Vertigo Management – Mapping prevalence and treatment. Understanding once a day preparation usage and place in therapy.

Pharma courses

pharma courses



Interpretation:
·         48.57% of the E.N.T Doctors prefer to give 8mg TID dose of Betahistine to patients to treat vertigo.
·         14.29% of the E.N.T Doctors prescribe 24mg BID dosage, while 11.43% of them prefer 16mg BID, for pharmacological therapy with Betahistine for Vertigo.
·            Only 2.86% of E.N.T Doctors prescribes 24mg C.R once a day formulation (Betahistine O.D) for treatment in of Vertigo.
·            Also, 14.29% E.N.T Doctors prescribe 16mg TID of Betahistine to their patients.

Duration:

Total Respondents = 35

Duration

Responses

% of responses

1-2 weeks

22

62.86

3-4 weeks

12

34.29

4-8 weeks

1

2.86

Table 65: Responses for duration of  pharmacological therapy for Vertigo

Interpretation:
·         1-2 weeks is the most preferred duration of therapy with Betahistine amongst 62.86% E.N.T Doctors.
·         34.29% E.N.T Doctors opted for 3-4 weeks of therapy with Betahistine, while 2.86% preferred 4-8 weeks.

10.  Do you titrate dosage?

Total Respondents = 35

Response to question

Responses

% of Responses

Yes

31

88.57

No

4

11.43

Table 66: Responses for dosage titration in treating Vertigo

Interpretation:
·         88.57% of the E.N.T Doctors were found to titrate the dosage in Vertigo treatment.
·         With the usual approach being tapering down the dosage in patients where symptoms are relieved and do not recur, and then putting it off. But in some recurrent cases of vertigo the dosage was increased.
·         Where as 11.43% of the E.N.T Doctors did not titrate the dosage.

11.  Doctor, are you aware of once a day Betahistine preparation?

Fig 61: Pie chart showing Betahistine once a day preparation awareness

Total Respondents = 35

Response to question

Responses

% of Responses

Yes

35

100

No

0

0

Table 67: Responses for Betahistine O.D awareness

Interpretation:
·         All of the E.N.T doctors (100%) were found to be aware of Betahistine once a day preparation.

12.  If Yes, have you used?

Total Respondents = 35

Response to question

Responses

% of Responses

Yes

15

42.86

No

20

57.14

Table 68: Responses for Betahistine O.D usage

Interpretation:
·         57.14% of the E.N.T Doctors did not use Betahistine O.D formulation, they reportedly used the conventional doses.
·         42.86% of the sampled E.N.T Doctors, were found to use Betahistine O.D formulation.

13.  If answer to Q11 is Yes, what is preferred strength & duration?

Total Respondents = 15 (out of 35 E.N.T doctors)

Strength

Duration

Responses

% of Responses

Overall %

24 mg

1 week

8

53.33

73.33

2 weeks

3

20

4 weeks

0

0

 

48 mg

1 week

2

13.33

26.67

2 weeks

1

6.67

4 weeks

1

6.67

 

Table 69: Responses for preferred strength of Betahistine O.D usage

Interpretation:
·         Amongst all E.N.T Doctors those who use Betahistine once a day preparation, 73.33% mostly prescribe 24mg C.R, while 26.67% use 48mg C.R formulation.
·         The duration for which 24mg C.R is prescribed the most is 1 week by 53.33% E.N.T Doctors, followed by 2 weeks amongst 20% E.N.T Doctors.
·         13.33% E.N.T Doctors use 48mg C.R for 1 week.
·         6.67% E.N.T Doctors use 48mg C.R for 2 weeks and 4 weeks repectively.

14.  If used, how do you use the OD formulation?

Total Respondents = 35

Response to question

Responses

% of Responses

Start with OD

22

62.86

Only Maintenance with OD

13

37.14

Table 70: Responses for preferred use of once a day formulation

Interpretation:
Majority of the E.N.T doctors (62.86%) prefer to use O.D formulation as a start up dose, while the rest (37.14%) preferred to use it as a maintenance dose only.

15.   Is the usage of OD preparation indication specific?

Total Respondents = 35

Response to question

Responses

% of Responses

Yes

5

14.29

No

30

85.71

Table 71: Responses for use of once a day formulation indication specifically

Interpretation:
·         Majority (85.71%) of the E.N.T doctors do not use O.D formulation particularly specific to any indication.
·         Only 14.29% of E.N.T doctors use it specifically against particular indication

16.  If yes, which is the indication and any specific reasons?

14.29% of the E.N.T doctors use O.D formulation in Acute cases of vertigo. They also prefer to use it in patients with severe symptoms.

