Medication after hospitalization for acutecoronary syndrome

BACKGROUND AND OBJECTIVE: This studyexamines drug changes from therapeutic medication given during hospitalizationto that in further out-of-hospital treatment prescribed by medical practitionersof patients with acute coronary syndrome. The main focus of thistrial was to demonstrate any change in such medication after hospitaldischarge. PATIENTS AND METHODS: During a six-monthperiod a "health diary" covering health statusand medication was filled in weekly by 104 patients who had beenhospitalized for acute coronary syndrome in the Cologne area ofGermany. The mean age of the patients was 62 years and 76 (73%)of them were men. Changes in medication between hospital dischargeand further treatment were recorded. Prescribed daily doses andguideline-recommended daily doses were compared for each drug class. RESULTS: Changes in medication werenot observed in a population-based approach but occurred on an individualpatient's level in 40% of them when only those drugs recommendedin therapeutic guidelines were analysed. A fifth more lipid-loweringdrugs and over a third more beta-blockers had been prescribed thanrecommended in the appropriate guidelines. For other groups of drugsno significant deviations from guideline recommendations were noted. DISCUSSION: No obvious interface problembetween hospital and further-treatment medication was observedin a population-based approach. However, variations in medicationwere found when drug prescriptions of individual patients were compared Butdespite these variations in individual patient the overall prescribingpractice by physicians out of hospital showed good implementationof the therapeutic guidelines.