To study the prescription patterns and adequacy of use of statins at a tertiary care center of North India

Suraj Khanal, S. Atwal, P. Dutta
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Abstract

Background: The role and benefits of lipid-lowering drugs in active management of dyslipidemia are well established. However, a little is known about whether these drugs are prescribed as per the recent guidelines and the desired effect is achieved or not in routine clinical practice. The aim of this study was to evaluate the prescription patterns and adequacy of use of statins at a tertiary care hospital. Patients and Methods: Patients aged ≥18 years eligible to receive statin therapy for primary or secondary prevention according to the American Heart Association 2018 guidelines were included in the study. Clinical records of all the cases were reviewed for indications of statins, and lipid profile was done at baseline and after 3 months of statin therapy. Results: There were 140 men and 103 women with a mean age of 52.24 ± 12.01 years. 109 (44.9%) patients received statins for primary prevention, whereas 134 (55.1%) patients received statins for secondary prevention. A total of 179 (73.7%) and 64 (26.3%) patients each received atorvastatin and rosuvastatin. 81.9% of the study population received statins according to the guidelines. After 3 months of statin therapy, there was a statistically significant change in the lipid profile in both primary and secondary prevention groups. Conclusions: There are some irrational prescribing practices among physicians affecting the performance of statin therapy in primary and secondary prevention of atherosclerotic cardiovascular disease. A need to rationalize the prescription practices by keeping abreast with the latest recommendations as well as effective patient counseling and education seems warranted.
研究印度北部三级保健中心他汀类药物的处方模式和使用充分性
背景:降脂药物在主动治疗血脂异常中的作用和益处已经得到了很好的证实。然而,在常规临床实践中,这些药物是否按照最近的指南开处方,是否达到预期的效果,人们知之甚少。本研究的目的是评估三级医院他汀类药物的处方模式和使用的充分性。患者和方法:根据美国心脏协会2018年指南,年龄≥18岁有资格接受他汀类药物一级或二级预防治疗的患者纳入研究。回顾了所有病例的临床记录,以确定他汀类药物的适应症,并在基线和他汀类药物治疗3个月后进行了血脂分析。结果:男性140例,女性103例,平均年龄52.24±12.01岁。109例(44.9%)患者接受他汀类药物一级预防,134例(55.1%)患者接受他汀类药物二级预防。分别有179例(73.7%)和64例(26.3%)患者接受阿托伐他汀和瑞舒伐他汀治疗。81.9%的研究人群根据指南接受了他汀类药物治疗。他汀类药物治疗3个月后,一级预防组和二级预防组的血脂水平均有统计学上的显著变化。结论:在动脉粥样硬化性心血管疾病的一级和二级预防中,医生存在一些不合理的处方做法,影响了他汀类药物治疗的效果。有必要通过跟上最新的建议以及有效的患者咨询和教育来使处方实践合理化。
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