الملخص الإنجليزي
Objectives: Angiotensin Receptor Blockers such as Valsartan,
are a newer class of drugs associated with significant reductions
in cardiovascular morbidity and mortality. They are commonly
used in hypertension, chronic heart failure, diabetes-related
nephropathy and post-myocardial infarction in patients who are
intolerant to Angiotensin Converting Enzyme inhibitors (ACEi).
A review of medicines used in Royal Hospital (an Omani tertiary
health care centre) during 2004 and 2005 showed that Valsartan
was one of 20 most expensive drugs used. The main objective of
this study was to evaluate the pattern of prescribing valsartan in
out-patient clinics.
Methods: a retrospective study, applying medicines use evaluation,
to describe the pattern of prescribing Valsartan in comparison
with international guidelines. The study carried out in the
outpatient pharmacy setting, Royal Hospital from 15th May
to 30th June 2006. It included 120 adult patients who had been
prescribed Valsartan at the outpatient clinics during the study
period.
Results: among the 120 patients only 109 patients were finally
included in the study. Elevenpatients who had had duplicated
prescriptionswere excluded from the study. 78% of the patients
were on Valsartan for its FDA-approved indications while 22%
of patients were for other non-approved indications. Half of the
patients were initiated on an ACEi before shifting to Valsartan.
The other half of the patients was started with Valsartan as a first
line choice without any clinical justification.
Conclusion: The study showed that half of the patients were
initiated on Valsartan without being prescribed an ACEi prior
to that, while the recommendation in most of the international
guidelines based on indication stated that ARBs are used in
patients who are intolerant to ACEi. The study emphasizes the
need for further research to highlight the need for developing
national guidelines and adhering to these guidelines for rational
prescribing.
