CLOPIDOGREL USE - ARE WE FOLLOWING THE GUIDE LINES?

Abstract

Objective: To see the prescription patterns of clopidogrel in the outpatientdepartment of a tertiary care hospital.

Methodology: This descriptive cross-sectional study was conducted at ArmedForces Institute of Cardiology and National Institute of Heart DiseasesRawalpindi, from 1st February 2012 to April 2012, after approval from Ethicalreview board of the institute. A structured team of MBBS doctors was created toconduct the study. Data on clopidogrel prescriptions was collected from thepharmacy where their source notes were assessed and patients takingclopidogrel were identified.

Results: The study population consisted of 2263 patients. The age of patientsranged from 25 to 93 years with the mean of 60.45 years ± 9.969. The standardindications found for clopidogrel prescription included ST elevation MI (STEMI) in582 (25.7%), Non-ST elevation MI (NSTEMI) in 130 (5.7%), percutaneouscoronary interventions (PCI) in 703 (31.1 %), CABG in 300 (13.3%), stroke/TIA in60 (2.6 %) and atrial fibrillation in 15 (0.66%). These standard indicationsconstituted 79.09% of prescription. The duration of clopidogrel use ranged from1 year to maximum of 10 years with mean of 3.38 ± 2.13 years. Patients whohad suffered a NSTEMI 84.6%, and 84.3% who had suffered a STEMI more than 1year ago were still receiving clopidogrel.

Conclusion: We concluded that indications for which clopidogrel wereprescribed to most patients were according to recommended internationalguidelines. But duration of its use is not according to guideline directed medicaltherapy.