Assessment of Prescription Pattern of Anti-Diabetic Drugs: A Case Study from Tertiary Care Hospital of Bangladesh

This chapter aimed to determine the pattern of prescription among diabetic patients relevant to current evidence and clinical guidelines. Glycemic control remains the major therapeutic objective for prevention of target organ damage and other complications arising from diabetes. Poor glycemic control in diabetes mellitus can be prevented by using rational use of oral hypoglycemic agents. Chronic hyperglycemia of diabetes mellitus (DM) is associated with long-term damage, dysfunction and failure of various organs, especially the eyes, kidneys, nerves, heart and blood vessels. We aimed to evaluate the prescribing pattern of antidiabetic drugs among Type 2 diabetes patients. This study was conducted for collecting the demographic details of diabetic patients and determining the pattern of medications prescribed among them in an outpatient department of a tertiary healthcare center.

It is a descriptive type of cross-sectional study conducted for a period of 3 months from 1 May to 31 July, 2015 among the diabetic patients, irrespective of age, sex and race, attending the outpatient department of diabetic clinic of Dhaka Medical College Hospital (DMCH) in Dhaka, Bangladesh. Structured case record form was used for demographic data & prescription details. Data were analyzed using SPSS 22 and Microsoft Excel 2010 in computer.

In total, 105 patients, 40 males (38.1%) and 65 females (61.9%) were enrolled with urban predominance (69.5%) where 51 (48.6%) were in the age group of 47-61 years with a mean of 53.4 (SD±10.6) years. 70 (66.7%) had diabetes for less than 5 years and 66 (62.9%) had at least one other concurrent illness. Hypertension accounted for majority (34.3%) of complications. About the dosage formulation of prescribed anti-diabetic agents, 30 were prescribed both oral and injectable drugs concurrently among 105 respondents. Majority (62.9%) were prescribed oral drugs singly and 8.6% injectable preparations alone. On an average, 5.62 (SD±3.16) drugs were advised per prescription for diabetes as well as associated co-morbidities and majority (23.8%) had 4 drugs. Metformin alone predominated in 41% prescriptions followed by the combination of Metformin and Sitagliptin (31.4%).

Before creating and releasing any new medication, the results can be used as a reference to determine the best anti-diabetic medication formulation and combination for this region of the world. To reduce morbidity and mortality in diabetic patients, we must ensure optimum glycemic control not only by prescribing keeping in line with guidelines, but also by ensuring patients’ adherence to treatment plan.