DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20181654

Prescribing trends of HMG Co-A reductase inhibitors in outdoor patients at tertiary care teaching hospital of central India: a retrospective observational study

Sudharam T. Bhagwate, Renuka S. Harwani, Dheeraj S. Jeswani, Sagar N. Yalgundee, Rupesh A. Warbhe

Abstract


Background: To analyze the prescribing patterns of statins a hypolipidemic agents by using HMIS database in outdoor patients at tertiary care teaching hospital of central India.

Methods: In this retrospective study Using HMIS database, 1000 prescriptions were analyzed for statin use for various WHO prescription indicators using ATC code of statins, the ratio of prescribed daily dose (PDD) and defined daily dose (DDD) was calculated.

Results: Atorvastatin was the only statin which was prescribed as monotherapy (61.1%), whereas as combination with aspirin (38.9%). While analyzing the prescriptions, it was found that patients having abnormal lipid profiles (51.8%) and normal lipid profiles (48.2%) were prescribed atorvastatin. Hypertension with diabetes (37%) was the most common disease followed by hypertension (21.2%) and diabetes mellitus (21%) for which atorvastatin was prescribed. The average number of drugs per prescription were 3.8±1.65.

Conclusions: This study depicts the use of atorvastatin in various disease conditions, both as primary and secondary preventive measures. There was no polypharmacy. Such studies should be done to educate the physicians on good prescribing practices and to rationalize use of hypolipidemic drugs.


Keywords


Atorvastatin, Dyslipidemia, HMG Co-A inhibitors, Prescription Pattern

Full Text:

PDF

References


WHO. Cardiovascular diseases (CVDs). 2015. Available at: http://www.who.int/mediacentre/ factsheets/fs317/en/. Accessed 28 December 2017.

Kumar T, Kapoor A. Premature coronary artery disease in North Indians: An angiography study of 1971 patient. Indian Heart J. 2005;57:311-8.

Stone NJ, Robinson JG, Lichtenstein AH, Merz CN, Blum CB, Eckel RH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Part B):2889-934.

NICE Clinical Guideline 181. Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. 2014. London: National Clinical Guideline Centre, 2014.

European Association for Cardiovascular Prevention & Rehabilitation, Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, et al. ESC Committee for Practice Guidelines (CPG) 2008-2010 and 2010-2012 Committees. ESC/EAS Guidelines for the management of dyslipidaemias: the Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). Eur Heart J. 2011;32(14):1769-818.

Baigent C. Cholesterol Treatment Trialists'(CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267-78.

Cholesterol Treatment Trialists' Collaboration, Fulcher J, O'Connell R, Voysey M. Efficacy and safety of LDL‐lowering therapy among men and women: meta‐analysis of individual data from 174,000 participants in 27 randomised trials. Lancet. 2015;385:1397-405.

Maron DJ, Fazio S, Linton MF. Current perspectives on statins. Circulation. 2000;101:207-13.

Ford I, Murray H, McCowan C, Packard CJ. Long-Term safety and efficacy of lowering low-density lipoprotein cholesterol with statin therapy clinical perspective: 20-year follow-up of west of Scotland coronary prevention study. Circulation. 2016;133(11):1073-80.

Introduction to Drug Utilisation Research. WHO library cataloguing-in-publication data. Available at: www.whocc.no/filearchive/publications/drug_utilization_research.

Rosenson RS, Kent ST, Brown TM, Farkouh ME, Levitan EB, Yun H, et al. Underutilization of high-intensity statin therapy after hospitalization for coronary heart disease. J Am Coll Cardiol. 2015;65(3):270-7.

Ferrajolo C, Arcoraci V, Sullo MG, Rafaniello C, Sportiello L, Ferrara R, et al. Pattern of statin use in southern italian primary care: can prescription databases be used for monitoring long-term adherence to the treatment?. PloS one. 2014;9(7):e102146.

Svensson E, Nielsen RB, Hasvold P, Aarskog P, Thomsen RW. Statin prescription patterns, adherence, and attainment of cholesterol treatment goals in routine clinical care: a Danish population-based study. Clinical epidemiology. 2015;7:213.

Geleedst-De Vooght M, Maitland-van der Zee AH, Schalekamp T, Mantel-Teeuwisse A, Jansen P. Statin prescribing in the elderly in the Netherlands. Drugs aging. 2010;27(7):589-96.

Patel K, Joshi H, Khandhedia C, Shah H, Shah K, Patel V. Study of drug utilization, morbidity pattern and cost of hypolipidemic agents in a tertiary care hospital. Int J Basic Clin Pharmacol. 2013;2(4):470.

Sreedevi K, Venkateswara Rao J, Fareedullah M, Vijayakumar S. A study on prescription pattern of statins in cardiovascular disease. Der Pharm Lett. 2011;3(3):393-6.

Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). J Am Med Association (JAMA). 2001;285:2486-97.

Sharma KK, Gupta R, Agrawal A, Roy S, Kasliwal A, Bana A, et al. Low use of statins and other coronary secondary prevention therapies in primary and secondary care in India. Vasc Health Risk Manag. 2009;5:1007-14.

Packham C, Robinson J, Morris J, Richards C, Marks P, Gray D. Statin prescribing in Nottingham general practices: a cross-sectional study. J Public Health. 1999;21(1):60-4.

Batalla A, Hevia S, Reguero JR, Cuber GI. Underutilization of lipid-lowering therapy in coronary artery disease. Arch Intern Med. 2000;160:2683-84.