Assessment of Anti-Diabetic Drug Utilization Using Who Prescribing Indicators and Atc/DDD Methodology With Evaluation of a Patient Information Leaflet in Type 2 Diabetes Mellitus Patients

Background and objectives: Rational use of antidiabetic medicines is important in patients with diabetes, particularly when comorbidities increase treatment complexity. This study assessed antidiabetic drug utilization and prescribing patterns and evaluated whether a patient information leaflet (PIL) improved knowledge, attitude, and practice (KAP) related to diabetes and its complications. Methods: A prospective observational study was conducted among 155 adults with diabetes and comorbidities admitted to a tertiary care hospital over six months. We obtained demographic and prescription data from case records and treatment charts. Antidiabetic utilisation was examined using the Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD) approach, and prescribing patterns were assessed using World Health Organization (WHO) core prescribing indicators. A PIL on diabetes and its complications was developed, translated into Kannada, validated, and assessed for readability. Data were analysed using IBM SPSS Statistics version 28; paired t-test and Pearson correlation were used, with P<0.001 considered statistically significant. Results: Among the 155 participants, 86 (55.4%) were men and 69 (44.5%) were women; 47 (30.3%) were aged 61–70 years. Hypertension was the most frequently reported comorbidity (100/155, 64.5%). Oral hypoglycaemic agents accounted for 126/223 (56.5%) antidiabetic drugs, and insulin for 97/223 (43.4%). Dapagliflozin and regular insulin were the most frequently recorded agents within their respective groups. Brand-name prescribing accounted for 154/170 (90.5%) drugs, while generic prescribing accounted for 16/170 (9.4%). The reported WHO indicators included a mean of 15 medicines per encounter, generic prescribing in 8.08%, antibiotic use in 83.22% of encounters, injection use in 98.06%, and prescribing from the essential medicines list in 50.38%. Among 155 prescriptions assessed for DDD pattern, 118 (76.12%) had a DDD ratio <1, 20 (12.9%) had a ratio of 1, and 17 (10.96%) had a ratio >1. Mean KAP scores increased from 2.57 to 4.66 for knowledge, 2.96 to 4.69 for attitude, and 2.96 to 4.62 for practice after the PIL intervention (P<0.001 for each). Interpretation and conclusions: The study identified substantial variation from the prescribing patterns expected by WHO core indicators, alongside extensive brand-name prescribing and frequent use of antibiotics and injections. The PIL was associated with marked short-term improvement in diabetes-related KAP scores and was well accepted by participants. Larger, multicentre studies with longer follow-up and clinical outcomes are needed to determine whether these improvements are sustained and translate into better diabetes control.