Drug utilization patterns among elderly hospitalized patients on poly-pharmacy in Punjab, Pakistan

Muhammad Rehan Sarwar, Muhammad Atif, Shane Scahill, Anum Saqib, Muhammad Qamar-uz-Zaman, Zaheer Babar

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Reports from drug utilization reviews are important tools employed in the assessment of healthcare practices. The objective of this study was to evaluate drug utilization patterns among elderly hospitalized patients on poly-pharmacy regimens in Pakistan. Methods: A descriptive, non-experimental, cross-sectional study was carried out from December 2015 to March 2016 in six tertiary-care hospitals in the Punjab province of Pakistan. The population under study were patients aged ≥60 years, taking ≥5 medicines per day (i.e., patients on poly-pharmacy) and who were hospitalized in the selected tertiary-care hospitals. In this study, data was collected from 600 hospitalized elderly patients (100 patients per hospital). All medicines prescribed on each in-patient chart were noted on a pre-designed pro-forma sheet and were classified under the Anatomical Therapeutic Chemical (ATC) classification system. Multiple linear regression analysis was used to determine the independent factors associated with poly-pharmacy in this cohort. Statistical Package for Social Sciences (SPSS) was used to analyze the data. P-value <.05 indicated statistical significance. Results: In 600 hospitalized in-patient (male 52.7% and female 47.3%) medication charts, 3179 medicines were prescribed. The most commonly prescribed drug classes were: A: alimentary tract and metabolism 80% (A02: drugs for acid related disorders 64.5%, A03: drugs for functional gastrointestinal disorders 21.5%), N: nervous system 66.3% (N02: analgesics 67.2%, N03: antiepileptic's 11.2%), J: anti-infectives for systemic use 62.2% (J01: antibacterial for systemic use 82.5%, J04: antimycobacterials 15.3%) and C: cardiovascular system 48.3% (C07: beta blocking agents 19.8%, C10: lipid modifying agents 16.5%), respectively. The most commonly prescribed active substances were: A02BC01 (omeprazole 51.3%), N02BE01 (paracetamol 50.8%) and J01DD04 (ceftriaxone 40.2%), respectively. In multiple linear regression analysis, male gender (95% CI -.205, -.006, p = .039, B = -.091), being divorced (95% CI -.604, -.136, p = .002, B = -.130) and presence of comorbidity (95% CI.068,.267, p = .001, B = .144) were the independent factors associated with increased drug use among elderly hospitalized patients on poly-pharmacy. Conclusions: The rational use of medicines is of utmost importance, most particularly in the elderly population. More consideration should be given to rationalizing pharmacotherapy in elderly hospitalized patients who are on poly-pharmacy regimens in Pakistan.

LanguageEnglish
Article number23
Number of pages16
JournalJournal of Pharmaceutical Policy and Practice
Volume10
DOIs
Publication statusPublished - 4 Aug 2017

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Drug Utilization
Pakistan
Tertiary Healthcare
Tertiary Care Centers
Pharmaceutical Preparations
Linear Models
Drug Utilization Review
Regression Analysis
Divorce
Omeprazole
Ceftriaxone
Social Sciences
Gastrointestinal Diseases
Acetaminophen
Cardiovascular System
varespladib methyl
Anticonvulsants
Nervous System
Population
Analgesics

