Study finds inappropriate medicines lead to increased expenditure in Delhi

A study has revealed that comorbidities, prolonged hospitalisation, inappropriate medicines, polypharmacy and parenteral medicines being prescribed contribute to increased expenditure on drugs in elderly patients.

The study titled ‘Pharmacoeconomics of medicines used for geriatric individuals in a tertiary care hospital in Delhi’, published in the Indian Journal of Medical Research (IJMR), stressed on the need for framing a drug policy for them along with a surveillance on spending on prescribed medicines in view of the rising number of geriatric inpatients.

The hospital-based observational study, which included 1,000 geriatric inpatients aged 60 years and above, was conducted in the Department of Medicine and Pharmacology, Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi.

Data were collected regarding demographic characteristics, prescribed medicines, expenditure incurred on medicines, appropriateness of medicines prescribed and adverse drug reactions (ADRs). Geriatric inpatients comprised 41.3 per cent of the total individuals admitted in the ward during the study period.

A total of 8,366 medicines were prescribed in 127 formulations. The total expenditure on prescribed medicines was Rs 1,087,175 with a per capita expenditure of Rs 1,087. Parenteral medicines accounted for 91 per cent of the expenditure on medicines. Maximum expenditure (70 per cent) was incurred on 11.9 per cent of the medicines prescribed. The per capita expenditure was significantly higher in individuals with comorbidities and those who had a longer duration of hospital stay, the study found.

About 28.1 per cent prescriptions were inappropriate. Also ADRs (140) were observed in 139 (13.9 per cent) inpatients. Individuals with inappropriate medicines prescriptions and ADRs had a longer duration of hospital stay and more number of medicines prescribed, the study stated.