जर्नल ऑफ मॉलिक्यूलर फार्मास्यूटिक्स एंड ऑर्गेनिक प्रोसेस रिसर्च

अमूर्त

Socio-Demographic Characteristics and Drug Related Problems of Patients Presenting to the Emergency Department: General Linear Model and Factorial Analysis

Amit Sharma

ABSTRACT
Objectives:The paper discusses
exploratory correlational analysis and general linear
model which provides an summary of the
connection between the drug related problems
occurring during the course of study with sociodemographic
profile of the patients admitted in
emergency department. Study design: Prospective
observational study. Methods: The study was
conducted in the emergency department of two
different hospitals located in Punjab for a period of 6
months. A total of 260 patients were included for
analysis as per inclusion and exclusion criteria.
Results: it had been revealed that 61.9% (161) patients
were found male whereas 38.1% (99) patients were
female. The value of kolmogorov-smirnov (ks)
(p=0.12), shappiro-wilk (sw) (p=0.065) which
confirms that standard distribution. the value of r2 for
the dependent variable that is age, weight and height
was found to be r2 = 0.150a , 0.559b , 0.015c
respectively in linear regression model.
The results shows that there was significant effect
of experimental variable like number of drug per
prescription and medicines from essential drug list
with variable like disease state e.g. type of the disease
in emergency department and emergency type also as
errors associated with drug related problems.
Drug utilization study, as described by the WHO, is a
structured process which is used to assess the quality
of drug therapy by engaging in the evaluation of data
on drug prescribing, dispensing and patient use during
a given health care environment, against
predetermined, prescribed criteria and standards, with
special emphasis on the resulting medical, communal,
and financial consequences. Proper drug evaluation
study features a great emphasis to global minimization
in morbidity and mortality with its associated medical,
communal and financial benefits [2]. It is more
prevalent in developing countries where health
allowance is less and 30-40% of the total health
allowance is spent on medicines . World Health
Organization (WHO) has formulated a group of core
drug use indicators, which measure the performance
of prescribers, patients experience at health facilities and
whether the health personnel can function effectively.
The assessment of drug use indicators consistent
with WHO guidelines on the way to investigate drug use
in health facilities are prescribing indicators, patient care
indicators, facility indicators and complementary
indicators . Emergency medicine is that the specialty
that cares for the care seeker, at the foremost vulnerable
moments of their life. It faces the challenge ofevaluating
the early phases of the biological behaviour in diseases.
Urgency, unpredictability and therefore the got
to acquire skills of the whole spectrum aged , gender and
therefore the pathology are the hallmark of the specialty
. Patients come to the emergency department (ED) for
evaluation of emergent or urgent conditions for afterh
medical aid , or by referral from their primary
physician. In the ED, physicians face crucial and sever
cases that require to be treated quickly with top quality .
This prospective observational study was conducted in
the emergency department of three different
multispecialty hospitals in Punjab for period of 6 months
after getting approval from Institutional Ethical
Committee. Each individual signed a consent form that
outlined the aims and methodology of the study. The
confidence interval of the study was selected as 95%
with cut off interval (p=0.05) as significant level . A
sample size was calculated through software called
Epiinfo (Stat Cal) . The total number of patients enrolled
in the study was 320 as per sample size. A total of 260
patients were included for analysis as per inclusion and
exclusion criteria. Inclusion criteria: All patients
irrespective of age, diagnosis admitted in emergency
department were included in the study. Exclusion
criteria: Patients who were critical in clinician’s opinion
were excluded from the study. The patients enrolled for
the evaluation was grouped based on their age group and
category of disease. The study was analysed by SPSS
version 16. Descriptive and analytical analysis was used
to describe the results. A descriptive study was
conducted to describe basic features of data in the study
and to provide simple summaries about the sample and
the measures . Descriptive analysis includes mean,
standard deviation (for normally distributed data)
whereas median and interquartile range (for not normally distributed data). An analytical study was
conducted to find out the effect of independent
variable on the dependent variable . A general linear
model and factorial analysis was conducted to seek
out out the connection and correlation also on predict
the methods for further analysis on sizable amount of
populations
From this study, we concluded that general linear
model shows strong correlation between sorts
of disease and sort of emergency with number of
medicine prescribed per prescription and number of
drugs prescribed from essential drug list that is drugs
prescribed is dependent upon disease condition that is
if there are comorbidities then the drug per
prescription may vary. More the severity of the
disease, more drugs are going to be prescribed to the
patient for early recovery. Even we can conclude that
comorbidities even lead to polypharmacy and thereby
also increasing chances of DRPs (drug related
problems). The facilities available in the hospitals
which are given by healthcare providers were the
factors that had the greatest impact on overall
satisfaction of the patient’s in emergency department.
Multiple factor is found directly correlated with the
socio-demographic factor of the patients in an
emergency department. During the study it was found
that the burden of multimorbidity is the strongest
clinical predictor of ED attendance. Another factor
that contributes more is patient drug compliance, drug
choice problem, drug interactions and other drug
related problems. The GLM explains about the
relationship of number of drug per prescription and
number of drugs from essential drug list is directly
correlating with the type of disease and type of
emergency which were found highly significant. The
data of this study can be useful forpreparing National
Health Policies towards emergency care as well as for
clinical guideline development.
Keywords: Drug related problems; General linear
model; Factorial analysis