Study of Corticosteroids Utilization in the Department of General Medicine and Dermatology at a Tertiary Care Teaching Hospital, Nuh, Haryana

Background: Corticosteroids are used consistently in healthcare for the management of several immunological and inflammatory diseases. To keep better regulation over the quality of drug utilization or prescribing in terms of appropriate/rational use of corticosteroids in any healthcare setting, it is necessary to estimate and evaluate its pattern of drug utilization by periodically conducting the DUE (drug utilization evaluation) studies. Aim and Objectives: Estimation and evaluation of the pattern of corticosteroid utilization to promote their safer and appropriate use. Materials and Methods: This was a 12 months long, observational, cross-sectional DUE study carried out in a total of 260 participants which included patients (OPD and IPD) of all ages receiving corticosteroid in the department of general medicine and dermatology, SHKM GMC, Nalhar. Outcomes measured were the socio-demographic characteristics, drug use related information of corticosteroids and evaluation of pattern of utilization using WHO Prescribing indicators. The results were expressed as frequencies, percentages, and averages. Results: Out of 260 participants, with 66.9% (174) majority of the participants were males. A total of 333 corticosteroids were utilized with a prevalence of 16.9%. A higher corticosteroid use prevalence of 28.5% and FDCs prescribing of 46.8% was observed in the department of dermatology to that of general medicine department with use prevalence of 11% and FDC prescribing of 16.3%. However, in general medicine department, a higher injectable prescribing of 44.7%, generic prescribing of 89.5% and prescribing from NLEM of 100% was observed when compared to that of dermatology department with an injectable prescribing of 7.8%, generic prescribing of 42.2% and prescribing from NLEM of 29.2% only. WHO Prescribing indicators revealed that a total of 197 corticosteroids were prescribed in 160 outpatients, out of which 49.7% corticosteroids were generic and 41.1% were prescribed from NLEM, average number of drugs prescribed per outpatient was found to be 4.4, prescriptions with antibiotics and injectable were 65% and 4% respectively. Conclusion: Corticosteroid use prevalence was found to be lower than the use prevalence reported by some previous studies conducted in different parts of India as well as internationally. However, to further enhance the appropriateness of corticosteroid utilization, reduction in the average number of drugs and corticosteroids per prescription, more prescribing from the essential medicines list and generic prescribing are needed.