Pharmaceutical care for patients with acute myocardial infarction in Hungary.

OBJECTIVE

To obtain informationon the main causatives of acute myocardialinfarction (AMI), the background needs to be analyzed. Our aim was to identify those pharmaceutical aspects of this polymorbidity where the pharmacist can contribute. Earlier and recent European and Hungarian studies show similar results: cardiovascular (CV) death is still the leading cause of mortality. The quality of life is much lower and life expectancy is shorter in the investigated Borsod-Abaúj Zemplén county population compared to the whole of the country. After pharmaceutical care has been defined, its role should be established.

METHODS

A retrospective hospital-based survey was carried out. Medical records of 659 patients treated for myocardial infarction at the 1st Department of Internal Medicine-Cardiology of Borsod-Abaúj-Zemplén County Hospital and University Hospital were analyzed. Data were obtained using the MedWorkS integrated hospital information system and were selected based on Social Security Number (TAJ) and The International Statistical Classification of Diseases and Related Health Problems (ICD). We focused on the therapy and medication of patients.

RESULTS

The obtained results are consistent with those of previous Hungarian studies (OLEF 2000) and statistical analyses. Based on the present study we suggest that pharmacists should work more closely with the medical staff. In studying the medication, we concentrated on antiplatelet therapy and studied the use of aspirin alone compared to aspirin plus clopidogrel. Of the 659 patients only 172 received aspirin as a preventive agent. We noticed that during this study only a low number of patients received ASA treatment and it could be seen in the outcome of the illness. We also found that dual antiplatelet therapy did not decrease the incidence of reinfarction in patients with AMI.

DISCUSSION

In this study the theory (guidelines, other studies) and the clinical practice of the therapy and medication of AMI were compared. ASA therapy did not produce any significant effect. Our results are similar to those studies which concluded that ASA did not decrease the risk of cardiovascular events.

CONCLUSION

Most patients with AMI suffer from polymorbidity. Since the occurrence of underlying chronic diseases is high, not only AMI must be treated, but therapy and medication must be complex. Complex therapeutic management is the key to the success of pharmaceutical care in the community pharmacy following hospital treatment.