EVALUATION OF MEDICATION INAPPROPRIATENESS IN THE MANAGEMENT OF OBSTRUCTIVE AIRWAY DISEASES IN VETERANS

A. P. Sreeja, R. D. Kiran, T. P. Angel Rose*, Edcy Edvi, Celesti Sibi Jose, Sandra Elsa Thomas

ABSTRACT

Obstructive airway diseases refers to a group of disease that cause airflow blockage and air breathing related problems, and it includes emphysema ,chronic bronchitis, bronchiectasis and asthma. According to WHO estimates these diseases have remained the leading cause of death globally in last 15 years especially among old aged patients. The aim of this study was to apply the Medication Appropriateness Index (MAI) by a clinical pharmacist to identify issues of inappropriate prescribing amongst patients admitted from the general medicine. This was a prospective observational study conducted in 202 patients to determine the inappropriateness of antibiotic in obstructive airway diseases. The most common problems were seen with indication, dose of antibiotic, directions, duplication, expensiveness and duration of therapy. Of the 202 patients, 174(86%) cases had a problem with antibiotic prescribing according to the MAI criteria. In contrast to our study ex-smokers were more prone to infective exacerbations. In majority of the cases the daily dosage 164(15.92%) was lower than recommended. Apart from inappropriate dose, duration of therapy 149(14.47%) as well as effectiveness of antibiotics 151(14.66%) were also considered to be inappropriate according to MAI criteria. The study concluded that high rate of inappropriate antibiotic prescribing that extends beyond antibiotic selection for patients diagnosed with COPD, chronic bronchitis, asthma, bronchiectasis.

Keywords: Medication appropriateness index (MAI), obstructive airway diseases, inappropriate prescribing, Infective exacerbations.