Yaman Walid Kassab, Yahaya Hassan, Noorizan Abd Aziz, Omar Ismail
Background: Despite the availability of various prevention guidelines on coronary artery disease, secondary prevention practice utilizing aspirin, beta-blockers, angiotensin converting enzyme inhibitors and statins still can be sub-optimal.
Objective: In this study, we aimed to assess the guideline adherence of secondary prevention prescribing and the continuity of adherence for a 17-month period in a small cohort of patients angiographically diagnosed to have acute coronary syndrome (ACS).
Method: In this prospective study, 190 patients who were angiographically diagnosed to have ACS were followed up for 17 months. The baseline demographic, clinical and drug data were collected at the day of discharge. All patients were followed up for three scheduled follow-up cardiac clinic visits (17 months period). After each clinic visit, Outpatient Medical Progress Notes (OMPN) were reviewed and prescribed treatments were recorded.
Results: The ‘initial prescribing rate’ at discharge was found to be 98% for statins, 95.3% for aspirin, 87.2% for beta blockers, 73.8% for ACE inhibitors and 60% for all these medications in combination. ‘Continuity of prescribing’ for 2 years was 92.7% for aspirin, 89.3% for statins, 69.3% for beta-blockers, 58.7% for ACE inhibitors and 32.7% for all these medications in combination.
Conclusions Besides the sub-optimal prescribing of secondary prevention drugs, absence of continuity of prescribing seems to be a challenging issue in pharmaceutical care of coronary artery disease patients.
