Abstract
Introduction Anticoagulants have a wide spectrum of use and risks associated with their therapy due to their narrow therapeutic range. This study aimed to evaluate the anticoagulant utilization and cost analysis in patients admitted to the cardiology ward of a tertiary care hospital in western Nepal. Methods A prospective cohort study was conducted in patients admitted to the cardiology ward of Manipal Teaching Hospital (MTH), Pokhara, Kaski, Nepal, from August to November 2019. All patients (n = 132) aged ≥18 years of either gender receiving anticoagulants for any indication in the cardiology ward were included in the study. Anticoagulant utilization, the average prescribed daily dose (PDD/DDD) and the cost of anticoagulant per patient were calculated. Descriptive statistics were performed using IBM-SPSS 20.0. Results Acute coronary syndrome (66.67%) was a common indication, unfractionated heparin + enoxaparin (45.45%) and enoxaparin (27.3%) were the most frequently prescribed anticoagulants. The performance of monitoring parameters such as international normalized ratio (INR), prothrombin time (PT), activated partial thromboplastin time (aPTT), and renal function test were consistent with the American College of Chest Physician (ACCP) guidelines. The average prescribed daily dose of anticoagulants was 1.3 (unfractionated heparin), 2.25 (enoxaparin), 0.5 (warfarin), and 1.0 (dabigatran). Heparin was associated with the majority of cases of drug interactions (52 cases). Enoxaparin was the most expensive of all the anticoagulant drug classes. The median (IQR) cost of anticoagulants used per patient was US$79.92 ($46.32). Conclusion Our study suggests that the utilization of unfractionated heparin and enoxaparin and the cost of anticoagulants per patient were higher in the patients admitted to the cardiology ward of the hospital.
Highlights
Anticoagulants have a wide spectrum of use and risks associated with their therapy due to their narrow therapeutic range. is study aimed to evaluate the anticoagulant utilization and cost analysis in patients admitted to the cardiology ward of a tertiary care hospital in western Nepal
Anticoagulants are frequently prescribed drugs in deep vein thrombosis, pulmonary embolism, myocardial infarction, unstable angina, atrial fibrillation, acute coronary syndrome, rheumatic heart disease, vascular surgery, and prosthetic heart valve, in both inpatient and outpatient settings [3]. ey are divided into oral and parenteral agents [indirect thrombin inhibitors: unfractionated heparin (UFH) and low molecular weight heparin (LMWH), such as enoxaparin, dalteparin, and direct thrombin inhibitor, lepirudin]. e latter is widely used for short-term therapy, basically when rapid anticoagulation is required [4]
Is represented that this patient population was at a higher risk of developing cardiovascular diseases. is finding was consistent with that of another study conducted in Pakistan [15]
Summary
Anticoagulants have a wide spectrum of use and risks associated with their therapy due to their narrow therapeutic range. is study aimed to evaluate the anticoagulant utilization and cost analysis in patients admitted to the cardiology ward of a tertiary care hospital in western Nepal. Is study aimed to evaluate the anticoagulant utilization and cost analysis in patients admitted to the cardiology ward of a tertiary care hospital in western Nepal. Anticoagulant utilization, the average prescribed daily dose (PDD/DDD) and the cost of anticoagulant per patient were calculated. Acute coronary syndrome (66.67%) was a common indication, unfractionated heparin + enoxaparin (45.45%) and enoxaparin (27.3%) were the most frequently prescribed anticoagulants. E average prescribed daily dose of anticoagulants was 1.3 (unfractionated heparin), 2.25 (enoxaparin), 0.5 (warfarin), and 1.0 (dabigatran). Our study suggests that the utilization of unfractionated heparin and enoxaparin and the cost of anticoagulants per patient were higher in the patients admitted to the cardiology ward of the hospital. E ability to monitor the degree of anticoagulation, reversibility of effects, and low-cost generic availability of warfarin appealed both patients and physicians for its use. Despite its effectiveness in reducing thromboembolic events, it has several drawbacks, including
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
