Spectrum of Disease and Prescription Pattern for Outpatients with Neurological Disorders: An Empirical Pilot Study in Bangladesh

Abstract

Background: Neurological disorders represent one of the most prominent causes of morbidity and mortality that adversely affect the lifestyle of patients and a major percentage of these diseases exists in developing countries.

Purpose: The objective of this study was to examine the prevalence and prescription pattern for outpatients with neurological disorders in Bangladesh.

Methods: The study was conducted on 1,684 patients in 6 hospitals (National Institute of Neurosciences and Hospital, Dhaka Medical College and Hospital, Bangabandhu Sheikh Mujib Medical University, Shaheed Suhrawardy Medical College, Sir Salimullah Medical College, and Apollo Hospitals Dhaka) of the Dhaka City from March 2014 to June 2015. Data were collected through a predesigned questionnaire from the patients that contain information about gender, age, marital status, occupation, residential status, affected disease, self-medicated medicines, and prescribed medicines.

Results: Out of 1,684 patients, 28.38% patients were aged 51-60 years and male, 57.19% predominance. The study exposed headache and migraine for 29.75% patients, followed by stroke for 23.93% patients and seizure for 7.07% patients. Genetic reason for the neurological disorders was seen only among 12.35% patients. In this study, 16.98% patients had been affected by neurological disorders for more than 2 years and 19% of patients for less than 6 months. Most extensively prescribed medicines were multivitamins and multiminerals used by 17.89% of patients followed by nonsteroidal anti-inflammatory drugs and other analgesic by 14.84%; afterwards antiulcerants were used by 12.62%, subsequently anticoagulants were used by 11.61% followed by antihyperlipidemic medicines by 10.26% and antiepileptic drugs by 8.08% of patients. The crucial reasons for the selection of prescribed medicines were the confidence that patients had with the physician's prescribed medicines, which was shown for 40.97% patients and knowledge of the medicines was reported for 35.04% patients. The period of prescribed medicine usage was 1-3 months for 39.73% patients and 3-6 months for 29.16% patients. The patient's compliance for prescribed medicines was satisfactory for 34.56% patients, good for 28.15% patients, and side effects were reported for 23.22% patients.

Conclusion: In Bangladesh, it is not surprising to note that neurological diseases are more prevalent than other different diseases among different age groups and genders. Headache and migraine, stroke and seizure are most frequently encountered neurological disorders here. Treatment procedure of these disorders is not quite suitable due to the anomalies of health care management systems. Appropriate management of the health care system, especially the placement of hospital and community pharmacy can overcome the existing inconsistencies as well as increase the knowledge, awareness, and perception of the patients about health and neurological disorders.

Keywords: Community pharmacy; Health care; Hospital pharmacy; Multiminerals; Multivitamins; Neurological disorders; Nonsteroidal anti-inflammatory drugs; Outpatients.

Fig. 1

Family history of neurological disorders among patients (n = 1,684). If a patient has a family history, it does not mean that the family history is responsible for the disorders.

Fig. 2

Duration of neurological disorders among patients (n = 1,684). The suffering duration of the patients ranges from less than 6 months to greater than 2 years.

Fig. 3

Previous measures for neurological disorders (n = 1,684). The activities (i.e., allopathic, herbal, unani, homeopathic medicine/no treatment) taken by the patients to treat or control their disease and/or discomforts before assignation with this study.

Fig. 4

Patients follow-up for neurological disorders (n = 812). The consecutive activities (i.e., allopathic, herbal, unani, homeopathic medicine practitioner/do not follow) taken by the patients to treat or control their disease and/or discomforts.

Fig. 5

Compliance of previous measures for neurological disorders (n = 575). The outcomes (i.e., partial recovery, no recovery, worsened) obtained by patients owing to previous activities specified in Figure 3.

Fig. 6

Non-neurological disorders at outpatient department (n = 294). The negative outcome of the patients by ailments except neurological disorders. Here, PUD, peptic ulcer disease; HD, heart disease; DM, diabetes mellitus; RA, rheumatoid arthritis; BA, bronchial asthma; COPD, chronic obstructive pulmonary disease.

Fig. 7

Reason of self-medication for neurological disorders (n = 591). Reasons behind the administration of medicines by self-assessment of the patients.

Fig. 8

Duration of self-medication for neurological disorders (n = 591). The period of self-medication practice of the patients ranges from less than 1 month to 6–12 months.

Fig. 9

Compliance of self-medication for neurological disorders (n = 591). The opinion of the patients taken self-medication ranges from excellent to side effect/no comments.

Fig. 10

Reason of prescribed medicines for neurological disorders (n = 1,684). The reasons behind the administration of medicines by physician assessment.

Fig. 11

Duration of prescribed medicines for neurological disorders (n = 1,684). The period of administration of prescribed medicines ranges from less than 1 month to 6–12 months.

Fig. 12

Compliance of prescribed medicines for neurological disorders (n = 1,684). The opinion of the patients who have taken prescribed medicines ranges from excellent to side effect/no comments.