Prescribing patterns and cost analysis of anti glaucoma medications in a tertiary care teaching hospital

  • Dr Elfride Farokh Sanjana Professor, Department of Ophthalmology, Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry, India
  • Dr. Kishore Sastha Ram V. Lecturer, Department of Pharmacy College of Health Sciences, Mizan Tepi University, SNNPR, Ethiopia, Africa
  • Dr. Serin Philip Medical Claim Officer, Dar al Shifa hospital, Kuwait
Keywords: Beta blockers, Cost analysis, Fixed dose combinations, Prostaglandin analogues

Abstract

Aim: To study the prescribing patterns and cost analysis of anti glaucoma medications in a tertiary care teaching hospital.

Materials and Methods: This was a prospective study conducted in 62 patients of either sex who presented in the Department of Ophthalmology with an established diagnosis of glaucoma as per Asia Pacific Glaucoma Guidelines (SEAGIG). A specially designed proforma was used to collect data. Visual acuity with and without correction, intraocular pressure measurement with applanation tonometer which was corrected with pachymetry, stereoscopic evaluation of optic nerve head and Humphrey visual analysis was done to establish the diagnosis of glaucoma. All prescriptions were analyzed for the nature of drugs prescribed, percentage of prescriptions that included mono therapy versus fixed dose combinations, the preferred regimen chosen and switch over amongst the various classes.

Results: The incidence of glaucoma was maximum in the 5th -6th decades of life. Mean age was 58+/_ 13.781, with males 63% and females 11.29%. Both eyes were affected in 49(79.03%) of patients. Risk factors were identified commonly diabetes mellitus and hypertension. Thirty (50%) of patients were on beta blockers, followed by prostaglandin analogues 13(21.6%) and fixed dosed combinations comprising 12(20%) and alpha agonists 5(8.33%). The cost per bottle of monotherapy and fixed drug combinations was analyzed and beta blockers were the most economical drugs in the management of glaucoma.

Conclusion: Beta blockers remained the first drug of choice followed by prostaglandin analogues. No patient had clinically significant ocular or systemic side effects from beta blockers and it continues to remain a suitable economical option in patients with socioeconomic constraints in contrast to the Western world literature that choses prostaglandin analogue over beta blockers.

Downloads

Download data is not yet available.

References

Joseph T Dipiro. Pharmacotherapy- A pathophysiologic approach . 7th ed. New York. McGraw Hill, 2001.pg 1551-1558.

Allingham R, Shields’ text book of glaucoma,5th ed. Lippincot Williams and Willkins.

Parikh RS, Parikh SR, Navin S, Arun E, Thomas R. Practical approach to medical management of glaucoma.Indian J Ophhalmol.2008.May-Jun;56(3):223-30.DOI: http://www.ijo.in/text.asp?2008/56/3/223/40362.

Barbara Wells. Pharmacology 7th ed. Mac Graw Hill. New York. 2009.

George R, Vijaya L. First world glaucoma day. March 6,2008:Tackling challenges in India .Indian J Ophthalmol.2008;56(2):97-8.DOI: http://www.ijo.in/text.asp?2008/56/2/97/39111.

George R, Arvind H, Baskaran M, Ramesh S Ve, Vijaya L. The Chennai Glaucoma study. Indian J Ophthalmol.2010 May-Jun;58(3):243-45.DOI: http://www.ijo.in/text.asp?2010/58/3/243/62655.

Jacob A, Thomas R, Koshi SP, Braganza A, Muliyil J. Prevalence of Primary glaucoma in an urban south Indian population. Indian J Ophthalmol.1998;46(2):81-6.doi: http://www.ijo.in/text.asp?1998/46/2/81/14973.

Dandona R, Dandona L. Review of findings of Andhra Pradesh eye disease study :policy implications for eye care study . Indian J Ophthalmol.2001Dec;49(4):215-34.doi: http://www.ijo.in/text.asp?2001/49/4/215/14696.

Nirmalan PK, Katz J, Robin A.L, Krishnadas R, Ramakrishnan R, Thulasiraj RD, Teilsch J. Utilisation of eye care services in rural south India: the Aravind Comprehensive Eye Survey. Br J Ophthalmol 2004.Oct;88(10):1237-41.DOI: https://doi.org/10.1136/bjo.2004.042606.

South East Asia Glaucoma Interest Group. http//www.seagig.org.

Yadav AK,Patel V.Drug use in Primary open angle glaucoma.: A prospective study at a tertiary care teaching hospital.Indian J Pharmacol.2013.Mar;45(2):117-20. DOI: https://dx.doi.org/10.4103%2F0253-7613.108279.

Sharma R,Khajuria R, Sharma P, Sadhotra P, Kapoor B, Kohli K ET AL/ Glaucoma therapy: Prescribing pattern and cost analysis. JK Science 2004 Apr-Jun;Vol.6(2):88-92.

Singh K, Shrivastava A. Medical management of glaucoma: Principles and practice. Indian J Ophthalmol.2011Jan;59(1):S88-92. DOI: https://dx.doi.org/10.4103%2F0301-4738.73691.

Magacho L, Reis R, Shetty RK, Santos L.C, Avila MP. Efficay of Latanoprost or Fixed –Combination Latanoprost –Timolol in patients switched from a combination of Timolol and a nonprostaglandin medication. Ophthalmology 2006.Mar;113(3):442-45. DOI: http://dx.doi.org/10.1016/j.ophtha.2005.11.011.

Varma R, Hwang L J, Grunden J W, Bean GW. Using diurnal intraocular pressure fluctuation to assess the efficacy of fixed-combination latanoprost/timolol versus latanoprost or timolol monotherapy. Br J Opthalmol.2010 Jan;94(1):80-84. DOI: http://dx.doi.org/10.1136/bjo.2009.162107.

Carroll SC, Gaskin BJ, Goldberg I, Danesh-Meyer HV. Glaucoma prescribing trends in Austrailia and new Zealand. Clin Exp Ophthalmol.2006 Apr;34(3):213-8. DOI: https://doi.org/10.1111/j.1442-9071.2006.01196.x.

Kashiwagi K. Changes in trend of newly prescribed anti glaucoma medications in recent nine years in a Japanese local community. Open Ophthalmol J.2010 Apr;4:7-11.DOI: http://dx.doi.org/10.2174/1874364101004010007.

Prescribing patterns and cost analysis of anti glaucoma medications in a tertiary care teaching hospital
CITATION
DOI: 10.17511/ijmrr.2016.i12.19
Published: 2016-12-31
How to Cite
1.
Elfride Farokh S, Kishore Sastha RV, Philip S. Prescribing patterns and cost analysis of anti glaucoma medications in a tertiary care teaching hospital. Int J Med Res Rev [Internet]. 2016Dec.31 [cited 2024Nov.8];4(12):2193-8. Available from: https://ijmrr.medresearch.in/index.php/ijmrr/article/view/787
Section
Original Article