Abstract

PERIOPERATIVE DRUG USE AMONG GERIATRIC INPATIENTS UNDERGOING CATARACT SURGERY IN A TERTIARY CARE HOSPITAL

Sudhindra Prathap A. and *Dr. Radhika M. S.

Abstract

Background: Older people are potentially at a greater risk of medication error. Cataract is a frequently encountered eye disease in the elderly. Also cataract surgery is the commonest surgery which is performed in this age group of patients, in order to identify prescribing related problems. It isthe fundamental step in improving the quality of prescription and patient care among such geriatric patients. Objectives: To assess drug use pattern before and after cataract surgery among geriatric inpatients of department of ophthalmology of a tertiary care hospital. Materials and Methods: Case records fulfilling inclusion criteria were collected from hospital Medical record department (MRD) and analyzed using the World Health Organization (WHO) core prescribing indicators for rationality and pattern of prescribing. Results: Total of 749 case records were collected and analyzed, 396 were of male patients (52.87%) and 353 were of female patients (47.12%). Unlike older studies, a male preponderance was noted in this study. Bilateral cataract was found to be higher compared to unilateral in geriatric patients in this study (28.23%).Of the various groups of oral drugs prescribed in the study (n = 584), antibiotics formed most commonly prescribed drug group (57.1 %).Among the topical drugs, antibiotics (35.8) followed by analgesics (46.2%) were most commonly prescribed in this study (n = 1195). Most commonly prescribed antibioticwas Ciprofloxacin (topical) (70.62%). All case records had at least one FDC (100%). The three FDCs used were Ketorolac 5mg + Ofloxacin 3mg, Tropicamide 0.8% + Phenylephrine 5% & Ciprofloxacin 0.3% + Dexamethasone 0.1%. Rationality of prescriptions was assessed using WHO core prescribing indicators. Both DCGI and FDA approved drug prescriptions were 81% and 72% of drug prescriptions were included in both WHO-EML and NLEM depicting rational use of drugs in this study. The most commonly prescribed ATC class of drugs include R01A, S01F, M01A and S02A. Conclusion: Although usage of antibiotics and topical drugs was conforming the WHO recommended standards, there is a need to improve prescription pattern by using generic name and drugs from Essential Drug List.

Keywords: Cataract, Geriatric, Ophthalmological medication, Eye diseases.