Prescribing Pattern in Coronary Artery Disease of Indian Railway Hospital

Abstract

The objective of this study was to assess the prescribing pattern in coronary artery disease of Indian railway hospital. The prospective, interventional and follow up study was conducted in inpatient department of cardiology. Coronary artery disease patients were enrolled into the study by considering inclusion and exclusion criteria. Details of demography, treatment and other medical details were captured in patient data collection form at baseline. Medication knowledge of the patient was assessed using medication knowledge assessment questionnaire assessment questionnaire at baseline after which the patient was counselled systematically. Medication knowledge of the patient were reassessed at first follow up and second follow up followed by counselling by pharmacist. Pattern of different drugs prescribed in coronary artery disease were analyzed. 150 patients were enrolled in the study of which 78 (52%) were male patients and 72 (48%) were female patients. The male to female ratio among the patients was 3:2. The incidence of CAD was more common in male compared to female. Among 150 prescriptions analyzed anti-platelet drugs were prescribed in 149 (99.3%) patients. Out of these (n=149), a fixed dose combination (75 mg) of aspirin and clopidogrel was found to be used in 145 (96.66%) and aspirin (150 mg) and clopidogrel (75 mg) singly were used in 130 (87.24%) of the patients. Aspirin alone was used in very few patients 11 (7.38%) and in least no. of patients 9(6.04%) clopidogrel alone was used. 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. Polypharmacy (9.68 drugs per prescription) was noticed. Very few drugs were prescribed by generic name. 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.