gms | German Medical Science

Context: Modifications in pharmaceutical treatment can occur at various extent and different stages in the course of continued medical care.

Aim of the study: This study examines changes in medication with therapeutic guideline recommendation of patients with acute coronary syndromes over a six-months period.

Material and method: A health diary covering health condition and medication was filled in on a weekly basis during a six-months period by n = 104 patients (73% male, average age = 62 years) initially hospitalised with acute coronary syndromes in the Cologne area (Germany). Changes in medication between hospital discharge, week 2, week 12 and week 24 were determined.

Results: 66% of patients showed 5 different diseases (ICD-10 diagnoses) at hospital discharge (Minimum = 1, Maximum = 9). Patients took on average 6 drugs per day within the observation period (Minimum at week 24 = 0, Maximum at week 24 = 14). Few changes in medication were observed in a population based approach: e.g. 56% of patients received clopidogrel at hospital discharge, while 43% obtained it at week 24. 85% of patients received acetylsalicylic acid at hospital discharge and 78% at week 24. Variation in prescription were determined on the individual level: e.g. 64% of those patients that received clopidogrel at hospital discharge continuously obtained it until week 24 and 86% of patients that obtained acetylsalicylic acid at hospital discharge still obtained it at week 24.

Conclusion: Many patients were treated with polypharmacy due to the relative high percentage of patients suffering from multimorbidity. Though few changes in medication were observed during continued medical care in a population based approach over a six-months period. However, broader variation in medication was determined on the individual level. Despite the variation in prescription in the individual therapy, the overall prescription behaviour of physicians showed a good implementation of therapeutic guidelines.