Evidence-based use of medications in patients with coronary artery disease in a rural Australian community.
OBJECTIVE
To evaluate the evidence-based use of major drug groups for coronary artery disease (CAD) in patients with chronic heart failure and to identify potential interactions.


METHODS
A retrospective study.


METHODS
A major non-metropolitan teaching hospital in rural New South Wales.


METHODS
Includes 24 men and 25 women, with an age average of 77.2 +/- 7.5 years, range 60-96 years. All patients were over 18 years old with CAD and heart failure.


METHODS
The evidence-based use of medications and potential drug interactions.


RESULTS
On admission, 71% were treated with aspirin/clopidogrel, 71% with angiotensin-converting enzyme inhibitors or angiotensin receptor blocker, 39% with beta-blockers, 29% with short-acting nitrates and 59% with statins. The use of these medications remained unchanged at time of discharge (P > 0.05). Of the 23 patients with hypertension at admission, blood pressure was controlled in seven (30%) before discharge. Potential drug interactions were identified in 37% of the patients. Non-steroidal anti-inflammatory drugs were used in seven (14%) patients.


CONCLUSIONS
The use of aspirin, angiotensin-converting enzyme inhibitors/angiotensin receptor blocker, beta-blockers, short-acting nitrate and statins in patients with CAD compares favourably with international literatures. However, there is room for improvement in the use of beta-blockers and statins. A greater effort needs to be made to prevent clinically significant drug interactions.
Granmyr
Jenny
J
Department of Pharmaceutical Biosciences, Division of Pharmacokinetics and Drug Therapy, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden.
Ball
Patrick
P
Curran
Shane
S
Wang
Lexin
L
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D004347:Drug Interactions; D019317:Evidence-Based Medicine / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D006780:Hospitals, Rural; D006784:Hospitals, Teaching; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D019035:Rural Health Services / Q000706:statistics & numerical data*
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002316:Cardiotonic Agents; D002317:Cardiovascular Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin