Prescription audit of antihypertensive drugs used in stroke patients in a tertiary care teaching hospital

B. Shaji, Jereena George, Aishwarya Shrestha, S. Stanly, N. Bose
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Abstract

Background: Stroke is considered as one of the important reasons of death and disability worldwide. A rational use of medications is needed to prevent the recurrence and the disease related complications.Methods: The current study is a prospective observational study. All stroke cases, with patients above the age of 25 and treated with antihypertensive agents were included in the study. A total of 189 patients were found suitable for inclusion in the study. Using a suitably designed data collection form, all pertinent data such as patient demographics, prescribed medicines, drug interactions and adverse drug reactions were collected from the patient’s case file, nurses’ charts, and medication charts. Prescription pattern of antihypertensive drugs were obtained. The causality of the ADR was assessed using the Naranjo causality assessment scale and reported in the institution where the study was conducted.Results: Majority of patients included in the study were in the age group of 61-70 years. The incidence of stroke in this study was more in males than in the females. Ischemic stroke (72%) was more prevalent when compared to Hemorrhagic stroke. Among the antihypertensive agents, calcium channel blockers (32%) were the most commonly prescribed class of drugs. In our audit, drug related problems were observed in 27% of the cases which included cases with improper dose (3 cases), contraindications (4 cases), major drug interactions (20 cases), and adverse drug reactions (17 cases). Most of the prescriptions were legible. Drug related problems had a great impact on the overall stroketherapy.Conclusions: The drug related problems are a relevant aspect to be considered when treating patients with stroke and it can arise irrespective of adherence to guidelines.
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某三级教学医院脑卒中患者降压药处方审核
背景:脑卒中被认为是世界范围内死亡和残疾的重要原因之一。合理用药,预防复发及相关并发症的发生。方法:本研究为前瞻性观察性研究。所有年龄在25岁以上并接受降压药治疗的脑卒中病例均被纳入研究。共有189名患者被发现适合纳入研究。使用适当设计的数据收集表,从患者病例档案、护士图表和用药图表中收集所有相关数据,如患者人口统计数据、处方药物、药物相互作用和药物不良反应。获得降压药处方模式。不良反应的因果关系采用纳兰霍因果关系评估量表进行评估,并在开展研究的机构报告。结果:纳入研究的大多数患者年龄在61-70岁之间。在这项研究中,男性中风的发病率高于女性。缺血性中风(72%)比出血性中风更普遍。在降压药中,钙通道阻滞剂(32%)是最常用的处方类药物。在我们的审核中,有27%的病例存在与药品有关的问题,其中剂量不当(3例)、禁忌症(4例)、重大药物相互作用(20例)、药物不良反应(17例)。大多数处方都是可读的。药物相关问题对整个中风治疗有很大的影响。结论:药物相关问题是卒中患者治疗时需要考虑的一个相关方面,无论是否遵守指南,都会出现药物相关问题。
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