Appropriateness and Efficacy of Atorvastatin Prescribing in Outpatients at U-thong Hospital

Abstract

Background: Atorvastatin is a statin drug that is effective in treating dyslipidemia and reducing cardiovascular disease. According to prescription data from U-thong Hospital, the number of prescriptions for atorvastatin continues to increase and was the most commonly prescribed drug in 2021–2022, with a value of 2,374,833 baht and 2,637,646 baht, respectively.

Objective:  To study the appropriateness of prescribing atorvastatin and its effectiveness in regulating blood lipid levels in outpatients with dyslipidemia.

Methods: This was a retrospective review of electronic medical records. The sample group consists of outpatients with dyslipidemia who took atorvastatin for the first time at U-Thong Hospital from October 1, 2021, to September 30, 2022. Descriptive statistics were used to analyze individual data and assess the appropriateness of the atorvastatin prescription, and inferential statistics were used to compare differences between mean lipid levels before and after taking atorvastatin.

Results: The results showed that there were 94 outpatients with dyslipidemia who met the inclusion criteria. Most of the patients used atorvastatin as primary prevention rather than secondary prevention of cardiovascular disease, accounting for 89.4% and 10.6%, respectively. This indicates an appropriate use rate of 60.7% for primary prevention and 100% for secondary prevention. Atorvastatin was statistically effective in reducing LDL-C levels with a p-value <0.05. Atorvastatin 20 mg reduced LDL-C levels by an average of 20.08% while atorvastatin 40 mg reduced LDL-C levels by an average of 38.73%. When monitoring adverse drug reactions with atorvastatin, no adverse drug reactions occurred in any patient taking atorvastatin 20 mg or 40 mg. However, the achievement rates of LDL-C goals in primary and secondary prevention were 60.7% and 20%, respectively.

Conclusion: The rationality of the initial prescription of atorvastatin for the primary and secondary prevention of cardiovascular disease is more than 60%. Atorvastatin is effective in lowering LDL-C levels. Atorvastatin 40 mg lowers LDL-C levels more than atorvastatin 20 mg. Adverse drug reactions were not found.