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冠心病二级预防药物应用的五年随访

Five-year follow-up of drug utilization for secondary prevention in coronary artery disease.

作者信息

Apikoglu Rabus Sule, Izzettin Fikret V, Sancar Mesut, Karakaya Osman, Kargin Ramazan, Yakut Cevat

机构信息

Clinical Pharmacy Department, Faculty of Pharmacy, Marmara University, Tibbiye Cd. Haydarpasa, 34668 Istanbul, Turkey.

出版信息

Pharm World Sci. 2008 Dec;30(6):753-8. doi: 10.1007/s11096-008-9234-3. Epub 2008 Jun 19.

Abstract

OBJECTIVE

Despite the availability of various prevention guidelines on coronary artery disease, secondary prevention practice utilizing aspirin, beta-blockers, angiotensin converting enzyme inhibitors and statins still can be sub-optimal. In this study, we aimed to assess the guideline adherence of secondary prevention prescribing and the continuity of adherence for a 5-year period in a small cohort of patients angiographically diagnosed to have coronary artery disease.

METHOD

In this prospective study, 73 patients who were angiographically diagnosed to have CAD were followed up for 5 years. The baseline demographic and clinical data were collected just before angiography. The baseline drug data were collected at the day of discharge. The fifth year data were taken from the patients via face-to-face consultations or phone interviews.

RESULTS

The 'initial prescribing rate' at discharge was found to be 82% for aspirin, 49% for statins, 44% for ACE inhibitors and 55% for beta-blockers. 'Continuity of prescribing' for 5 years was 45% for aspirin, 26% for statins, 17% for ACE inhibitors and 20% for beta-blockers.

CONCLUSIONS

Besides the sub-optimal prescribing of secondary prevention drugs, absence of continuity of prescribing seems to be a challenging issue in pharmaceutical care of coronary artery disease patients.

摘要

目的

尽管有各种关于冠状动脉疾病的预防指南,但利用阿司匹林、β受体阻滞剂、血管紧张素转换酶抑制剂和他汀类药物进行二级预防的实践仍可能不够理想。在本研究中,我们旨在评估一小群经血管造影诊断患有冠状动脉疾病的患者在二级预防用药方面对指南的遵循情况以及5年期间用药依从性的持续性。

方法

在这项前瞻性研究中,对73名经血管造影诊断患有冠心病的患者进行了5年的随访。在血管造影前收集基线人口统计学和临床数据。在出院当天收集基线用药数据。通过面对面咨询或电话访谈从患者处获取第5年的数据。

结果

出院时阿司匹林的“初始处方率”为82%,他汀类药物为49%,血管紧张素转换酶抑制剂为44%,β受体阻滞剂为55%。阿司匹林5年的“处方持续性”为45%,他汀类药物为26%,血管紧张素转换酶抑制剂为17%,β受体阻滞剂为20%。

结论

除了二级预防药物的处方不够理想外,处方缺乏持续性似乎是冠心病患者药物治疗中的一个具有挑战性的问题。

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