"A Prescription Study from a Tertiary Care Hospital: Reasonable Use of Fixed-Dose Combinations in Hypertensive Diabetic Patients"

Abstract

Background
Hypertension and diabetes mellitus commonly coexist and substantially increase the risk of developing cardiovascular complications like coronary artery disease, stroke, nephropathy and heart failure. Fixed-dose combinations are commonly used for treating these disease conditions as they improve adherence to therapy, reduce pill burden and improve outcomes. Nevertheless, using FDCs irrationally can cause harmful consequences, duplicating drugs and unnecessary polypharmacy.
Aim
To identify the demographic profile and rationality of fixed-dose combination therapy among hypertensive diabetic patients in a tertiary care hospital.
Methods
This prospective cross-sectional observational study involved a total of 290 hypertensive patients with type 2 diabetes mellitus. The patient case records were used to gather the information based on a systematic case proforma. Demographic variables, disease history, prescription behaviors, antihypertensive and antidiabetic medication use, and fixed-dose combinations (FDCs) were noted. The rationality of prescribed FDCs was determined on the recommendation of the world health organization, American Diabetes Association, American College of Cardiology, American Heart Association, and National Institute of Health and Care Excellence. Out of the 290 patients, 55 percent were male and 45 percent were female with the greatest number of the patients falling in the 41 59 years age bracket. FDCs prescribed included antihypertensive FDCs (74.48% of patients) and antidiabetic FDCs (70.34% of patients). Telmisartan + Amlodipine was the most used antihypertensive FDC and Metformin + Teneligliptin was the most used antidiabetic FDC. In general, it was found that 95.71 percent of the prescribed FDCs were rational.
Conclusion
The fixed-dose combinations are widely used in hypertensive-diabetic patients and are largely prescribed as per the guidelines. Regular prescription auditing and clinician awareness of irrational prescribing behaviour should be encouraged to rationalise drug use. In the prescription audit of prescription of fixed dose combination anti-hypertensive &anti diabetic agent in a tertiary care hospital.