Date of Award

Winter 1-4-2020

Document Type

Dissertation

Degree Name

PharmD

Department

Department of Pharmacy Practice

First Advisor

Dr. Shivashankara K N

Abstract

IntroductionDiabetes Mellitus is a metabolic disorder characterised by high sugar level over a prolonged period of time. It is associated with the developing of complication due to a number of factors like the degree of vulnerability, susceptibility, age, health status and immune system condition.(1) Patients with Diabetes Mellitus along with morbidities receiving medications lead to different Drug related problems like polypharmacy, drug-drug interaction, adverse drug reactions etc.ObjectivesTo assess the Drug related problems in Type 2 Diabetes Mellitus patients with comorbidities using PCNE classification and Hepler Strand classification in a tertiary care hospital in South India.Methodology A retrospective observational study conducted in Kasturba Hospital on patients with Type 2 Diabetes Mellitus with at least one morbidity who were admitted in the year 2018 after ethical committee approval and after relevant data were recorded in the CRF. Demographic data, medical and medication history, laboratory values, drug utilisation pattern, drug related problem identified using different software and classified using scales like PCNE classification and Hepler Strand classificationwere estimated and recorded. Collected data were documented and analysed using descriptive statistics in Microsoft Excel.ResultsA total of 250 patients’ data diagnosed as Type 2 DM in the year 2018 was included in the study among which majority 178(71.2%) patients were males and a greater number of 84(33.6%) patients were above 60 years old age. The mean age of the population was 62.5±12.86 years. Majority of the population had 93(37.2%) patients had hypertension as morbidity. It was found that 96(38.4%) patients received monotherapy among which Human insulin as the maximum percentage of hypoglycemic. In this study a total DRPs observed were 226.The average of 0.91 DRP was present in per patient. These are Potential drug-drug interaction(7.09%), insufficient clinical information (37.6%), adverse drug reactions (4.86%), no indication of drugs (0.44%), untreated indication(11.5%), prescribed drugs not available(1.77%), wrong dose (1.32%), inappropriate drug form(0.44%), inappropriate dosing interval(0.88%), drugs prescribed but not administered (3.53%), patient refused to take drugs(7.52%) and no update medication list (23%) were the problems identified in this study.ConclusionThis study concludes that identifying such problems is essential in preventing the occurrence of further complications in the patients related to drugs. It shows that the clinical pharmacists play an important role in the hospital to reduce the drug related problems in the patients.

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