Abstract

ASSESSMENT AND EVALUATION OF PRESCRIBING PATTERN AMONG THE PATIENTS ADMITTED IN THE INTENSIVE CARE UNIT

*Shah Mohammed Qutub-E-Alam, Niranjan Ishwar Kubasad, Tumu Saathvika, Nisar Ahmed and Mahendra Kumar Bettur Jayappa

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Abstract

Background: ICUs require prescribing pattern studies to understand drug use, trends, and patient outcomes. These studies help to identify drug-related problems and improve treatment standards. ICU patients are more likely to experience drug-drug interactions, drug accumulation due to organ dysfunction and sensitivity to drug responses. Drug utilization studies can modify prescribing practices, ensuring quality medical care and rational pharmacotherapy. Aim: To analyze the prescribing pattern among the patients admitted in the Intensive Care Unit. Methodology: A Prospective Observational study was conducted for a period of six months in CSI Holdsworth Memorial (Mission) Hospital, Mysore. All the patients who were admitted to Intensive Care Unit during the study period were reviewed intensively. All the required data were collected from various sources including medical records of the patient. Results: The study involved 112 patients with a mean age of 51.01 ± 18.8 years, with a higher percentage of male patients (71.4%) admitted than female patients (28.57%). 26.7% of the patients were alcoholic and 20.5% of patients were smokers, indicating a higher incidence of certain disorders in males. Acute poisoning was the most common factor for ICU admission, followed by CNS disorders and infective etiology. Hypertension and diabetes mellitus were the most common comorbidities. The average length of ICU stay was 3.75 ± 2.11days, with durations ranging from 1-3 days (61.6%) to 12-15 days (0.89%). On average, 8.75 ± 2.98 drugs were prescribed, with 29.1% being generic. The percentage of drugs prescribed from essential medicine list was (52.5%). Antibiotics in the prescription were 11.03% with beta-lactam antibiotics being the most commonly administered class. Parenteral administration was more common (65.37%), followed by enteral (32.48%). The drugs belonging to the class of gastrointestinal and hepatobiliary system (29.41%) were most commonly prescribed, followed by central nervous system (13.17%). Single drug utilization was 80.18%, and fixed drug combinations made up 19.81% of prescriptions. The average cost of prescription drugs per encounter per day was 956.13 Rs. Conclusion: This study observed predominance of male patients with acute poisoning being the most common reason for ICU admission. Diabetes and hypertension were prevalent comorbid conditions. The study revealed a predominant use of medications related to the gastrointestinal and hepatobiliary system. Most of the drugs were prescribed with brand names, so efforts must be made to encourage prescribing by generic names. Polypharmacy may be unavoidable in the treatment of patients admitted to the ICU.

Keywords: Intensive Care Unit, Prescribing pattern, Drug utilisation studies, Polypharmacy.