Drug Utilization Review of Alprazolam at Thanyarak Chiangmai Hospital

Abstract

Objective: To review drug utilization of Alprazolam at Thanyarak Chiangmai Hospital.

                Method: A retrospective study from October 1, 2016 to December 31, 2018, descriptive the nature of the prescribing and evaluation of drug prescribing of alprazolam in outpatients. In terms of indication, dose, duration, a doctor who prescribes, contraindications, precautions and adverse drug reactions.

                Result:  There were 44 cases (Forty males and four females; 685 visits), who were prescribed alprazolam. The alprazolam utilizing which accommodates the criteria for Rational Drug Use (RDU) according to the National list of essential medicines: Central Nervous System Volume 1 and Thai National Formulary 2015 Drugs used in Psychiatry were : indication (0.15%), dosage (0.15%), contraindication (9.78%), precaution ( 99.56%), adverse drug reaction (99.71%). There did not fit in the criteria : indication ( opioid dependence 70.66%, followed by insomnia 18.54%), dosage (99.85%), contraindication 90.22% (used combination with methadone 88.03%, followed by benzodiazepine 21.76%), precaution 0.44% (used 3 times in patients older than 65 years old), adverse drug reactions 0.29% ( drowsiness and confusion) and duration (100%).

                Conclusion and recommendations: Regard to the criteria for Rational Drug Use (RDU) in Psychiatry regard to the Central Nervous System Volume 1 and Thai Nation Formulary 2015, the evaluation of alprazolam prescribing found highly not fit criteria : the most was duration, followed by indication, dosage and contraindication respectively. Adverse drug reaction and precaution were 2 aspects that fit the criteria. Therefore, the hospital should have a clear policy on prescribing medication in order to make more reasonable use of medication.