An open-label prospective observational study to evaluate the efficacy and safety of alternate day versus daily dosing of atorvastatin in patients of dyslipidemia

Background: Hypercholesterolemia is a main driver of atherosclerosis. Cholesterol-containing lipoproteins induce endothelial dysfunction and macrophage activation. Foam cell formation results from the uptake of cholesterol-containing lipoproteins by macrophages, it is an essential step in the initiation and progression of atherosclerosis. Aims and Objectives: To evaluate the efficacy and safety of alternate day versus daily dosing of atorvastatin in patients with dyslipidemia. Materials and Methods: This open-label, prospective, observational study was conducted on dyslipidemic patients who came into the medicine Outpatient Department of Dhanalakshmi Srinivasan Medical College and Hospital, Tamil Nadu. Approval for the study was taken from the Institutional Ethical Committee. The duration of the study was 3 months. The efficacy of atorvastatin was checked by noting their blood lipid profile status. Results: Out of 100 patients included in the study 79 completed the study whereas 21 patients were lost in follow-up, 42 patients were analyzed in daily dose (Group A), and 37 patients in alternate dose (Group B) of atorvastatin (20 mg). There was no statistically significant difference based on triglyceride, total cholesterol, low-density lipoprotein, and high-density lipoprotein levels both prior and post-treatment in both the groups. Adverse drug reactions (ADR) profile showed a statistically significant difference between both the groups after treatment by atorvastatin (P=0.0001), with more ADRs noted in a daily dosing group. Conclusion: The results of this study show that alternate dosing of atorvastatin was better tolerated than daily dosing hence physicians can consider choosing an alternate day therapy to reduce pill burden on patients

Analysis of the prevalence and pattern of polypharmacy among elderly patients admitted in general medicine department of a rural tertiary care hospital in South India

Background: Quality and safety of prescribing drugs in older people remain a global healthcare concern. Inappropriate prescribing pattern in the elderly population is now considered as a major public health issue and polypharmacy is one of the common problems among the elderly patients. Aims and Objectives: The aims of this study were (1) to analyze the prevalence, pattern of polypharmacy with respect to age, and gender among the elderly patients and (2) to evaluate the most frequently prescribed drugs in the geriatric population. Materials and Methods: This prospective, cross-sectional, and observational study was conducted among the elderly patients admitted in the Department of General Medicine, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil Nadu. The duration of research project was 12 months from May 2018 to April 2019; approval for the study was taken from the Institutional Ethical Committee. Data on total number of prescribed drugs and main and adjuvant drugs prescribed to patients during treatment were collected and analyzed. Results: A total of 289 patients, that is, 167 male and 122 female were included in the study. The prevalence of minor polypharmacy (2–4 drugs) accounted for 15.22%, major polypharmacy (≥5 drugs) for 81.35%, and hyper polypharmacy (≥10 drugs) for 3.46%. Most commonly prescribed drugs were vitamins, proton-pump inhibitors, antipyretic agents, and H2 receptor blockers. They accounted for 21.70%, 5.78%, 5.42%, and 4.94%, respectively. Conclusion: Polypharmacy is a preventable and can be rectified by prescribing appropriate medications. In future, a multidisciplinary approach which will be involving doctors, nurses, and pharmacists, shall be implemented for rational use of drugs in elderly patients