17.  Do you also use two anti-vertigo molecules like morning/evening dose?

Total Respondents = 35

Response to question

Responses

% of Responses

Yes

5

14.29

No

30

85.71

Table 72: Responses for usage of two Anti-vertigo molecules

Interpretation:
·         85.71% of the E.N.T Doctors do not use two Anti-Vertigo molecules together.
·         Only 14.29% of the E.N.T Doctors use two Anti-vertigo molecules together as a morning-evening dose

If Yes, your usual approach

Sometimes Betahistine is prescribed with Dimenhydrinate or Cinnarizine.

18.  Do you think, combination of Betahistine with Dimenhydrinate is required? If yes, for which indication and condition is it useful?

Total Respondents = 60

Response

Number of Responses

% of response

Yes

19

54.29

No

1

2.86

Maybe

1

2.86

Not tried

14

40

Table 73: Responses for usage of combination of Betahistine with Dimenhydrinate

Interpretation:
·         40% of the E.N.T Doctors have not tried this combination, but 54.29% said it to be a potent and viable combination.
·         They were further aided by 2.86% of doctors who felt it maybe a fruitful combination.
·         2.86% of E.N.T Doctors feel that this would not serve to be a good combination.

DIABETOLOGISTS

DIABETOLOGISTS(SAMPLE SIZE = 10)
·               The incidence of 10-15% patients who seek anti-vertigo medications was found to be a majority amongst 40 % Diabetologists.
·               The % of female patients who seek anti-vertigo medications were found to be on the higher side amongst Diabetologists.
·               50% of the Diabetologists felt that a 40:60 (Male:Female) ratio is most observed in their practice.
·               70% Diabetologists reported that 40-50 years was the prevalent category of the patients.
·               It was revealed through the study that 90% of the Diabetologists, observed patients with secondary to pre-existing ailment.
·               Diabetes Mellitus (47.39%) is the most common secondary to pre-existing ailment, followed by Spondylosis and Hypertension & Cardiac problems amongst 21.05% Diabetologists.
·               BPPV is the most common cause of Vertigo, followed by Labyrinthitis and Meniere’s Disease amongst the sampled Diabetologists.
·               Pharmacological therapy is the most preferred line of treatment amongst 70% Diabetologists for effective Vertigo management.
·               Betahistine) is the most preferred drug of choice for treating vertigo amongst 90.9% Diabetologists.
·               30% of the Diabetologists prefer to give 8mg TID dose of Betahistine to patients to treat vertigo.
·               1-2 weeks is the most preferred duration of therapy with Betahistine amongst 90% Diabetologists.
·               90% of the Diabetologists were found to titrate the dosage in Vertigo treatment.
·               With the usual approach being tapering down the dosage in patients where symptoms are relieved and do not recur, and then putting it off. But in some recurrent cases of vertigo the dosage was increased.
·               Majority (90%) of the Diabetologists were found to be aware of Betahistine once a day preparation. Only 10% Diabetologists were still unaware of Betahistine O.D formulation.
·               60% of the Diabetologists did not use Betahistine O.D formulation, they reportedly used the conventional doses.
·               Amongst all Diabetologists those who use Betahistine once a day preparation, 100%  prescribe 24mg C.R, while none  use 48mg C.R formulation.
·               The duration for which 24mg C.R is prescribed the most is 2 weeks by 100% Diabetologists.
·               70% of the Diabetologists prefer to use O.D formulation as a start up dose, while the rest (30%) preferred to use it as a maintenance dose only.
·               Majority (90%) of the Diabetologists do not use O.D formulation particularly specific to any indication.
·               80% of the Diabetologists do not use two Anti-Vertigo molecules together.
·               40% of the Diabetologists have not tried this combination, but 40% said it to be a potent and viable combination.
·               They were further aided by 10% of doctors who felt it maybe a fruitful combination.

1.      In your practice what is the incidence of patients who need anti-vertigo medication?

Total Respondents = 10

Category

Responses

Percentage of responses

5-10%

3

30

10-15%

4

40

15-25%

2

20

More than 25%

1

10

Table 74: Responses for incidence of patients requiring Anti-Vertigo Medication per week

Interpretation:
·         The incidence of 10-15% patients who seek anti-vertigo medications was found to be a majority amongst 40 % Diabetologists.
·         30% of the Diabetologists observed incidence of 5-10% of patients.
·         20% of Diabetologists had observed 15-25% patients in their practice. While only 10% Diabetologists had more than 25% patients requiring anti-vertigo medication

2.      May I know the approximate bifurcation of patients gender wise (in %)?

Total Respondents = 10

% of Patients

Approx Ratio

Responses

% of Responses

Male

40

5

50

Female

60

 

Male

50

2

20

Female

50

       

Male

30

3

30

Female

70

Table 75: Responses for gender bifurcation of patients requiring Anti-Vertigo Medication per week

NOW YOU CAN ALSO PUBLISH YOUR ARTICLE ONLINE.

SUBMIT YOUR ARTICLE/PROJECT AT articles@pharmatutor.org

Subscribe to PharmaTutor Alerts by Email

FIND OUT MORE ARTICLES AT OUR DATABASE


 

Pages

FIND MORE ARTICLES