The results of frequency analysis of drug prescriptions for patients with ischemic heart disease as a quality criterion for pharmacotherapy

Abstract

The aim of the study is to assess the pharmacotherapy rationality of patients with chronic ischemic heart disease (IHD) in an average statistical Ukrainian health care institution. The retrospective analysis of prescription leaflets of drugs for 100 patients with IHD and the frequency analysis of drug prescriptions by pharmacotherapeutic groups (PhGs), International Nonproprietary Names (INNs) and the comparison of the drugs prescribed with those recommended by the current European and national clinical guidelines have been conducted. All patients had concomitant diseases, such as atherosclerosis, heart failure, and hypertension. In all, 94 INNs from 9 PhGs of the first level of the ATC classification were prescribed. The number of prescriptions per one patient was 11, thus indicating polypharmacy. Almost 75% of prescriptions were cardiovascular drugs (CVDs), antithrombotic and perfusion solutions. In the structure of CVDs prescriptions the leading positions by the frequency were occupied by secondary metabolic drugs: 1.2 prescriptions per a patient. The prescriptions of vital CVDs were as follows: RAS blockers – ACE inhibitors, angiotensin II receptors antagonists and fixed combinations of ACE inhibitors with hydrochlorothiazide – 17.8%, and 92% of patients received them; β-blockers and diuretics – 15.5% each, 80% of patients received them; statins – 7%, 36% of patients received them. The leaders among antithrombotics were sodium enoxaparin, clopidogrel and acetylsalicylic acid. The dominant directions of pharmacotherapy of patients with IHD were anti-ischemic and antiplatelet treatment. The leaders by the number of prescriptions were the secondary metabolic drugs. The vital drugs, particularly statins, are insufficiently presented in the treatment of chronic ischemic heart disease. To optimize pharmacotherapy it is necessary to intensify the use of statins and reduce the number of prescriptions of the secondary metabolic drugs.