Exploring perceptions on polypharmacy and drug adverse effects in a sample of post myocardial infarction patients
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Date
2016-11-05
Authors
Jegavanthan, A.
Kogulan, T.
Bandara, H.G.W.A.P.L.
Kodithuwakku, N.W.
Hewarathna, U.I.
Karunaratne, R.M.S.P.
Ambagaspitiya, A.W.D.T.
Jayawickreme, S.R.
Journal Title
Journal ISSN
Volume Title
Publisher
University of Peradeniya, Sri Lanka
Abstract
Polypharmacy brings-about an imperative concern for patients’ safety and it has been linked with increased adverse drug reactions, morbidity and mortality with special reference to patients with multiple comorbidities. This study aims to evaluate the perception and patients’ concerns on polypahrmacy (≥ 4 drugs) and drug adverse effects (ADE) in patients who are receiving treatment for myocardial infarction (MI).
A cross sectional descriptive study was conducted at Cardiology unit, Kandy in 2015. Data was collected by interviewer administered questionnaire and by studying patients’ health records.
A total of 150 patients (81% males) with a mean age of 60±9 years were studied. The duration following MI ranged from 0.5 to 5 years. The prevalence of polypharmacy was 100%. The mean number of drugs in polymedicated patients was 7.5±1.6. Out of them 52.3% felt that they were taking a large number of medications. However 73% of them were comfortable with the number of medications they were taking and 87% of them were in a view that all their medications were essential. Only 38.3% had a good understanding of the reasons for prescribing each of their medications and 89% of them were willing to stop medications according to physicians’ decision without questioning. With respect to drug adverse effects, the prevalence of aspirin associated Gastro-esophageal reflux disease (GORD) was 41%. Major and minor bleeding was observed in 1% and 6% patients respectively. Statin related muscle diseases were observed in 26% and nitrates associated headache was reported by 4.3%. There were 14% of patients who complained of angiotensin converting enzyme inhibitor associated cough.
Prevalence of polyparmacy is high among the post MI population despite having less ADE. Majority is in acceptance of taking many drugs and they are totally dependent on the physician for decision making. Hence, physicians should bear these considerations in mind before each prescription and review all medications used at each visit to avoid unnecessary addictions or hazardous drug interactions.
Description
Keywords
Polypharmacy , Myocardial infarction
Citation
Proceedings of the Peradeniya University International Research Sessions (iPURSE) – 2016, University of Peradeniya, P 179