title: Secondary prevention therapies for coronary heart disease in patients with type 2 diabetes: an audit.
abstract: BACKGROUND
  Use of evidence based pharmacotherapy reduces risk of secondary events in patients with established coronary heart disease (CHD). To determine frequency of their use in diabetic CHD we performed prescription audits.
  
  
  METHODS
  Frequency of prescriptions of aspirin, beta-blockers, angiotensin converting enzymes inhibitors (ACEI) or angiotensin receptor blockers (ARB), lipid-lowering medicines, and other drugs in CHD patients at primary, secondary and tertiary levels of care in out-patients' departments in Rajasthan was determined. Patients' and physicians' demographic details and prescribing patterns were obtained. Descriptive statistics are reported.
  
  
  RESULTS
  We audited prescriptions of 2290 CHD patients aged 60.9 +/- 8.7 years. There were 1033 patients of CHD with diabetes (45.1%, age 61.9 +/- 8.6) and 1257 without (54.9%, age 59.9 +/- 8.9). In CHD patients with diabetes vs. without, use of beta blockers was lower (59.4 vs 69.2%) while ACEI/ARB (86.5 vs 82.1%) and statins (67.1 vs 59.7%) greater. Use of other drugs such as aspirin (88.7 vs 88.3%), fibrates (11.9 vs 11.1%), non-dihydropyridine CCB (16.0 vs 17.9%) and nitrates (38.8 vs 14.5%) was similar. Use of beta blockers was lowest among diabetologists (37.6%) as compared to other physicians (64.4%) and cardiologists (59.4%) and was the lowest in primary care.
  
  
  CONCLUSIONS
  Low use of beta-blockers is observed in diabetic CHD patients.
authors.affiliation: Department of Medicine and Research, Fortis Escorts Hospital, Jaipur 302017, India.
authors.forename: Krishna Kumar
authors.initials: KK
authors.lastname: Sharma
authors.forename: Soneil
authors.initials: S
authors.lastname: Guptha
authors.forename: Rajeev
authors.initials: R
authors.lastname: Gupta
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D011307:Drug Prescriptions; D005260:Female; D058607:Fibric Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009566:Nitrates / Q000627:therapeutic use; D055502:Secondary Prevention
chemical_list: D000319:Adrenergic beta-Antagonists; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D058607:Fibric Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D009566:Nitrates; D001241:Aspirin