Development of a Notification System on the Duration of Clopidogrel Prescribing in Patients with Coronary Artery Disease at Sawang Arom Hospital, Uthai Thani Province
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Abstract
Objective: To develop a notification system for the duration of clopidogrel prescribing according to the indications for patients with ischemic heart disease and to study the effect of the system on the consistency of clopidogrel prescribing with the recommendations in the clinical practice guidelines and the value of clopidogrel prescribed for more than 1 year. Methods: The study consisted of 2 parts. Part 1 was a retrospective study of patients with coronary artery disease who received clopidogrel by collecting the data from the electronic medical record database in the hospital or HOSxP program from January 1, 2021 to December 31, 2021. The data collected included the number of patients with clopidogrel prescribing consistent to the recommendation for each indication, dosage and instruction of use, number of pills prescribed exceeding one year, value of clopidogrel prescribed exceeding one year, and the duration of receiving dual antiplatelet therapy (DAPT). Part 2 studied the results of using the notification system on the duration of drug prescribing and the appropriateness of clopidogrel prescribing from February 1, 2022 to December 31, 2022. Results: After the implementation of the notification system, the percentage of patients who received clopidogrel consistent with the indications increased from 50.94 percent before system implementation to 82.1 percent after system implementation. The average duration of DAPT prescribing reduced from 25.23 months before the system implementation to 12.36 months. The number of pills prescribed exceeding the recommended duration reduced from 21,030 pills before the system implementation to 420 pills, resulting in a decrease in the value of drugs prescribed beyond the recommended duration from 73,605 baht to only 1,470 baht after the system implementation. Conclusion: The implementation of a notification system for the duration of clopidogrel prescribing according to the indications increases drug prescribing in accordance with indications and can reduce the cost of unnecessary drug use.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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