Drug utilisation pattern in dermatology outpatient department at a tertiary care hospital

Background: Skin is the part of integumentary system that constitutes the largest organ of human body and thus it is exposed to injury by various extrinsic and intrinsic factors. The skin disorders have serious detrimental effect on quality of life of the general population. The present study was planned to define the prescription pattern in terms of rationality, drug interactions and financial burden of disease to the individual. Also, in the identification of problems related to drug use such as poly-pharmacy and drug-drug interaction.Methods: The present study was conducted in the male and female out-patient Department of Dermatology at a Tertiary Care Hospital in Hyderabad, Telangana over a period of two months. Prescriptions of 400 patients were analyzed i.e. 200 each were taken from the male and female OPD patients. An observational and cross-sectional study design was adopted for this study.Results: Prescriptions of 400 patients were analyzed. The average number of drugs per prescription was 3.73 in male OPD and 3.59 in female OPD. The percentage of generic drugs prescribed was 84.13% in male OPD and 77.3% in female OPD, drugs prescribed by brand name was 15.82% in male OPD and 22.7% in female OPD. Antihistamines were the most commonly prescribed drugs followed by antibacterial in female OPD and antifungals in male OPD.Conclusions: Prescription of maximum drugs was by their generic name and was dispensed free of cost to the patients from the hospital pharmacy. Almost all the drugs prescribed as oral formulation were present in the NLEM, India 2011. Whereas some topical formulations prescribed are not present in the NLEM. Therefore, were prescribed by trade name. Regular educational interventions like sensitization on pharmacovigilance may further promote rational prescribing

Drug utilization study of drugs used in the management of post-partum hemorrhage at a tertiary care hospital

Background: Postpartum haemorrhage remains a major cause of both maternal mortality and morbidity worldwide, uterotonic drugs such as oxytocin, with or without ergometrine, have been used to prevent PPH. The objective to study the drugs used in the management of post-partum haemorrhage at a tertiary care hospital.Methods: An observational and cross-sectional study design was adopted for this study. The case sheets of 100 patients presenting in active stage of labour to the labour room in a tertiary care hospital were analysed.Results: In the prescriptions analysed from the patients in the labour room, drugs used to prevent PPH are oxytocin and misoprostol. Oxytocin is the most commonly prescribed drug to prevent PPH in the study group. It is a life-saving drug to prevent PPH and thereby maternal mortality. In the study group having 103 patients, a total of 81 patients received only 10 IU oxytocin IM and 14 patients received 10 IU oxytocin IM and 600 g misoprostol to prevent PPH.Conclusions: Oxytocin is an essential drug included in the WHO essential drug list and in the national list of essential medicine, so it shouldn’t have been dealt in such a biased manner

­­Eleven tips for operational researchers working with health programmes: our experience based on implementing differentiated tuberculosis care in south India

Due to the workload and lack of a critical mass of trained operational researchers within their ranks, health systems and programmes may not be able to dedicate sufficient time to conducting operational research (OR). Hence, they may need the technical support of operational researchers from research/academic organisations. Additionally, there is a knowledge gap regarding implementing differentiated tuberculosis (TB) care in programme settings. In this ‘how we did it’ paper, we share our experience of implementing a differentiated TB care model along with an inbuilt OR component in Tamil Nadu, a southern state in India. This was a health system initiative through a collaboration of the State TB cell with the Indian Council of Medical Research institutes and the World Health Organisation country office in India. The learnings are in the form of eleven tips: four broad principles (OR on priority areas and make it a health system initiative, implement simple and holistic ideas, embed OR within routine programme settings, aim for long-term engagement), four related to strategic planning (big team of investigators, joint leadership, decentralised decision-making, working in advance) and three about implementation planning (conducting pilots, smart use of e-tools and operational research publications at frequent intervals). These may act as a guide for other Indian states, high TB burden countries that want to implement differentiated care, and for operational researchers in providing technical assistance for strengthening implementation and conducting OR in health systems and programmes (TB or other health programmes). Following these tips may increase the chances of i) an enriching engagement, ii) policy/practice change, and iii) sustainable implementation