Assessment of prescribing pattern in coronary artery disease

Abstract

Background

Cardiovascular disease is the leading cause of death and disease burden globally. In recent years, India has become a country with the largest number of cardiovascular disease patients. Dyslipidaemia in the patients with diabetes has been shown to increase the risk of coronary heart disease. There is a much larger burden and overall medical costs on coronary artery disease itself. Study of drug-prescribing pattern can give insight into the trends in using the drugs in coronary artery disease in treating their co-morbid conditions. The knowledge of prescription pattern can lead us toward the rational drug use and help to take measures to improve prescribing habits. Multimorbidity is common in old age. Deaths associated with cardiovascular events remains constant in many countries due to new therapeutic approaches for prevention and treatment of cardiovascular diseases. This condition is widely attributable to unhealthy outcomes in its association with risk factors such as Hypertension, Diabetes mellitus, smoking, alcohol consumption and sedentary lifestyle which play a significant role in the progression of cardiovascular diseases.

Objectives

The objective of this study was to evaluate the coronary artery disease prevalence and drug utilization pattern in the department of general medicine in a tertiary care hospital in Karnataka, India.

Study design

A Cross Sectional study was carried out in the General Medicine Department, MIMS Teaching Hospital, Mandya, Karnataka, using a well-designed patient data collection form.

Results

In this study, among 99 cases of coronary artery diseases analysed, which consists of male n=60 (60.6%) and n=39 (39.4%) were females. The incidence of CAD was more common in male compared to female. In this study two different type of coronary artery disease were identified which includes 33 Angina Pectoris patients and 66 Myocardial infarction (MI) patients. Most of the patients diagnosed with coronary artery disease were of the age group of 41-60 (55.55%). The most common co-morbid conditions were hypertension in 10 (10.10%) and a combination of hypertension, diabetes, dyslipidaemia 42 (42.42%) patients. The prescription pattern of various cardiovascular drugs were found to be as – antiplatelet drugs 99 (100%), anti-hyperlipidemic drugs 81 (81.81%), antibiotics 87 (87.87%), anti-anginal drugs 33 (33.33%), antihypertensives 42 (42.42%), anticoagulants 35 (35.35%), diuretics 65 (65.65%) and bronchodilators 57 (57.57%).
The average number of drugs per prescription was found to be 7.34 and the percentage of drugs prescribed by generic name was found as 24.20%. The most commonly prescribed drug classes in coronary artery disease were antiplatelet drugs followed by antihyperlipidemics and antibiotics. This was followed by anti-anginal drugs, antihypertensives and anticoagulants. The prescribing pattern could be improved by reducing the number of drugs per prescription and by prescribing generic drugs to reduce the economic burden of the patients.

Conclusion

Uncontrolled DM, Hypertension, Hyperlipidaemia risk factors for developing coronary artery disease. Anti-thrombotic followed by Statins, antidiabetics and antihypertensive were most prescribed drugs. Combinations of drugs were prescribed to the patients for effective therapy. The present study will help the healthcare professionals to optimize the efficient and safe use of cardiovascular drugs.