OBJECTIVES

General objective

To evaluate the medication utilization in patients with acute coronary syndrome.

Specific objectives

1. To identify the prescribing pattern of medications in patients with acute coronary syndrome. 2. To evaluate the rational use of medications in patients with acute coronary syndrome. 3. To identify the medication related problems in patients with acute coronary syndrome.

METHODS A prospective observational study was conducted at the Coronary Care Unit (CCU) over a period of 6 months. Patients diagnosed with IHD were enrolled in the study. The information on patient was collected from the medical records, treatment chart, laboratory data, interview with patients and caretakers. Socio-Demographic data, reason(s) for CCU admission, diagnosis, medications prescribed, medication-related problems and the discharge medications were documented and analyzed.

RESULTS A total of 300 patients with the mean age of 59 years were included in the study, 68% of which were males. About 92(30%) patients had ST-elevation myocardial infarction (STEMI), 141(47%) patients had non-ST-elevation myocardial infarction (NSTEMI) and 41(13%) had unstable angina. Two hundred and thirty (76.66%) patients treated with thrombolytic therapy and 70 patients (23.33%) were undergone Percutaneous Coronary Intervention. The average number of drugs per prescription was 11.09±1.17, majority were Anti-Platelets 520 (16.72%) followed by Gastro-protective agents 282 (8.7%) followed by Lipid lowering agents 264(8.17%) and anti-anginals 227(7.03%). Anti-platelets included 257(49%) Aspirin, 140(26.9%) Clopidogrel, 123(23.6%) Ticagrelor. Among 288 patients (excluding 12 death cases) considered for assessing compliance for discharge medications, more than 85% were compliant with AHA/ACC guideline. Majority of the prescriptions were compliant for lipid lowering therapy 276 (95.8%) whereas least compliance was observed for Beta blockers 253 (87.8%). The total DRPS reported were 1903 out of which DDIs were 1,785(93.7%), medication incidents were 84(4.41%) and ADRs were 34(1.78%).

CONCLUSIONS In patients admitted with Acute coronary syndrome, medications prescribed were rational and majority were in accordance to the AHA/ACC guidelines.