Drug utilisation evaluation of antiplatelet agents in a tertiary care teaching hospital-a prospective observational study

Abstract

Background: Cardiovascular and cerebrovascular diseases were becoming predominant cause of morbidity and mortality in India. Antiplatelet agents remain as the cornerstone therapy for acute thrombotic coronary syndromes, IHD, STROKE, CHD and PCI and are essential for thromboprophylaxis. The current study was undertaken to evaluate the drug use pattern of antiplateletagents and to study the prescribing pattern, observe co-morbid conditions, social habits [alcohol/smoking], adverse events and drug-drug interactions associated with antiplatelet agents.
 Methods: A prospective observational study was conducted at MIMS hospital, study population of 160 inpatients from cardiology, general-medicine and neurology departments. Data was analyzed in Microsoft excel.
 Results: Data records obtained from 160 patients in which 51.87% were females followed by males 48.125%. most patients with IHD and stroke were found in age group 50-70 years. Hypertension was most found co-morbidity among the patients [61.88%] followed by diabetes [34.38%], hypothyroidism [5%], epilepsy[3.75%]. Utilisation pattern of antiplatelet agents aspirin, clopidogrel were found to be[97.5%] [82.5%] respectively. patients on DAPT[81%] were highest compared to monotherapy [19%]. Patients found with social habits were 38.75% smokers, 31.25% alcoholics and 22% both alcohol and smoking.
 Conclusion: The present study concludes that DAPT [aspirin+clopidogrel] was found to be superior to monotherapy, and incidence of IHD which is more common in males compared to females. Patients in the group 51-70 were most affected with stroke, IHD and with female predominance over male. Antiplatelet therapy which is clearly efficacious in reducing the incidence of ischemic events/ thromboembolic events DAPT[aspirin+ clopidogrel] was most effective and reduced ischemic events, yet have the risk of bleeding or resistance. Newer anti platelet agents such a Prasugrel and Ticagrelor can be utilised considering the bleeding risk.