Department of Clinical Pharmacy School of Pharmacy College of Medicine and Health Sciences University of Gondar Gondar Ethiopia.
Master's program in Health Economics, Policy and Management Department of Learning Informatics, Management and Ethics LIME Karolinska Institutet Solna Sweden.
Pharmacol Res Perspect. 2019 Apr 21;7(3):e00474. doi: 10.1002/prp2.474. eCollection 2019 Jun.
Investigating the prescribing trend is important to improve rational prescribing. This study aimed at assessing the cardiovascular drug use, pattern, and its impact on clinical outcome. A cross-sectional study was employed in the outpatient department of chronic illness clinic of Gondar University specialized hospital, Ethiopia from 15 January 2017 to 15 March 2017. The independent variables were sociodemographic, medication, and other clinical information while cardiovascular disease improvement is the outcome variable. Binary logistic regression was used to test the association between the independent variables and the outcome variable. Kaplan Meier curve was used to analyze the clinical improvement while the Log-rank test was employed to compare the clinical outcome with the number of medications. Eight hundred thirty-three cardiovascular patient medical records were included in the final analysis. The majority (62.5%) of patients were females and more than 61% were above 50 years of age. Diuretics monotherapy accounted for a third (33.6%) of cardiovascular drug use, followed by combination therapy of angiotensin convertase enzyme inhibitors with Diuretics (21.8%) and calcium channel blockers with diuretics (8.3%). Cardiovascular patients followed for 72 months found to have a good level of clinical improvement on combination medication (Log Rank of 28.9, = 0.000). In this study, diuretics monotherapy or in combination with angiotensin convertase enzyme inhibitors were found to be the frequently prescribed drugs in cardiovascular patients. Combination therapy has an implication for good cardiovascular improvement on long term follow-up. It seems clinicians were restricted to certain cardiovascular medications while plenty of choices are available from the diverse classes of cardiovascular drugs.
研究处方趋势对于改善合理处方至关重要。本研究旨在评估心血管药物的使用、模式及其对临床结果的影响。本研究采用横断面研究方法,于 2017 年 1 月 15 日至 3 月 15 日在埃塞俄比亚贡德尔大学专科医院慢性病门诊进行。自变量为社会人口统计学、药物和其他临床信息,而心血管疾病改善是结果变量。采用二元逻辑回归检验自变量与结果变量之间的关系。采用 Kaplan-Meier 曲线分析临床改善情况,采用 Log-rank 检验比较临床结果与用药数量。最终分析包括 833 份心血管患者病历。大多数(62.5%)患者为女性,超过 61%的患者年龄在 50 岁以上。利尿剂单药治疗占心血管药物使用的三分之一(33.6%),其次是血管紧张素转换酶抑制剂与利尿剂联合治疗(21.8%)和钙通道阻滞剂与利尿剂联合治疗(8.3%)。对随访 72 个月的心血管患者进行研究发现,联合用药具有良好的临床改善水平(Log Rank 为 28.9,=0.000)。在这项研究中,利尿剂单药治疗或与血管紧张素转换酶抑制剂联合使用是心血管患者经常开的药物。长期随访发现联合治疗对心血管改善有影响。似乎临床医生只限于某些心血管药物,而从心血管药物的不同类别中可以有更多的选择。