Cite this

Sarwar, Muhammad Rehan ; Atif, Muhammad ; Scahill, Shane ; Saqib, Anum ; Qamar-uz-Zaman, Muhammad ; Babar, Zaheer. / Drug utilization patterns among elderly hospitalized patients on poly-pharmacy in Punjab, Pakistan. In: Journal of Pharmaceutical Policy and Practice. 2017 ; Vol. 10.
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title = "Drug utilization patterns among elderly hospitalized patients on poly-pharmacy in Punjab, Pakistan",
abstract = "Background: Reports from drug utilization reviews are important tools employed in the assessment of healthcare practices. The objective of this study was to evaluate drug utilization patterns among elderly hospitalized patients on poly-pharmacy regimens in Pakistan. Methods: A descriptive, non-experimental, cross-sectional study was carried out from December 2015 to March 2016 in six tertiary-care hospitals in the Punjab province of Pakistan. The population under study were patients aged ≥60 years, taking ≥5 medicines per day (i.e., patients on poly-pharmacy) and who were hospitalized in the selected tertiary-care hospitals. In this study, data was collected from 600 hospitalized elderly patients (100 patients per hospital). All medicines prescribed on each in-patient chart were noted on a pre-designed pro-forma sheet and were classified under the Anatomical Therapeutic Chemical (ATC) classification system. Multiple linear regression analysis was used to determine the independent factors associated with poly-pharmacy in this cohort. Statistical Package for Social Sciences (SPSS) was used to analyze the data. P-value <.05 indicated statistical significance. Results: In 600 hospitalized in-patient (male 52.7{\%} and female 47.3{\%}) medication charts, 3179 medicines were prescribed. The most commonly prescribed drug classes were: A: alimentary tract and metabolism 80{\%} (A02: drugs for acid related disorders 64.5{\%}, A03: drugs for functional gastrointestinal disorders 21.5{\%}), N: nervous system 66.3{\%} (N02: analgesics 67.2{\%}, N03: antiepileptic's 11.2{\%}), J: anti-infectives for systemic use 62.2{\%} (J01: antibacterial for systemic use 82.5{\%}, J04: antimycobacterials 15.3{\%}) and C: cardiovascular system 48.3{\%} (C07: beta blocking agents 19.8{\%}, C10: lipid modifying agents 16.5{\%}), respectively. The most commonly prescribed active substances were: A02BC01 (omeprazole 51.3{\%}), N02BE01 (paracetamol 50.8{\%}) and J01DD04 (ceftriaxone 40.2{\%}), respectively. In multiple linear regression analysis, male gender (95{\%} CI -.205, -.006, p = .039, B = -.091), being divorced (95{\%} CI -.604, -.136, p = .002, B = -.130) and presence of comorbidity (95{\%} CI.068,.267, p = .001, B = .144) were the independent factors associated with increased drug use among elderly hospitalized patients on poly-pharmacy. Conclusions: The rational use of medicines is of utmost importance, most particularly in the elderly population. More consideration should be given to rationalizing pharmacotherapy in elderly hospitalized patients who are on poly-pharmacy regimens in Pakistan.",
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Drug utilization patterns among elderly hospitalized patients on poly-pharmacy in Punjab, Pakistan. / Sarwar, Muhammad Rehan; Atif, Muhammad; Scahill, Shane; Saqib, Anum; Qamar-uz-Zaman, Muhammad; Babar, Zaheer.

In: Journal of Pharmaceutical Policy and Practice, Vol. 10, 23, 04.08.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Drug utilization patterns among elderly hospitalized patients on poly-pharmacy in Punjab, Pakistan

