Surveillance of consumption pattern of antihyperglycaemic agents in outpatient Pharmacy Department, Hospital Tengku Ampuan Rahimah, Klang / Wirdiana Yusoff

Nowadays, diabetes mellitus is one of the most common health problems affecting Malaysian populations. The prevalence of diabetes mellitus is increasing in time. Thus, this will lead to an increment of consumption of antidiabetic agents. The main aim of this study was to assess the consumption pattern of antidiabetic agents that were prescribed in Hospital Tengku Ampuan Rahimah (HTAR), Klang. Since HTAR is still using manual written prescription, this may correlate with high incidence of prescription errors which were also determined in this study. The study was conducted retrospectively at Outpatient Pharmacy Department (OPD), HT AR, Klang. The prescriptions from August 2008 to January 2009 were screened in order to select the prescriptions with at least one type of antidiabetic agent. The patients' demographic data include gender, race and age were recorded in order to determine the general prevalence of diabetes mellitus within the study population. The data regarding drugs include the dose, frequency, duration and dosage form were also being recorded. The data were separated into two groups that were oral antidiabetic agents (OADs) and insulin preparations. Besides, the price of every drug was calculated in order to estimate the expenditure spent by OPD, HT AR within the respective duration. For prescription errors, two broad categories were analyzed include incomplete prescriptions (dose, frequency, duration, signature, date, patients' profile) and inappropriate regimen (medication, frequency, dose duration). The total number of prescriptions contained antidiabetic agents within six months was 4070 prescriptions. Diabetes was highly diagnosed in Indians, followed by Malays, Chinese and other races. Diabetes was more common in men compared to women. According to the data collected, the trend of prescribing insulin preparations showed a higher percentage (58%) compared to OADs ( 42%). For insulin preparations, pre-mixed insulin was the most frequently prescribed, followed by rapid acting insulin, intermediate acting insulin and long acting insulin. For OADs, the physicians prefer to prescribe metformin, followed by sulfonylureas, a­ glucosidase inhibitors (AGI) and combination of metformin and gliclazide. The expenditure for OADs and insulin preparations were RM 56 758.99 and RM 126 043.18, respectively. The study also demonstrated that the ODD for antidiabetic agents at OPD HT AR showed parallel values as reported by Malaysian Statistics in Medicine in 3 consecutive reported years. Most of the prescription errors were due to incomplete information regarding to age of patients. Further study is suggested to be conducted in longer duration at diabetic clinics in different hospitals.