Prescribing Pattern of Antidiabetic and Antihypertensive Drugs in a Tertiary Care Teaching Hospital

Abstract

Background: Systematic studies evaluating the drug use patterns of antidiabetic and antihypertensive medications in a diverse country like India are always necessary. Objectives: To determine the prescribing and drug use patterns of antidiabetic and antihypertensive drugs in type 2 diabetes mellitus (T2DM) patients with or without hypertension (HT), to measure the glycemic response, and to assess the cost of prescribed antidiabetic and antihypertensive drugs. Methods: The T2DM patients with or without HT were included in the study (N = 98). The drug utilization of antidiabetic and antihypertensive agents was analyzed using the World Health Organization-anatomical therapeutic chemical (ATC)/defined daily dose (WHO-ATC/DDD) system. Results: Forty-seven percent of the study population received metformin, and all fixed-dose combinations (FDCs) contained metformin as one of the components. 58% of the antihypertensive drugs prescribed were from the classes of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin ii receptor blockers (ARBs). Both metformin and enalapril were underutilized, with only 60% and 40% of the prescribed dose, respectively. Controlled T2DM patients had a poor glycemic response with a 19% increase in fasting blood glucose (FBG) values compared to patients with uncontrolled diabetes mellitus (DM), who showcased a comparatively favorable glycemic response with a 2.6% decrease in FBG values (P = 0.005). The average cost per day for empagliflozin, olmesartan, glibenclamide, and enalapril was ₹. 50, ₹. 11, ₹. 2, and ₹. 2, respectively. Conclusions: Metformin and enalapril were the most commonly prescribed antidiabetic and antihypertensive drugs, respectively. Controlled and uncontrolled subgroups of T2DM patients demonstrated differential glycemic responses. Glibenclamide and enalapril were found to be the most cost-effective antidiabetic and antihypertensive drugs, respectively.