PRESCRIBING PATTERNS OF FIXED DOSE COMBINATIONS IN HYPERTENSION, DIABETES MELLITUS AND DYSLIPEDIMIA AMONG PATIENTS ATTENDING A CARDIOLOGY CLINIC IN A TERTIARY CARE TEACHING HOSPITAL IN INDIA

Fixed-dose combination decreases the risk of medication non-compliance and should be considered in patients with chronic conditions like hypertension and diabetes mellitus for improving medication compliance which can translate into better clinical outcomes. This statement holds well probably also in conditions like dyslipidemia and IHD. Compared with free-drug combinations, fixed dose combinations (FDCs) of antihypertensive agents are associated with a significant improvement in compliance and with no significant beneficial trends in BP and adverse effects. Objective: To describe the prescribing pattern of FDCs of antihypertensive, antidiabetic and hypolipedemic drugs among patients attending a cardiology clinic in a tertiary teaching hospital. Methods: The study was carried out in the cardiology outpatient department of a tertiary care teaching hospital. All prescriptions issued for two months in the outpatient departments were collected and analyzed. Results and Discussion: Among these 326 prescriptions FDCs were found in 208(63.8%) prescriptions. Fifty nine prescriptions had more than one FDCs. Mean cost of FDCs per prescription was Rs9.03. Only 24(7.3%) prescriptions of FDCs cost more than 15 rupees whereas 128(39.3%) prescriptions cost less than Rs. 10 per day. Among 168 patients who had more than one co-morbid (cardiovascular and diabetes mellitus) conditions 122(72.6%) were prescribed FDCs. Many of the prescriptions of FDCs were not found in essential drug list. Conclusion: Increasing requirement of drugs when more than one disease is found in a patient justifies the use of FDCs to improve compliance. There was marginal increase in the cost when FDCs were used instead of free drug components. A relook and rationalization may be required into the FDCs in essential drug list in view of the large no of FDCs prescribed for cardiovascular diseases.