Drug utilization review of corticosteroids in a tertiary care hospital of Salem District, Tamilnadu, India

Abstract

Corticosteroids are widely used compounds for allergic reactions, autoimmune diseases, inflammatory conditions, hormone replacement therapy etc. Hence, with widespread use and actions, these have several interactions with drugs and diseases. The purpose of this study was to obtain information about Corticosteroids prescribing and utilization pattern, to understand the prescribing behaviour of  physicians and to identify drug interactions. A retrospective observational study was conducted in the department of dermatology and general medicine in a tertiary care hospital for 6 months. All the patients receiving any category of steroid therapy were included, and the prescribing and tapering pattern of steroids were reviewed. Drug utilization pattern (DUR) was observed and analysed among 150 patients during the study period. The results revealed that steroids were prescribed for various respiratory illnesses (66%) and skin-related conditions (34%). The steroid utilization was found to be more in elderly patients, particularly in males. Intravenous administration was common in 33% of cases. Budesonide was the most commonly prescribed steroid (36%), followed by Hydrocortisone (24%) and Dexamethasone (14%). The most frequent drug-drug interaction was between Hydrocortisone and Theophylline as well as Hydrocortisone and Hypoglycaemic agents. Most drugs were prescribed rationally, although some factors like prescribing drugs in the brand name, without mentioning route of administration, frequency and dose were deviating away from rationality. Not much variation was found in the pattern of prescription amongst healthcare professionals. Although most of the drugs were prescribed rationally, the involvement of a clinical pharmacist in patient care can help in more rational prescribing along with prevention and early detection of ADRs which can directly promote drug safety and better patient outcomes.