Ppt

1. PRESCRIPTION PATTERN OF DRUGS AND
MEDICATION ADHERENCE IN ASTHMA PATIENTS AT
TERTIARY CARE HOSPITAL.
Under the guidance of:
Dr MERIN SUSAAN ABRAHAM,
Assistant professor
Department of pharmacy practice
The oxford college of pharmacy, Hongasandra
Bangalore 560068
Under the co-guidance of:
Dr JYOTHI
DEPARTMENT OF PULMONOLOGY
The Oxford Medical College Hospital and research Centre.
Attibele, Bangalore
Name of participants
1. MANOHARA.YM
2. ABHISHEK J
3. AMEEN KHAN
4. ANAND KRISHNA.C

2. INTRODUCTION
DEFINITION : Asthma is a long-term condition affecting children and adults. The air passages in the lungs become narrow due to inflammation
and tightening of the muscles around the small airways.
AETIOLOGY AND RISK FACTORS:
•The prevalence of asthma varies widely around the world, probably because of gene-by-environment interactions.
•Prenatal risk factors for asthma may include maternal smoking, diet and nutrition, stress, use of antibiotics and delivery by Caesarean section.
•Childhood risk factors for asthma may include allergic sensitization, environmental tobacco smoke, exposure to animals, breastfeeding,
decreased lung function in infancy, family size and structure, socio-economic status, antibiotics and infections, and sex and gender.
•Occupational exposures constitute a common risk factor for adult asthma.
SIGNS AND SYMPTOMS:
•Chest tightness
•Coughing, especially at night or early morning
•Shortness of breath
•Wheezing, which causes a whistling sound when you exhale
While other conditions can cause the same symptoms as asthma, the pattern of symptoms in people who have asthma usually has some of the
following characteristics.
 They come and go over time or within the same day.
 They start or get worse with viral infections, such as a cold.
 They are triggered by exercise, allergies, cold air, or hyperventilation from laughing or crying.
 They are worse at night or in the morning

3. TREATMENT GUIDELINES:
Generally preferred guidelines for prescribing in asthma patients are GINA 2021 GUIDELINES
(THE GOBAL INITIATIVE FOR ASTHMA)

4. TREATMENT APPROACH
STEPWISE MANAGEMENT OF ASTHMA.
Step 1: Mild intermittent asthma.
Inhaled short acting beta 2 agonist is required.
Step 2: Regular preventer therapy.
•Inhaled steroid is administered of dose 200-800mcg/day.
•Start the dose based on severity of the disease.
Step 3: Add on therapy.
Add inhaled long acting beta 2 agonist.
Assess the control
•Good response continue LABA.
•Benefits from LABA but no adequate control: continue LABA and increase the inhaled steroid up to 800 mcg.
•No benefits from LABA, stop LABA and increase the inhaled steroids up to 800 mcg, still no adequate control, add leukotriene receptor
antagonist.
Step 4: Persistent poor control.
•Increase the inhaled steroid up to 2000 mcg/ day.
•Add fourth drug leukotriene receptor antagonist, beta 2 agonist tablet.
Step 5: Continuous or frequent use of oral steroids.
•Increase the inhaled steroid up to 2000 mcg
•Use the oral steroids of low dose continuously
•Use other treatment to get adequate control.

5. NEED FOR THE STUDY
•Need of study is to improve the patient healthcare and prescribing practices of
asthma as it is very common diseased condition worldwide.
• This study will help in interpretation of the therapy options used in the healthcare
setting and providing treatment option having optimum therapy with maximum
safety and efficacy and proper medication adherence as asthma affects every
population .
•This study will also help the healthcare professionals to analyse the most
commonly prescribed drugs and to improve the quality of treatment and patient
medication adherence. The efficacy of treatment mainly depends on the drugs
prescribed by physician and medication adherence by patients.
•The study help to determine the most commonly prescribed drugs and patients
adherence to the drugs.

6. AIMS AND OBJECTIVES
AIM: To study the need of prescribing pattern and patient medication adherence in
asthma patients.
PRIMARY OBJECTIVE
•To assess the prescribing pattern of drugs in asthma patients.
SECONDARY OBJECTIVE
•To assess the medication adherence of patients.
•To improve medication taking pattern.
•To improve the quality of life by patient education about disease.

7. METHODOLOGY
• STUDY SITE: The Oxford Medical College Hospital and Research Centre, Attibele
• STUDY DESIGN: PROSPECTIVE CROSS-SECTIONAL STUDY
• STUDY PERIOD: 1 YEAR
• ETHICAL APPROVAL FOR THE STUDY: Ethical approval will be obtained from the
institutional ethics committee of The Oxford Medical College Hospital and Research Centre,
Attibele
SAMPLE SIZE: Cases admitted during the period of 2022
STEP 1: To obtain consent from the patient through informed consent form in English and Kannada
language.
STEP 2: Collection of demographics of the patient (Name, Age, Weight, etc), prescribed drugs,
indication, their route of administration, frequency, dose of drugs, number of days of stay in case of
in patients.
STEP 3: Obtaining data through survey questionnaires.
STEP 4: Assessment and analysis of data collected from survey questionnaires.
STEP 5: To study the prescribing pattern and medication adherence of drugs in asthma patient. The
obtained data will be subjected for suitable statistical method.

8. STUDY CRITERIA
INCULSION CRITERIA:
•Patients above 18 years of age.
•Inpatients and Outpatients.
•Patients who are willing enrol in study with consent.
•Patients with asthma condition.
•Patients of both gender.
6.6.2 EXCULSION CRITERIA
•Pediatric patients are excluded.
•Pregnant women are excluded.
•Patient who are not willing to enrol in study

9. SOURCES OF DATA COLLECTION
•PATIENT CASE RECORDS
•CASE RECORD FORMS
•PATIENT INTERVIEW
•MEDICATION PRESCRIPTION
OPEATIONAL MODALITY
• IDENTFICATION OF PATIENTS:
Asthma cases of outpatients and inpatients from the pulmonary department of The Oxford Medical
College Hospital and Research Centre Attibele.
• COLLECTION OF DATA:
The medical records of asthma patients who are admitted and visiting in the hospital during the
period of 2022 collected from the pulmonary department. Demographic details like name, age,
gender, past medication history, occupation , history of medical condition, medications, family
history , patient current therapeutic plan , diagnosis were recorded. Along with these patient interview
will be conducted. And other details about medication adherence are recorded from the
Questionaries.
• OUTCOME ANALYSIS:
After the investigating the prescribing pattern of drugs and patient medication adherence through
questionnaire and guidelines. The prescribing pattern will be assessed using appropriate statistical
analysis.

10. REFERENCE
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5.Herfindal Eric T, Helms RA, Quinn DJ. Text book of Therapeutics. 2nd ed. Lippincot William and Wilkins; pp. 658–81.
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8.Global Asthma Network. The Global Asthma Report. 2018. Available at: http://www.globalasthma
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11. THANK YOU