A retrospective drug utilization evaluation of antihyperlipidaemic agents in a medical centre in Taiwan

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Abstract
Objective: The purpose of this study was to retrospectively evaluate the prescribing of antihyperlipidaemic agents in an 800‐bed medical centre in southern Taiwan.Methods: A retrospective study based on reviewing medical records was conducted using a computerized database. We randomly selected 344 patients (age range 5–85 years) who received an antihyperlipidaemic agent between 1 April 1994 and 30 September 1994 and reviewed their medical records. All the related data from the date when the antihyperlipidaemic agent was first prescribed to 31 December 1994 was assessed. Usage guidelines for antihyperlipidaemic agents were defined by referring to the literature and specialist opinion.Results: Two hundred and twenty‐two patients (64·5%) were treated with antihyperlipidaemic agents in accordance with the usage guidelines. In addition, most of the treatments complied with the regulations laid down by related health insurance programmes. The other 122 cases (35·5%) failed to meet any of the indications of the usage guidelines. Only 102 patients (29·7%) had their baseline lipid profiles examined and 117 patients (34%) had their baseline liver function tested. Over all, very few cases had lipid profiles and liver function tests every 3 months while taking antihyperlipidaemic agents. Patients who had been prescribed antihyperlipidaemic agents for more than 1 year were evaluated to assess the effectiveness of their pharmacological therapy. The prescribed doses were found to be lower than recommended in the general literature except for patients who received lovastatin and pravastatin.Conclusions: There are many treatment guidelines for hypercholesterolaemia in north America and Europe. This study revealed that a large proportion of antihyperlipidaemic agents used in our patient population did not comply with these general recommendations. Although the reasons for not complying with usage guidelines need to be further investigated, our study findings may well serve as the basis for further quality management and pharmacoeconomic analysis.

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