DRUG UTILIZATION EVALUATION OF LOW MOLECULAR WEIGHT HEPARIN IN A TERITARY CARE TEACHING HOSPITAL

Binu Mathew*, Nimmy N. John, Lovely Panavila and H. Doddayya

ABSTRACT

Low molecular weight heparins (LMWH) have achieved poly therapeutic drug status and additional indications for their use. Therefore, it is necessary to evaluate the usage of LMWHs in the hospital settings. The main objective of the study was to analyse the prescribing habits of LMWH for their appropriateness and to promote its rational use. The prospective study was carried out in a total of 200 patients treated with LMWH in hospital. Patients receiving unfractionated heparins and other anticoagulant drugs in the hospital were excluded. Details of in patient who were treated with LMWHs were collected from patient files. Evaluation of demographic data revealed that 70.5% (n=141) were males while 29.5% (n=59) were females. A high percentage of patients aged between 53 -73 years were found in the study population. Laboratory monitoring analysis shows that haemoglobin test was done for 91% (182) followed by APTT monitoring (73%) and INR 61% (122) of the total populations. The most commonly prescribed LMWH was enoxaparin (82.5%). The most prominent indication for which it was prescribed was Ischemic Heart Disease (37.5%). Aspirin was the most other antiplatelet drug prescribed along with LMWH for maximum number of patients 31% (n=62). In cost analysis, it was found that maximum number of patients was in 5000-1000 Rs range about 42.5%. During the study period, APTT monitoring was found to be inappropriate according to the LMWH prescribing guidelines. Also implementation of guidelines for the use of LMWHs would promote the rational use of LMWHs.

Keywords: APTT, Enoxaparin, Heparin, Guidelines, LMWH, UFH.