Manuscript for Review Process
DRUG UTILIZATION EVALUATION OF ANTICOAGULANTS AMONG IN-PATIENT IN A TERTIARY CARE TEACHING HOSPITAL
Abstract:
Introduction: Anticoagulants have a wide spectrum of use and associated risk with their therapy due to their narrow therapeutic range. This research aimed to evaluate the anticoagulants utilization, know how monitoring was done, calculate Prescribed Daily Dose (PDD) and average prescribed daily dose (PDD/DDD) of each anticoagulants, identify potential drug interactions and access average direct cost of anticoagulant per patient.
Method: A prospective observational study was conducted for six months from May to October 2019 among in-patients of cardiology ward of tertiary care teaching hospital, for their prescriptions containing anticoagulants.
Results: A total of 132 patients meeting inclusion criteria were enrolled in the study. Acute Coronary Syndrome (66.67%) being the common indication, Unfractionated Heparin + Enoxaparin (45.45%) and Enoxaparin (27.3%) were the frequently prescribed anticoagulants but not in dose range as defined by WHO. International Normalized Ratio (INR), Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT) and Renal function test were performed in majority of the patient (87.9% and 94.87% respectively) and as in ACCP guideline. Of the total 65 potential drug-drug interactions identified, Heparin was involved in 52 cases. Enoxaparin was
the most expensive of all the anticoagulants with Rs 9840.76 ($86.28), the average cost of anticoagulants per patient.
Conclusion: Acute coronary syndrome was the main indication and Enoxaparin, the costliest and most frequently prescribed anticoagulant among the entire patient population. Performance of the monitoring parameters were consistent with ACCP guideline.
Keywords:
Anticoagulants, Drug utilization, PDD, PT/INR/aPTT, Drug interactions, Cost analysis.
