| DOI: https://doi.org/10.14456/mujps.2016.17 | Pharm Sci Asia 2016; 43(3), 143-152 |
Adherence to clinical practice guidelines on prescribing for patients with acute coronary syndrome in Vietnamese hospital practice and its association with clinical outcomesM.L. Duong, Q.H. Nguyen, H.T. Nguyen*
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Medicine and Pharmacy, Ho Chi Minh city, Vietnam
Sufficient use of guideline-recommended medications reduced in-hospital and post-discharge mortality rates in acute coronary syndrome (ACS) patients. Little is known about prescribing patterns for ACS patients in Vietnam. The objectives of this study were to identify the extent of adherence to clinical guidelines on prescribing for ACS patients in Vietnamese hospitals and its association with patients’ mortality and re-admission rates within one month after discharge. The study was conducted at two large public hospitals in Ho Chi Minh city, Vietnam to include patients with ACS discharged between April and June 2015. Patients’ characteristics and details of medications prescribed were reviewed relying on prescribing indicators. The patients then were followed up for one month after discharge to collect information about clinical events. There were 106 ACS patients included (mean age of 64 years and 66.0% male). The percentages of patients receiving aspirin, P2Y12 inhibitors, dual antiplatelet therapy, or statins were high (around 90%). The prescribing of beta blockers was low (39.6% at arrival and 52.4% at discharge). The use of angiotensin converting enzyme inhibitors/angiotensin II receptor blockers was 62.1% at arrival and increased at discharge (91.8%). There were 16 patients loss to follow-up and 13 patients experienced clinical events. There has been no significant difference in one-month-after-discharge mortality and re-admission rates between patients receiving all guideline-recommended medications and those with fewer recommended medications. Overall, adherence to ACS guidelines in Vietnamese hospital practice was good. Large studies are needed to identify the association between full adherence to guideline-recommended medications and patients’ clinical events.
Keyword:
guideline adherence, prescribing indicators, acute coronary syndrome, Vietnam
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