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

Objective: To evaluate the evidence-based prescription 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 (NSW). Participants: Includes 24 male and 25 female, with an age average of 77.2 ± 7.5 year, range 60-96 years. All patients were over eighteen years old with coronary artery disease (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 (ACEI) or angiotensin receptor blocker (ARB), 39% with beta-blockers, 29% with short-acting nitrates, and 59% with statins. The prescription of these major drug groups remained unchanged at discharge (P>0.05). Of the 23 patients with hypertension at admission, blood pressure was controlled in 7 (30%) before discharge. Potential drug interactions were identified in 37% of the patients. Non-steroidal-anti-inflammatory-drugs (NSAIDs) were used in 7 (14%) patients. Conclusions: The use of aspirin, ACEI/ARB, 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.