Low use of statins and other coronary secondary prevention therapies in primary and secondary care in India

Autor: Atul Kasliwal, Ravindra K. Tongia, Ajeet Bana, Sanjeeb Roy, Prakash Deedwania, Krishna Kumar Sharma, Aachu Agrawal, Rajeev Gupta
Jazyk: angličtina
Rok vydání: 2009
Předmět:
Male
Endocrinology
Diabetes and Metabolism
Angiotensin-Converting Enzyme Inhibitors
Coronary Disease
Practice Patterns
030204 cardiovascular system & hematology
Cardiovascular
0302 clinical medicine
Secondary Prevention
Pharmacology (medical)
030212 general & internal medicine
Practice Patterns
Physicians'
Original Research
Secondary prevention
Aspirin
Evidence-Based Medicine
beta blockers
Dihydropyridine
Hematology
General Medicine
Health Services
Middle Aged
3. Good health
Heart Disease
angiotensin-converting enzyme inhibitor
6.1 Pharmaceuticals
Combination
Practice Guidelines as Topic
Platelet aggregation inhibitor
Drug Therapy
Combination
Female
Guideline Adherence
Cardiology and Cardiovascular Medicine
medicine.drug
Adult
medicine.medical_specialty
Statin
medicine.drug_class
aspirin
Clinical Sciences
Adrenergic beta-Antagonists
India
Drug Prescriptions
statins
03 medical and health sciences
Pharmacotherapy
Drug Therapy
Clinical Research
Internal medicine
medicine
Humans
Medical prescription
coronary heart disease
Beta blocker
Heart Disease - Coronary Heart Disease
Aged
Physicians'
Primary Health Care
business.industry
Public Health
Environmental and Occupational Health
Evaluation of treatments and therapeutic interventions
Drug Utilization
Vascular Health and Risk Management
Good Health and Well Being
Cardiovascular System & Hematology
Hydroxymethylglutaryl-CoA Reductase Inhibitors
business
Platelet Aggregation Inhibitors
Zdroj: Vascular Health and Risk Management
ISSN: 1178-2048
Popis: Krishna K Sharma1, Rajeev Gupta2, Aachu Agrawal3, Sanjeeb Roy2, Atul Kasliwal2, Ajeet Bana2, Ravindra K Tongia2, PrakashC Deedwania41Department of Pharmacy, LBS College of Pharmacy, Jaipur, India; 2Departments of Medicine, Cardiology and Cardiac Surgery, Fortis Escorts Hospital, Jaipur, India; 3Department of Home Science, University of Rajasthan, Jaipur, India; 4Department of Cardiology, University of California San Francisco-VA Health System, Fresno, CA, USAObjective: To determine the frequency of use of pharmacotherapy with aspirin, beta blocker, statin, and angiotensin-converting enzyme (ACE) inhibitor in patients with stable coronary heart disease (CHD) among physicians at different levels of health care in Rajasthan state, India.Methods: Physicians practicing at tertiary hospitals and clinics at tertiary, secondary and primary levels were contacted. Prescriptions of CHD patients were audited and descriptive statistics reported.Results: We evaluated 2,993 prescriptions (tertiary hospital discharge 711, tertiary 688, secondary 1,306, and primary 288). Use of aspirin was in 2,713 (91%) of prescriptions, beta blockers 2,057 (69%), ACE inhibitors or angiotensin receptor blockers (ARBs) 2,471 (82%), and statins 2,059 (69%). Any one of these drugs was prescribed in 2,991 (100%), any two in 2,880 (96%), any three in 1,740 (58%), and all four in 1,062 (35.5%) (P< 0.001). As compared to tertiary hospital, prescriptions at tertiary, secondary, and primary levels were lower: aspirin (96% vs 95%, 91%, 67%), beta blockers (80% vs 62%, 66%, 70%), statins (87% vs 82%, 62%, 21%): two drugs (98% vs 96%, 98%, 85%), three drugs (75% vs 58%, 55%, 28%), or four drugs (54% vs 44%, 28%, 7%) (P < 0.01). Use of ACE inhibitors/ARBs was similar while nitrates (43% vs 23%, 43%, 70%), dihydropyridine calcium channel blockers (12% vs 15%, 30%, 47%), and multivitamins (6% vs 26%, 37%, 47%) use was more in secondary and primary care.Conclusions: There is suboptimal use of various evidence-based drugs (aspirin, beta blockers, ACE inhibitors, and statins) for secondary prevention of CHD in India.Keywords: statins, coronary heart disease, aspirin, beta blockers, angiotensin-converting enzyme inhibitor
Databáze: OpenAIRE
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