A Study on Antiplatelets and Anticoagulants Utilisation in A Tertiary Care Hospital

Abstract

Cardiovascular and cerebrovascular diseases were becoming predominant now a day due to the dramatic life style changes as well as the sedentary occupations in the people, which make them to find the medical interventions to prevent further morbidity and mortality. We explored the utilisation of antiplatelets and anticoagulants in the cardiovascular and non-cardiovascular indications by performing a prospective observational study using the patient medication records and through direct patient interview. About 131(65.5%) were males and elderly with occupation coolies in key share. Commonly observed modifiable risk factors were high blood pressure, alcohol, smoking, high blood sugar. Aspirin was the most commonly utilized drug in 146(61.86%) patients among antiplatelets followed by clopidogrel i.e., in 77(32.64%) patients. Combination of aspirin and clopidogrel was observed in the 4(87.25%) patients. Enoxaparin and acenocoumarol were the commonly utilized anticoagulants in 14(38.89%) and 13(36.12%) patients respectively. Combinations of the anticoagulants were preferred in only 7(3.5%) patients whereas combinations of antiplatelets along with anticoagulants were preferred in 20(10%) patients. Platelet count was the most commonly measured parameter compared to Bleeding time (BT), Clotting time (CT), Prothrombin time (PT), International normalized ratio (INR) and activated partial thromboplastin time (aPTT). In our study we have observed that use of antiplatelet and anticoagulants in high risk as well as contraindicated cases that have led to adverse outcomes. So the choice of therapy based on the patients risk status and comorbidities will aid in the better prognosis that can be possible through clinical pharmacist interventions along with physician.