Assessment of corticosteroid utilization pattern among dermatology outpatients in a tertiary care teaching hospital in Eastern India

Abstract

Background: Owing to the rampant availability in the market, corticosteroids, the mainstay in the treatment of diverse dermatological conditions, is frequently used for their palliative effect leading to its misuse in medicine practice. This study aimed to monitor the utilization pattern of corticosteroids and to analyze the rationality of drug usage in a dermatology outpatient department setup. Materials and Methods: A cross-sectional observational study was conducted in which patients attending dermatology department, receiving corticosteroids in any form were included in the study. Demographic profile, clinical presentation, and undergoing treatment plan were recorded on a prestructured, customized data collection sheet. Trends in steroidal prescribing were duly analyzed. Results: A total of 328 prescriptions were analyzed during the entire study period. A number of drugs per prescription varied from 1 to 3 with an average of 2.01. Of 328 prescriptions analyzed, the most common indications requiring corticosteroid prescribing was eczema, followed by psoriasis, dermatitis, vitiligo, etc. Most of the corticosteroids prescribed were given topically (86.21%). Of the total topical corticosteroids prescribed, trend revealed that high potency corticosteroids were majorly prescribed (38%), followed by those of ultra-high potency (35%) and medium potency (19%). Most commonly prescribed steroids were clobetasol, followed by betamethasone dipropionate, mometasone, prednisolone, respectively. Conclusion: The misuse of topical corticosteroids has a huge impact on dermatological practices which needs multi-dimensional interventions, involving educational, lawful and managerial approaches to overcome it. Irrational prescribing of corticosteroids must thus be minimized which subsequently will avoid polypharmacy and related drug interactions.