AU - Sarwar, Muhammad Rehan

AU - Atif, Muhammad

AU - Scahill, Shane

AU - Saqib, Anum

AU - Qamar-uz-Zaman, Muhammad

AU - Babar, Zaheer

PY - 2017/8/4

Y1 - 2017/8/4

N2 - Background: Reports from drug utilization reviews are important tools employed in the assessment of healthcare practices. The objective of this study was to evaluate drug utilization patterns among elderly hospitalized patients on poly-pharmacy regimens in Pakistan. Methods: A descriptive, non-experimental, cross-sectional study was carried out from December 2015 to March 2016 in six tertiary-care hospitals in the Punjab province of Pakistan. The population under study were patients aged ≥60 years, taking ≥5 medicines per day (i.e., patients on poly-pharmacy) and who were hospitalized in the selected tertiary-care hospitals. In this study, data was collected from 600 hospitalized elderly patients (100 patients per hospital). All medicines prescribed on each in-patient chart were noted on a pre-designed pro-forma sheet and were classified under the Anatomical Therapeutic Chemical (ATC) classification system. Multiple linear regression analysis was used to determine the independent factors associated with poly-pharmacy in this cohort. Statistical Package for Social Sciences (SPSS) was used to analyze the data. P-value <.05 indicated statistical significance. Results: In 600 hospitalized in-patient (male 52.7% and female 47.3%) medication charts, 3179 medicines were prescribed. The most commonly prescribed drug classes were: A: alimentary tract and metabolism 80% (A02: drugs for acid related disorders 64.5%, A03: drugs for functional gastrointestinal disorders 21.5%), N: nervous system 66.3% (N02: analgesics 67.2%, N03: antiepileptic's 11.2%), J: anti-infectives for systemic use 62.2% (J01: antibacterial for systemic use 82.5%, J04: antimycobacterials 15.3%) and C: cardiovascular system 48.3% (C07: beta blocking agents 19.8%, C10: lipid modifying agents 16.5%), respectively. The most commonly prescribed active substances were: A02BC01 (omeprazole 51.3%), N02BE01 (paracetamol 50.8%) and J01DD04 (ceftriaxone 40.2%), respectively. In multiple linear regression analysis, male gender (95% CI -.205, -.006, p = .039, B = -.091), being divorced (95% CI -.604, -.136, p = .002, B = -.130) and presence of comorbidity (95% CI.068,.267, p = .001, B = .144) were the independent factors associated with increased drug use among elderly hospitalized patients on poly-pharmacy. Conclusions: The rational use of medicines is of utmost importance, most particularly in the elderly population. More consideration should be given to rationalizing pharmacotherapy in elderly hospitalized patients who are on poly-pharmacy regimens in Pakistan.

AB - Background: Reports from drug utilization reviews are important tools employed in the assessment of healthcare practices. The objective of this study was to evaluate drug utilization patterns among elderly hospitalized patients on poly-pharmacy regimens in Pakistan. Methods: A descriptive, non-experimental, cross-sectional study was carried out from December 2015 to March 2016 in six tertiary-care hospitals in the Punjab province of Pakistan. The population under study were patients aged ≥60 years, taking ≥5 medicines per day (i.e., patients on poly-pharmacy) and who were hospitalized in the selected tertiary-care hospitals. In this study, data was collected from 600 hospitalized elderly patients (100 patients per hospital). All medicines prescribed on each in-patient chart were noted on a pre-designed pro-forma sheet and were classified under the Anatomical Therapeutic Chemical (ATC) classification system. Multiple linear regression analysis was used to determine the independent factors associated with poly-pharmacy in this cohort. Statistical Package for Social Sciences (SPSS) was used to analyze the data. P-value <.05 indicated statistical significance. Results: In 600 hospitalized in-patient (male 52.7% and female 47.3%) medication charts, 3179 medicines were prescribed. The most commonly prescribed drug classes were: A: alimentary tract and metabolism 80% (A02: drugs for acid related disorders 64.5%, A03: drugs for functional gastrointestinal disorders 21.5%), N: nervous system 66.3% (N02: analgesics 67.2%, N03: antiepileptic's 11.2%), J: anti-infectives for systemic use 62.2% (J01: antibacterial for systemic use 82.5%, J04: antimycobacterials 15.3%) and C: cardiovascular system 48.3% (C07: beta blocking agents 19.8%, C10: lipid modifying agents 16.5%), respectively. The most commonly prescribed active substances were: A02BC01 (omeprazole 51.3%), N02BE01 (paracetamol 50.8%) and J01DD04 (ceftriaxone 40.2%), respectively. In multiple linear regression analysis, male gender (95% CI -.205, -.006, p = .039, B = -.091), being divorced (95% CI -.604, -.136, p = .002, B = -.130) and presence of comorbidity (95% CI.068,.267, p = .001, B = .144) were the independent factors associated with increased drug use among elderly hospitalized patients on poly-pharmacy. Conclusions: The rational use of medicines is of utmost importance, most particularly in the elderly population. More consideration should be given to rationalizing pharmacotherapy in elderly hospitalized patients who are on poly-pharmacy regimens in Pakistan.

KW - Drug use

KW - Drug utilization pattern

KW - Elderly

KW - Hospitalized

KW - Poly-pharmacy

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