Evidence-based use of medications in patients with coronary artery disease in a rural Australian community

Abstract

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.

Design: A retrospective study.

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

Participants: 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.

Main outcome measures: 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.