DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20170327

A study of drug utilization trends in acute coronary syndrome in intensive cardiac care unit at a tertiary care hospital, Mysore

Saranya Kalyanasundarram Lakshmi, Hema Narasimhe Gowda, Kanchanahalli Siddegowda Sadananda

Abstract


Background: Acute Coronary Syndrome (ACS) is an emergency condition where usage of many drugs during its management in ICCU is common. This could be a potential cause for Polypharmacy, Potential Drug-Drug Interactions and increased Cost Burden on patients. The objective of the study was WHO criteria for prescription like, 1) Average number of drugs per prescription, 2) Percentage of drugs prescribed by Generic name, 3) Percentage of drugs with Injections prescribed, 4) Percentage of prescriptions with Antibiotics and 5) Percentage of drugs prescribed from the WHO Essential Drugs List.

Methods: After obtaining approval from Institutional Ethics Committee, an observational study was carried out among 125 patients in a tertiary care hospital, Mysore. Patients diagnosed with ACS admitted in Intensive Cardiac Care Unit (ICCU) for initial 48 hrs were included in the study. The prescriptions were analyzed for WHO criteria for prescription. The results were analyzed using Descriptive Statistics and T- test.

Results: In our present study the most common diagnoses were found to be ACS- Anterior wall myocardial infarction (36.8%) and ACS-Inferior wall myocardial infarction (32.8%). Hypertension (35.2%) and Type 2 diabetes mellitus (29.6%) were the frequently associated co-morbid conditions. Antiplatelet drugs (100%) and Hypolipidemic drugs (100%) were the most commonly prescribed, followed by Anti coagulants (94.4%). The average number of drugs per prescription was 9.09±2.17. Percentage of drugs prescribed by generic names was 37.29%. The percentage of drugs prescribed from essential drug list was 50.84%.

Conclusions: The present study provides valuable insight about the overall pattern of drugs used in Acute Coronary syndrome. Physician should be encouraged to prescribe drugs with generic name.


Keywords


Acute coronary syndrome, Drug utilization, Intensive cardiac care unit, Poly pharmacy, Prescription pattern, WHO prescription indicators

Full Text:

PDF

References


Christian RP, Rana DA, Malhotra SD, Patel VJ. Evaluation of rationality in prescribing, adherence to treatment guidelines and direct cost of treatment in intensive cardiac care unit: A prospective observational study. Indian J Crit Care Med. 2014;18(5):278-84.

Zachariah G, Harikrishnan S, Krishnan MN, Mohanan PP, Sanjay G, Venugopal K, et al. Prevalence of coronary artery disease and coronary risk factors in Kerala, South India: A population survey- Design and methods. Indian Heart J. 2013;65(3):243-9.

Chandana N, Subash V, Kumar VG. A prospective study on drug utilization of cardiac unit in acute myocardial infarction of hosptalized patients. Inter. J. of Pharmacotherapy. 2013;3(1):6-11.

Jyothi K, Saleem T, Vineela L, Gopinath C, Reddy K. A Retrospective Drug Utilization Study of Antiplatelet Drugs in Patients with Ischemic Heart Disease. International Journal of Medical, Health, Biomedical, Bioengineering and Pharmaceutical Engineering. 2015;9(7):605-8.

Barot PA, Malhotra SD, Rana DA, Patel VJ, Patel KP. Drug utilization in emergency medicine department at a tertiary care teaching hospital: A prospective study. J Basic Clin Pharma. 2013;4:78-81.

Nagabushan H, Roopadevi HS, Prakash GM, Pankaja R. A prospective study of drug utilization pattern in cardiac intensive care unit at a tertiary care teaching hospital. Int J Basic Clin Pharmacol. 2015;4:579-83.

Gaedke MA, Da Costa JSD, Manenti ERF, Henn RL, Paniz VMV, Nunes MF, et al. Use of medicines recommended for secondary prevention of acute coronary syndrome. Rev. Saúde Pública 2015;49:88.

Choudhary P, Agrawal JM, Malhotra SD, Patel VJ. Drug utilization pattern in acute coronary syndrome at tertiary care hospital: a prospective cross-sectional observational study. Int J Basic Clin Pharmacol. 2016;5:513-6.

González-Pacheco H, Vargas-Barrón J, Vallejo M, Piña-Reyna Y, Altamirano-Castillo A, Sánchez-Tapia P. Prevalence of conventional risk factors and lipid profiles in patients with acute coronary syndrome and significant coronary disease. Ther Clin Risk Manag. 2014;10:815-23.

Giugliano RP, Braunwald E. The Year in Acute Coronary Syndrome. J Am Coll Cardiol. 2014;63(3):201-4.

Auer R, Gencer B, Räber L, Klingenberg R, Carballo S, Carballo D, et al. Quality of Care after Acute Coronary Syndromes in a Prospective Cohort with Reasons for Non-Prescription of Recommended Medications. PLoS One 2014; 9(3): e93147.

Smith JN, Negrelli JM, Manek MB, Hawes EM, Viera AJ. Diagnosis and management of acute coronary syndrome: An evidence-based update. J Am Board Fam Med. 2015;28:283-93.

Kaur S, Rajagopalan S, Kaur N, Shafiq N, Bhalla A, Pandhi P. Drug Utilization Study in Medical Emergency Unit of a Tertiary Care Hospital in North India. Emerg Med Int. 2014:1-5.

Pendhari SR, Chaudhari DR, Burute SR, Bite BM. A Study on the Drug Utilization Trends in the Cardiovascular Emergencies in a Tertiary Care Hospital. J Clin Diagn Res. 2013;7(4):666-70.

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 centre in Kolkata. Asian Journal of Pharmacy and Life Science. 2012;2(2):155.

Afroz F, Parveen F, Ara F, Iqbal MJU, Saha RR, Rozario RJ. Patterns of Drug Utilization in Cardiology Department of a Tertiary Level Hospital in Bangladesh. Bangladesh J. physiol. pharmacol. 2014;28(1 and 2):1-4.

Jhaveri BN, Patel TK, Barvaliya MJ, Tripathi CB. Drug utilization pattern and pharmacoeconomic analysis in geriatric medical in-patients of a tertiary care hospital of India. J Pharmacol Pharmacother. 2014;5(1):15-20.

Chandana SM, Lakshmi A, Sathish K. An evaluation of drug use patterns in Acute Coronary Syndrome patients using WHO prescribing indicators. World J Pharm Res. 2015;4(8):2095-103.

Demeke B, Molla F, Assen A, Melkam W, Abrha S, Masresha B, et al. Evaluation of drugs utilization pattern using who prescribing indicators in ayder referral hospital, Northern Ethiopia. Int J Pharm Sci Res. 2015;6(2):343-7.