more patients were Dalteparin (73.16%) and corticosteroids like methyl prednisolone (52.63%) and dexamethasone (51.05%). 35.68% of the drugs were prescribed with generic name .45.43% of the drugs were injectables . 2.96% of the drugs were prescribed as fixed dose combinations.

 Conclusion: In summary, the drug utilization for hospitalized patients with COVID-19 was diverse but generally complied with the ongoing guidelines. The drug were mostly prescribed from WHO essential drug list and percentage of fixed dose combination prescription was low. However not prescribing the drugs by generic name and large encounters of injectable was matter of concern. To get a better glimpse of drug utilization a more extensive study needs to be undertaken.

1. World Health Organization (COVID-19) Dashboard 2021. Coronavirus disease Pandemic. Available from: http://www.int/emergencies/disease/novel-coronavirus-2019 . Assessed [cited 2021,June 20].
2. Kumar SU, Kumar DT, Christopher BP, Doss CGP. The rise and impact of COVID-19 in India. Front Med (Lausanne) [Internet]. 2020;7(250):1-7.
3. Kumar G, Mukherjee A, Sharma RK, et al. Clinical profile of hospitalized COVID-19 patients in first & second wave of the pandemic: Insights from an Indian registry based observational study. Indian J Med Res. 2021;153(5 & 6):619–28.
4. Asrani P, Eapen MS, Hassan MI, Sohal SS. Implications of the second wave of COVID-19 in India. Lancet Respir Med. 2021;9(9):e93–4.
5. Frediansyah A, Nainu F, Dhama K, Mudatsir M, Harapan H. Remdesivir and its antiviral activity against COVID-19: A systematic review. Clin Epidemiol Glob Health .2021;9:123–7
6. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available from: https://www.covid19 treatment guidelines .nih. gov/. Accessed[cited on 2021, June 19].
7. Nasonov E, Samsonov M. The role of Interleukin 6 inhibitors in therapy of severe COVID-19. Biomed Pharmacother.2020;131(110698):1-13
8. Infante M, Ricordi C, Alejandro R, Caprio M, Fabbri A. Hydroxychloroquine in the COVID-19 pandemic era: in pursuit of a rational use for prophylaxis of SARS-CoV-2 infection. Expert Rev Anti Infect Ther. 2021;19(1):5–16.
9. Bryant A, Lawrie TA, Dowswell T, et al. Ivermectin for prevention and treatment of COVID-19 infection: A systematic review, meta-analysis, and trial sequential analysis to inform clinical guidelines: Am J Ther. 2021;28(4):e434–60.
10. Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30(3):269-271.
11. Williamson BN, Feldmann F, Schwarz B, et al. Clinical benefit of remdesivir in rhesus macaques infected with SARS-CoV-2. Nature. 2020;585(7824):273-6.
12. Remdesivir (Veklury) [package insert]. Food and Drug Administration. 2020. Available from: https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/214787Orig1s000lbl.pdf. Assessed [cited 2022, November 9]
13. DLin KJ, Schneeweiss S, Tesfaye H, et al. Pharmacotherapy for hospitalized patients with COVID-19: Treatment patterns by disease severity. Drugs .2020;80(18):1961–72.
14. Von EE, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495–9.
15. Gurumurthy B, Das SK, Shetty S, Veerabhadrappa RC, Kosinepalli SS, Dharamaraju SH. CT severity score: an imaging biomarker to estimate the severity of COVID-19 pneumonia in vaccinated and non-vaccinated population. Egypt J Radiol Nucl Med. 2022;53(1).
16. COVID-19 Treatment Guidelines Panel. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. National Institutes of Health. Available from: https://www.covid19 treatment guidelines.nih. gov/about-the-guidelines/whats-new/. Accessed [cited on 200 November 7]
17. World Health Organization. How to investigate drug use in health facilities: selected health use indicators. WHO/ DAP/ 93. Geneva; 1993. Available from: https//apps.who.int/iris/handle/10665/60519. Accessed[cited on 2021, June 20]
18. Bwire GM. Coronavirus: Why men are more vulnerable to Covid-19 than women? SN Compr Clin Med. 2020;2(7):874–6.
19. Sanyaolu A, Okorie C, Marinkovic A, et al. Comorbidity and its impact on patients with COVID-19. SN Compr Clin Med. (2020) 2:1069–76.
20. Madhav P, Gorle SB, Gutti S. Prescription pattern among mild to moderate COVID-19 patient in a tertiary care centre; Anil Neerukonda Hospital Vishakapatnam. International Journal of health and Clinical research 2021:4(6);95-9.
21. WHO Therapeutics and COVID-19: living guideline. Who.int. Assessed [cited 2022 Nov 9]. Available from: https://www.who.int/publications-detail-redirect/WHO-2019-nCoV-therapeutics-2022.4
22. Molla M, Yeasmin M, Islam M, et al. Antibiotic Prescribing Patterns at COVID-19 Dedicated Wards in Bangladesh: Findings from a Single Center Study. Infection Prevention in Practice. 2021;3(2):100134.
23. Tang N, Bai H, Chen X, Gong J, Li D, Sun Z. Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. Journal of Thrombosis and Haemostasis.2020;18(5):1094-9.
24. Ranjbar K, Moghadami M, Mirahmadizadeh A, et al. Methylprednisolone or dexamethasone, which one is superior corticosteroid in the treatment of hospitalized COVID-19 patients: a triple-blinded randomized controlled trial. BMC Infect Dis.2021;21(1):337.
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IssueVol 10, No 4 (Autumn 2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/jpc.v10i4.11581
Keywords
COVID-19 Drug Utilization Study Retrospective
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How to Cite
1.
Gawali U, Gurung A. Study of Drug Utilization Pattern during Second Wave of Covid-19 in a Tertiary Care Centre: A Retrospective Cross Sectional Study. J Pharm Care. 2022;10(4):211-217.