Clopidogrel prescribing and concordance with the Pharmaceutical Benefits Scheme in hospital patients
Luinstra, M and Naunton, M and Peterson, GM and Bereznicki, LRE, Clopidogrel prescribing and concordance with the Pharmaceutical Benefits Scheme in hospital patients, Journal of Pharmacy Practice and Research , 39, (4) pp. 265-268. ISSN 1445-937X (2009) [Refereed Article]
Background: Clopidogrel is used for the secondary prevention
of cerebrovascular and cardiovascular events. Clopidogrel has
a similar safety profile to low-dose aspirin but is considerably
more expensive. Clopidogrel is subsidised for restricted
indications via the Pharmaceutical Benefits Scheme (PBS).
Aim: To examine c1opidogrel prescribing in hospital; and to
identify patients discharged on clopidogrel according to PBS
Method: Cross-sectional evaluation of patients started on
clopidogrel (July 2006 to June 2007) at the Royal Darwin and
Royal Hobart Hospitals.Clopidogrel prescribing was examined
and the indication for discharge on c1opidogrel was documented.
The primary outcome was concordance between clopidogrel
use and PBS criteria.
Results: Data were collected for 385 patients. 54% of patients
from the Royal Darwin Hospital and 39% of patients from the
Royal Hobart Hospital discharged on c1opidogrel met PBS
criteria.The main reason for noncompliance with the PBS was
absenceof a history of cardiovascularor cerebrovascularevents
while on low-dose aspirin and an absence of contraindications
to aspirin at the time of c1opidogrel prescribing.
Conclusion: Although c1opidogrel prescribing at the hospitals
was often not in accordance with PBS criteria, in most cases
prescribing was based on the available evidence.