Evaluation of the uses of aspirin, statins and ACEIs/ARBs in a diabetes outpatient population in southern Thailand.
OBJECTIVE
To evaluate the uses of aspirin, statins and angiotensin converting enzymes inhibitors/angiotensin receptor blockers (ACEIs/ARBs) in a diabetes population in southern Thailand.


METHODS
A review of outpatient medical records at the diabetic clinics of the regional hospital (n=304) and a community hospital (n=313), and a review of pharmacy computerized diabetes prescribing data (n=398) of the teaching hospital. All were in the province of Songkhla, southern Thailand.


RESULTS
A total of 1015 diabetes patients, mean age (SD) 60.1 (12.1) years, were identified, with type 2 diabetes being most prevalent (93%). Females constituted 69%. Hypertension was a co-morbidity in almost half. Mean time (SD) since diagnosis was 5.8 (4.7) years. Where lipid profiles were available, less than one-third achieved the target LDL-C of <2.6 mmol L(-1). Almost all patients (96%) were candidates for treatment with a statin according to the American Diabetes Association (ADA) recommendation, whereas only 6.6 and 38.5% were actually taking one in the regional and the teaching hospital, respectively. Over 90% should have been taking primary prophylactic aspirin, whereas only 5.7-29% were actually prescribed one. A few had existing cardiovascular/cerebrovascular disease, and all were taking aspirin. There was no documented proteinuria status; however, 30-50% were on a ACEI/ARB, most likely as part of an antihypertensive regimen.


CONCLUSIONS
Aspirin as a primary prophylaxis of cardiovascular disease in diabetes is remarkably underused. Screening for albuminuria was apparently lacking. Statin therapy also presented a major deficiency. ACEI/ARB was probably prescribed for hypertension rather than in relation to proteinuria.
Pongwecharak
J
J
Department of Clinical Pharmacy, Faculty of Pharmaceutical Science, Prince of Songkla University, Hatyai, Songkla, Thailand. pjurapor@pharmacy.psu.ac.th
Maila-ead
C
C
Sakulthap
J
J
Sripanitkulchai
N
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010045:Outpatients; D013785:Thailand
D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin