Five-year follow-up of drug utilization for secondary prevention in coronary artery disease

Pharm World Sci. 2008 Dec;30(6):753-8. doi: 10.1007/s11096-008-9234-3. Epub 2008 Jun 19.

Abstract

Objective: Despite the availability of various prevention guidelines on coronary artery disease, secondary prevention practice utilizing aspirin, beta-blockers, angiotensin converting enzyme inhibitors and statins still can be sub-optimal. In this study, we aimed to assess the guideline adherence of secondary prevention prescribing and the continuity of adherence for a 5-year period in a small cohort of patients angiographically diagnosed to have coronary artery disease.

Method: In this prospective study, 73 patients who were angiographically diagnosed to have CAD were followed up for 5 years. The baseline demographic and clinical data were collected just before angiography. The baseline drug data were collected at the day of discharge. The fifth year data were taken from the patients via face-to-face consultations or phone interviews.

Results: The 'initial prescribing rate' at discharge was found to be 82% for aspirin, 49% for statins, 44% for ACE inhibitors and 55% for beta-blockers. 'Continuity of prescribing' for 5 years was 45% for aspirin, 26% for statins, 17% for ACE inhibitors and 20% for beta-blockers.

Conclusions: Besides the sub-optimal prescribing of secondary prevention drugs, absence of continuity of prescribing seems to be a challenging issue in pharmaceutical care of coronary artery disease patients.

MeSH terms

  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Aspirin / therapeutic use
  • Cohort Studies
  • Continuity of Patient Care / standards
  • Coronary Artery Disease / drug therapy
  • Coronary Artery Disease / prevention & control*
  • Data Collection
  • Drug Utilization
  • Female
  • Follow-Up Studies
  • Guideline Adherence*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / standards*
  • Prospective Studies
  • Turkey / epidemiology

Substances

  • Adrenergic beta-Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Platelet Aggregation Inhibitors
  • Aspirin