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


  • Vidhi Thaker Department of Pharmacology, GCS Medical College, Hospital and Research Centre, Ahmedabad, Gujarat, India
  • Kamlesh Patel Department of Pharmacology, NHL Municipal Medical College, Ahmedabad, Gujarat, India




Acute coronary syndrome, Drug utilization, Drug use pattern, NSTEMI, NLEM, STEMI


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.


Nag T, Ghosh A. Cardiovascular disease risk factors in Asian Indian population: A systematic review. J Cardiovasc Dis Res. 2013;4(4): 222-8.

Kumar A, Christopher P. Cannon. Acute Coronary Syndromes: Diagnosis and Management, Part I. Mayo Clin Proc. 2009;84(10):917-38.

Puymirat E, Simon T, Steg PG. Association of changes in clinical characteristics and management with improvement in survival among patients with ST-elevation myocardial infarction. JAMA. 2012;308(10):998-100.

Roffi M, Patrono C, Jean-Philippe C, Christian M. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. European Heart Journal. 2015:1-59.

Cannon CP, Brindis RG, Chaitman BR, Cohen DJ. 2013 ACCF/AHA Key Data Elements and Definitions for Measuring the Clinical Management and Outcomes of Patients with Acute Coronary Syndromes and Coronary Artery Disease. Circulation. 2013;127:1052-89.

Ghosh A, Das AK, Pramanik S, Saha UK. Drug utilization study in patients of acute coronary syndrome on follow-up visits at a tertiary care center in Kolkata. Asian Journal of Pharmacy and Life Science. 2012;2(2):155-65.

Fahimi F, Baniasadi S, Behzadnia N, Varahram F Tabatabaie LG. Enoxaparin Utilization Evaluation: An Observational Prospective Study in Medical Inpatients.Iranian Journal of Pharmaceutical Research. 2008;7(1):77-82.

Kaur S, Rajagopalan S, Kaur N, Shafiq N, Bhalla A, Pandhi P, et al. Drug utilization study in medical emergency unit of a tertiary care hospital in North India. Hindawi Publishing Corporation, Emergency Medicine International. 2014:1-5.

Sri Chandana M, Achutha Lakshmi P, Satish K. An evaluation of drug use pattern in acute coronary syndrome patients using WHO prescribing indicators. World J of Pharmaceutical Res. 2015;4(2):2095-103.

Chandana N, Subhash V, Vijay G. A Prospective study on drug utilization of cardiac unit in acute myocardial infarction of hospitalized patients. Int J Pahramcotherapy. 2013;3(1):6-11.




How to Cite

Thaker, V., & Patel, K. (2017). A study of drug utilization pattern in post-acute coronary syndrome (ACS) patients at tertiary care teaching hospital: a prospective unicentric study. International Journal of Basic & Clinical Pharmacology, 6(2), 308–311. https://doi.org/10.18203/2319-2003.ijbcp20170320



Original Research Articles