A study of drug utilization pattern in post-acute coronary syndrome (ACS) patients at tertiary care teaching hospital: a prospective unicentric study

Abstract

INTRODUCTIONCardiovascular diseases (CVDs) are the main cause of mortality globally and are the leading cause of death in India also. Several surveys conducted across the country over the past few decades have shown a rising prevalence of major risk factors for CVD in Asian population. The problem of increasing risk factors for CVD in India is because of lack of surveillance system, proper diagnosis and appropriate treatment. 1 ABSTRACT Background:The main objective of drug utilization research is to assess the rationality of drug use for specific disease. Long term survival in post-ACS patients depends largely on how well post ACS period is managed. Our aim is to record drug utilization pattern in post ACS patients after discharge and during follow-up visits. Methods: Prospective unicentric study was conducted in 200 patients suffering from ACS at Cardiology OPD of GCS Medical College, Hospital and Research Centre, Ahmedabad. Prescriptions issued to study subjects at the time of discharge and during follow-up who had recently suffered from ACS were intercepted after consultation and data recorded as per WHO guidelines as how to investigate drug use. Data were collected in the structured proforma (Case Record Form-CRF) which includes patient's demographic details, registration number, diagnosis and the drug prescribed. Each prescription was analyzed using WHO core prescribing indicators to evaluate the rationality of the prescriptions. Results: Out of 200, 104 (52%) suffered from unstable angina, 84(42%) suffered from STEMI and 12(6%) were suffered with NSTEMI. Male patients of 114(57%) were more prone to ACS than female patients of 86 (43%). Out of 200 patients, 193 (97%) received antiplatelet, 187 (94%) received antihypertensive, 184 (92%) received anticoagulants, 180 (90%) received lipid lowering drugs and 119 (60%) received Nitrates. As per WHO core prescribing indicators, the average number of drugs encountered per prescription was 7.96. The prescription showed a high usage of drugs from NLEM i.e. 72.20% in post-ACS patients. However the percentage of drugs prescribed by generic name was only 10.68%. The frequency of use of injectable preparations in post-ACS patients was found to be 17.84% which was in accordance with WHO reference value. Out of 17.84% injectable preparations, only 0.82% accounted for antibiotic injection. Conclusions: Although generic prescribing indicator shows a low range of usage, it is interesting to notice that prescription pattern has a high usage of drugs from NLEM (78.2%) in ACS. Thus present study provides valuable insight about the overall pattern of drugs used in post-Acute Coronary syndrome.

Evaluation of prescribing pattern of drugs use in patients of coronary artery disease at a tertiary care hospital

“…3,8,10,17 Anti-anginal drugs were prescribed to 70% of patients which was comparable to the reports presented by Dawalji et al, Sandozi et al, Thaker et al, in the similar studies. 13,15,18 The use of lipid lowering agent was found in 89% of patients which was again similar to the findings stated by Dawalji et al, Choudhary et al, Thaker et al, reflecting the rational use of these drugs for the purpose of secondary prophylaxis in CAD. 13,17,18 In present study, authors also found 51% of patients were prescribed aspirin and clopidogrel along with a proton pump inhibitor.…”

“…13,15,18 The use of lipid lowering agent was found in 89% of patients which was again similar to the findings stated by Dawalji et al, Choudhary et al, Thaker et al, reflecting the rational use of these drugs for the purpose of secondary prophylaxis in CAD. 13,17,18 In present study, authors also found 51% of patients were prescribed aspirin and clopidogrel along with a proton pump inhibitor. This finding perhaps is contradictory to the textual evidence stating the reduction in the therapeutic benefit of clopidogrel when administered with a proton pump inhibitor.…”

Drug utilization study in intensive cardiac care unit of tertiary care hospital

“…2 Cardiovascular diseases (CVDs) are also the main cause of mortality globally and are the leading cause of death in India. 3,4 In India, CVDs are the largest cause of mortality, accounting for around one-fourth of all deaths. 5 The Intensive Cardiac Care unit (ICCU) is well-equipped unit with continuous monitoring of the cardiac rhythm of each patient and hemodynamic monitoring in selected patients.…”