Drug utilization pattern and effectiveness analysis in diabetes mellitus at a tertiary care centre in eastern Nepal

An observational follow up study conducted for one year at a tertiary care centre in 154 newly diagnosed diabetes mellitus patients is presented. The aims of the study were to determine the demographics, prescribing patterns, drug cost and analyze effectiveness of different therapies. Effectiveness of therapies were analyzed in patients achieving glycemic control by Wilcoxon signed- rank test. Majority of patients (n = 114) fell into the middle age strata of 35-64 years and 97% were type 2 diabetics. A total of 282 prescriptions were screened that included antidiabetics and other drug categories. Mean number of drugs per prescription sheet was 1.83 +/- 1.31. Oral hypoglycemic agents were advised to 64% of the patients. The prescribing frequency of biguanides (24.5%) was more than sulphonylureas (19.9%). Only 67 patients followed up for 3 months +/- 15 days, of which 46 achieved glycemic control. The biguanides only group (p = 0.002) and combination therapy of biguanides and sulphonylureas group (p = 0.005) were the highly effective therapies, as their p values of fasting blood glucose levels on follow up were the lowest. Nearly 90% of patients on combination therapy achieved glycemic control. In conclusion, this study reflects the therapeutic approach followed in diabetes mellitus as optimal. Future research on a larger patient population is warranted to evaluate existing patterns of therapy for sound practice and quality of care.