Evaluation on the Drug Use for Cardiovascular Disease Before and After Evidence-Based Practice_Chinese Journal of Evidence-Based Medicine

Authors：

SHU Defen , DONG Birong

Department of Geriatrics; West China Hospital; Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Cardiovascular disease treatment; Rational drug use; Evidence-based practice

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Objective 　To evaluate the rationality of drug treatment for cardiovascular diseases in aged people and the effects of evidence-based practice.
Methods 　Descriptive study was conducted to compare the therapies for the patients suffering from cardiovascular diseases before and after evidence-based practice by investigating drug use during 1998-1999 (211 cases) and 2002-2003 (211 cases).
Results 　Among antihypertensive drugs, the ACEIs and diuretics played a more important role than before. CCBs and ACEIs were still the most frequently used drugs, and drug combination was more common, comparing to that before evidence-based practice. Lipid lowering drugs and ACEIs were used more common in coronary heart disease. Quality of life of patients was more emphasized and combination use of anti-anxiety drugs was adopted. When treating heart failure, β-receptor blockers, aldadinc and ACEIs were more frequently used.
Conclusions 　After evidence-based practice, drug use is much more based on evidence instead of experience and textbook. As a result, the rate of reaching ideal blood pressure is higher than before. The rate of rational drug use before and after evidence-based practice has increased from 42% to 78%, respectively.

Citation： SHU Defen,DONG Birong. Evaluation on the Drug Use for Cardiovascular Disease Before and After Evidence-Based Practice. Chinese Journal of Evidence-Based Medicine, 2004, 04(5): 314-317. doi: Copy

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1. ［1］Lewis EJ, Hunsicker LG, Clarke WR, Berl T, Pohl MA,Lewis JB, Ritz E, Atkins RC, Rohde R, Raz I; Collaborative Study Group. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes [J ]. N Engl J Med, 2001; 345 ( 12 ): 851 -860.
2. ［2］Carroll CA, Coen MM, Rymer MM. Assessment of the effect of ramipril therapy on direct health care costs for first and recurrent strokes in high-risk cardiovascular patients using data from the Heart Outcomes Prevention Evaluation ( HOPE )study[J]. Clin Ther, 2003; 25(4):1 248- 1 261.
3. ［3］Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial Collaborative Research Group. Diuretic versus alpha-blocker as first-step antihypertensive therapy: final results from the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial ( ALLHAT ) [ J ]. Hypertension, 2003; 42(3) :239 -246.
4. ［4］Blood pressure in Acute Stroke Cllaboration(BASC). Interventions for deliberately altering blood pressure in acute stroke.(systematic review) [ CD/M]. The Cochrane Library 2003,Issue 4.
5. ［5］Marz W, Wieland H. HMG-CoA reductase inhibition: antiinflammatory effects beyond hpid lowering[J] .9 Herz, 2000;25(2) :117 -125.
6. ［6］The Care Investigators. Reduction of stroke incidence after myocardial infarction with pravastatin: the Cholesterol and Recurrent Events (CARE) study [J]. Circulation, 1999; 99(2) :216 -223.
7. ［7］Coumadin Aspirin Re-infarction Study(CHRS) Investigators.Randomized double-blind trial of fixed low dose warfarin with aspirin after myocardial infarction [ J ]. Lancet, 1997; 350 ( 9049) :375 -380.
8. ［8］Antithrombotic Trialists’ Collaboration. Collaborative mete-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients [J]. BMJ, 2002; 324(7 329) :71 -86.
9. ［9］Magee KD, Sevcik W, Moher D, Rowe BH. low molecular weight heparins versus unfractionated heparin for acute coronary syndromes( systematic review) [ CD/M ]. the Cochrane Library 2003, Issue 4.
10. ［10］Swenson JR, O’ Connor CM, Barton D, Van Zyl LT,Swedberg K, Forman LM, Gaffney M, Glassman AH; Sertraline Antidepressant Heart Attack Randomized Trial (SADHART) Group. Influence of depression and effect of treatment with sertraline on quality of life after hospitalization for acute coronary syndrome [J]. Am J Cardiol, 2003; 92(11) :1 271 -1 276.
11. ［11］Mitchell PH, Powell L, Blumenthal J, Norten J, Ironson G,Pitula CR, Froelicher ES, Czajkowski S, Younghlood M,Huber M, Berkman LF. A Short Social Support Measure for Patients Recovering From Myocardial Infarction: the ENRICHD Social Support Inventory[J]. J Cardiopulm Rehabil,2003 ;23(6) :398 -403.
12. ［12］Hood WB Jr, Dans AL, Guyatt GH, Jaeschke R, McMurray JJV. Digitalis for treatment of congestive heart failure in patients in sinus rhythm (systematic review) [ CD/M]. the Cochrane Library 2003, Issue 4.
13. ［13］Berkow R, Editor-in-Chief. Fletcher AJ, Chir B, Assistant Editor. The Merck Manual of Diagnosis and Therapy [ C ].In: Cardiovascular Disorders, Section 3, Chapter 25 Heart Failure . 16 Ed. Rahway: Published by Merck Research Laboratories Division of Merck & Co, 1992:445 - 446.

Chinese Journal of Evidence-Based Medicine

Evaluation on the Drug Use for Cardiovascular Disease Before and After Evidence-Based Practice

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