Tags

Type your tag names separated by a space and hit enter

Evidence-based medication use among Chinese patients with acute coronary syndromes at the time of hospital discharge and 1 year after hospitalization: results from the Clinical Pathways for Acute Coronary Syndromes in China (CPACS) study.
Am Heart J. 2009 Mar; 157(3):509-516.e1.AH

Abstract

BACKGROUND

Coronary heart disease has emerged as a leading cause of death in China. Although there is strong evidence for the use of antiplatelet, blood pressure-lowering, and lipid-lowering therapy in patients with acute coronary syndromes, the extent to which these medications are used in China remains uncertain.

METHODS

We conducted a multicenter prospective study using data from consecutive patients diagnosed with suspected acute myocardial infarction or unstable angina pectoris admitted to the inpatient wards during the recruitment period. Medication adherence and reasons for nonadherence were reported using standardized questionnaires. Logistic regression was used to identify important patient and hospital characteristics associated with use of medication at 6 and 12 months after hospital discharge.

RESULTS

The use of drug therapy was high (above 90% for aspirin, 70% for beta-blockers and angiotensin-converting enzyme inhibitors, 80% for statin) at the time of hospital discharge but decreased during follow-up. However, fewer than half (48%) of patients were discharged on 4-drug combination therapy (antiplatelet, beta-blocker, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, and statin), and the proportion remaining on this treatment 1 year after discharge was even lower (41%). In adjusted logistic regression analyses, medical insurance, dyslipidemia, hypertension, and administration of invasive therapy (percutaneous coronary intervention or coronary artery bypass graft) were important in determining use of treatment at discharge and during follow-up. In a substantial proportion of patients, medication was considered "not indicated" by the treating physician.

CONCLUSIONS

The findings highlight opportunities to improve the use and maintenance of appropriate combinations of evidence-based treatment among patients with acute coronary syndromes presenting to hospitals in China.

Authors+Show Affiliations

The George Institute for International Health, Sydney, Australia.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19249422

Citation

Bi, Yufang, et al. "Evidence-based Medication Use Among Chinese Patients With Acute Coronary Syndromes at the Time of Hospital Discharge and 1 Year After Hospitalization: Results From the Clinical Pathways for Acute Coronary Syndromes in China (CPACS) Study." American Heart Journal, vol. 157, no. 3, 2009, pp. 509-516.e1.
Bi Y, Gao R, Patel A, et al. Evidence-based medication use among Chinese patients with acute coronary syndromes at the time of hospital discharge and 1 year after hospitalization: results from the Clinical Pathways for Acute Coronary Syndromes in China (CPACS) study. Am Heart J. 2009;157(3):509-516.e1.
Bi, Y., Gao, R., Patel, A., Su, S., Gao, W., Hu, D., Huang, D., Kong, L., Qi, W., Wu, Y., Yang, Y., & Turnbull, F. (2009). Evidence-based medication use among Chinese patients with acute coronary syndromes at the time of hospital discharge and 1 year after hospitalization: results from the Clinical Pathways for Acute Coronary Syndromes in China (CPACS) study. American Heart Journal, 157(3), 509-e1. https://doi.org/10.1016/j.ahj.2008.09.026
Bi Y, et al. Evidence-based Medication Use Among Chinese Patients With Acute Coronary Syndromes at the Time of Hospital Discharge and 1 Year After Hospitalization: Results From the Clinical Pathways for Acute Coronary Syndromes in China (CPACS) Study. Am Heart J. 2009;157(3):509-516.e1. PubMed PMID: 19249422.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evidence-based medication use among Chinese patients with acute coronary syndromes at the time of hospital discharge and 1 year after hospitalization: results from the Clinical Pathways for Acute Coronary Syndromes in China (CPACS) study. AU - Bi,Yufang, AU - Gao,Runlin, AU - Patel,Anushka, AU - Su,Steve, AU - Gao,Wei, AU - Hu,Dayi, AU - Huang,Dejia, AU - Kong,Lingzhi, AU - Qi,Wenhang, AU - Wu,Yangfeng, AU - Yang,Yuejin, AU - Turnbull,Fiona, AU - ,, Y1 - 2008/12/17/ PY - 2008/04/26/received PY - 2008/09/26/accepted PY - 2009/3/3/entrez PY - 2009/3/3/pubmed PY - 2009/4/1/medline SP - 509 EP - 516.e1 JF - American heart journal JO - Am Heart J VL - 157 IS - 3 N2 - BACKGROUND: Coronary heart disease has emerged as a leading cause of death in China. Although there is strong evidence for the use of antiplatelet, blood pressure-lowering, and lipid-lowering therapy in patients with acute coronary syndromes, the extent to which these medications are used in China remains uncertain. METHODS: We conducted a multicenter prospective study using data from consecutive patients diagnosed with suspected acute myocardial infarction or unstable angina pectoris admitted to the inpatient wards during the recruitment period. Medication adherence and reasons for nonadherence were reported using standardized questionnaires. Logistic regression was used to identify important patient and hospital characteristics associated with use of medication at 6 and 12 months after hospital discharge. RESULTS: The use of drug therapy was high (above 90% for aspirin, 70% for beta-blockers and angiotensin-converting enzyme inhibitors, 80% for statin) at the time of hospital discharge but decreased during follow-up. However, fewer than half (48%) of patients were discharged on 4-drug combination therapy (antiplatelet, beta-blocker, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker, and statin), and the proportion remaining on this treatment 1 year after discharge was even lower (41%). In adjusted logistic regression analyses, medical insurance, dyslipidemia, hypertension, and administration of invasive therapy (percutaneous coronary intervention or coronary artery bypass graft) were important in determining use of treatment at discharge and during follow-up. In a substantial proportion of patients, medication was considered "not indicated" by the treating physician. CONCLUSIONS: The findings highlight opportunities to improve the use and maintenance of appropriate combinations of evidence-based treatment among patients with acute coronary syndromes presenting to hospitals in China. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/19249422/Evidence_based_medication_use_among_Chinese_patients_with_acute_coronary_syndromes_at_the_time_of_hospital_discharge_and_1_year_after_hospitalization:_results_from_the_Clinical_Pathways_for_Acute_Coronary_Syndromes_in_China__CPACS__study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-8703(08)00908-3 DB - PRIME DP - Unbound Medicine ER -