DRUG UTILIZATION STUDY IN THE PATIENTS OF MYOCARDIAL INFARCTION AT A TERTIARY CARE HOSPITAL
DOI:
https://doi.org/10.22159/ijcpr.2026v18i2.8077Keywords:
Drug utilization, Cardiology, MI, Fibrinolytic, AnticoagulantAbstract
Objective: To evaluate the pattern of drug utilization, demographic characteristics, routes of administration, duration of hospital stay, and clinical outcomes in patients with myocardial infarction admitted to a tertiary care hospital.
Methods: This was a hospital-based observational study conducted over a period of six months in the Pharmacology Department in coordination with the Cardiology Department of a tertiary care hospital in southern Rajasthan. A total of 100 patients with confirmed diagnosis of myocardial infarction were included. Data regarding demographics, drug prescriptions from admission to discharge, routes of administration, fixed-dose combinations, and clinical outcomes were collected from inpatient records and analysed descriptively.
Results: The majority of patients were aged 61–70 y (37%), followed by 51–60 y (32%), with a marked male predominance (82%). Most patients recovered (93%), while in-hospital mortality was 7%. Combination routes of drug administration (oral, sublingual, and parenteral) were used in 84% of patients. Half of the patients had a hospital stay of 3–4 d. Antiplatelet drugs were prescribed to 99% of patients, with dual antiplatelet therapy being most common (73%). Statins (94%), beta-blockers (88%), anticoagulants (85%), and nitrates (89%) were widely used. Proton pump inhibitors were prescribed to all patients, while antibiotics were used in 51%. Fixed-dose combinations, particularly aspirin with clopidogrel and statins, were frequently prescribed.
Conclusion: The study demonstrates a high level of adherence to evidence-based guidelines in the pharmacological management of myocardial infarction at the tertiary care hospital. The prescribing pattern reflects rational use of essential cardiovascular drugs and effective acute management, as evidenced by favourable clinical outcomes. However, the use of certain non-cardiac medications highlights the need for regular prescription audits to further promote rational drug use.
Downloads
References
1. Lunde PK, Baksaas I. Epidemiology of drug utilization: basic concepts and methodology. In: WHO international working group for drug statistics methodology, who collaborating centres for drug utilization research & clinical pharmacological services. Introduction to drug utilization research. Acta Med Scand Suppl. 2003;721:7–11.
2. Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533-43. PMID 2316538.
3. Malik MA, Alam Khan S, Safdar S, Taseer IU. Chest pain as a presenting complaint in patients with acute myocardial infarction (AMI). Pak J Med Sci. 2013 Apr;29(2):565-8. doi: 10.12669/pjms.292.2921, PMID 24353577.
4. Sachdeva P, Kaur K, Fatima S, Mahak FN, Noman M, Siddenthi SM. Advancements in myocardial infarction management: exploring novel approaches and strategies. Cureus. 2023 Sep;15(9):e45578. doi: 10.7759/cureus.45578, PMID 37868550.
5. Jia S, Liu Y, Yuan J. Evidence in guidelines for treatment of coronary artery disease. Adv Exp Med Biol. 2020;1177:37-73. PMID 32246443. doi: 10.1007/978-981-15-2517-9_2, PMID 32246443.
6. Jain S, Upadhyaya P, Goyal J, Kumar A, Jain P, Seth V. A systematic review of prescription pattern monitoring studies and their effectiveness in promoting rational use of medicines. Perspect Clin Res. 2015;6(2):86-90. doi: 10.4103/2229-3485.154005, PMID 25878953.
7. Xavier D, Pais P, Devereaux PJ, Xie C, Prabhakaran D, Reddy KS. Treatment and outcomes of acute coronary syndromes in India (CREATE): a prospective analysis of registry data. Lancet. 2008;371(9622):1435-42. doi: 10.1016/S0140-6736(08)60623-6, PMID 18440425.
8. Gupta R, Mohan I, Narula J. Trends in coronary heart disease epidemiology in India. Ann Glob Health. 2016;82(2):307-15. doi: 10.1016/j.aogh.2016.04.002, PMID 27372534.
9. Yahagi K, Kolodgie FD, Otsuka F, Finn AV, Davis HR, Joner M. Pathophysiology of native coronary vein graft and in-stent atherosclerosis. Nat Rev Cardiol. 2016;13(2):79-98. doi: 10.1038/nrcardio.2015.164, PMID 26503410.
10. Raja S, Mohapatra S, Kumar JS, Rani RJ. Prescription patterns of hypolipidaemic drugs in a tertiary care teaching hospital of southern India. J Clin Diagn Res. 2014;8(4):HC01-3. doi: 10.7860/JCDR/2014/8010.4206, PMID 24959461.
11. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli Ducci C, Bueno H. ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation the task force for the management of acute myocardial infarction in patients presenting with st-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2018;39(2):119-77.
12. O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, De Lemos JA. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American college of cardiology foundation/American Heart Association task force on practice guidelines. Circulation. 2013;127(4):e362-425. doi: 10.1161/CIR.0b013e3182742cf6, PMID 23247304.
13. Kumar A, Mishra P, Singh S. Evaluation of prescribing pattern in patients of myocardial infarction. Int J Basic Clin Pharmacol. 2016;5(3):829-34.
14. Subramanian T, Ganesan A, Kumar S. Clinical profile and in-hospital outcome of acute myocardial infarction. Indian Heart J. 2015;67(3):289-94.
15. Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American college of cardiology/American Heart Association task force on practice guidelines. Circulation. 2014;129(25 Suppl 2):S1-45. doi: 10.1161/01.cir.0000437738.63853.7a, PMID 24222016.
16. Lalan HN, Lalan H, Devpura G. Drug utilization study in intensive cardiac care unit. Int J Pharm Sci Res. 2014;5(1):215-20.
Published
How to Cite
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.