Key result
Combination cardiovascular therapy is linked to significantly higher clinical improvement over monotherapy.
Why the study?
Investigating prescribing trends is important to improve rational prescribing, leading the authors to assess cardiovascular drug use patterns and their impact on clinical outcomes.
What are the prescribing patterns of cardiovascular medications and how does combination therapy versus monotherapy impact clinical improvement in outpatients with cardiovascular disease at an Ethiopian university hospital?
Cross-Sectional (n=833)
No
What are the prescribing patterns of cardiovascular medications and how does combination therapy versus monotherapy impact clinical improvement in outpatients with cardiovascular disease at an Ethiopian university hospital?
Answers are grounded in this paper and cite their sources.
In an Ethiopian tertiary care outpatient cohort, cardiovascular prescribing relied heavily on diuretic-based regimens (monotherapy or combined with ACE inhibitors), and combination therapy was associated with superior long-term clinical improvement over 72 months.
Investigating the prescribing trend is important to improve rational prescribing. This study aimed at assessing the cardiovascular drug use, pattern, and its impact on clinical outcome. A cross‐sectional study was employed in the outpatient department of chronic illness clinic of Gondar University specialized hospital, Ethiopia from 15 January 2017 to 15 March 2017. The independent variables were sociodemographic, medication, and other clinical information while cardiovascular disease improvement is the outcome variable. Binary logistic regression was used to test the association between the independent variables and the outcome variable. Kaplan Meier curve was used to analyze the clinical improvement while the Log‐rank test was employed to compare the clinical outcome with the number of medications. Eight hundred thirty‐three cardiovascular patient medical records were included in the final analysis. The majority (62.5%) of patients were females and more than 61% were above 50 years of age. Diuretics monotherapy accounted for a third (33.6%) of cardiovascular drug use, followed by combination therapy of angiotensin convertase enzyme inhibitors with Diuretics (21.8%) and calcium channel blockers with diuretics (8.3%). Cardiovascular patients followed for 72 months found to have a good level of clinical improvement on combination medication (Log Rank of 28.9, P = 0.000). In this study, diuretics monotherapy or in combination with angiotensin convertase enzyme inhibitors were found to be the frequently prescribed drugs in cardiovascular patients. Combination therapy has an implication for good cardiovascular improvement on long term follow‐up. It seems clinicians were restricted to certain cardiovascular medications while plenty of choices are available from the diverse classes of cardiovascular drugs.
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Tefera et al. (2019) conducted a cross-sectional in Cardiovascular diseases (primarily hypertension, heart failure, and rheumatic valvular heart disease) (n=833). Combination cardiovascular drug therapy (primarily ACE inhibitors with diuretics or CCBs with diuretics) vs. Cardiovascular drug monotherapy (primarily diuretics monotherapy) was evaluated on Clinical improvement on last follow-up as assessed by physician (good/fair prognosis clinically and in laboratory parameters) (p=0.000). Combination cardiovascular medication was associated with significantly better clinical improvement over 72 months compared to monotherapy (Log-rank 28.9, P=0.000), with 86.6% overall improvement.
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