CONFORMITY OF PRESCRIBING PRACTICES WITH NATIONAL CHOLESTEROL EDUCATION PROGRAM (NCEP) GUIDELINES AT SAUDI ARABIA CARDIAC HOSPITAL

Abdulhamid Albisher, Khalid Alnemer

Saudi Arabia


Abstract:


Introduction

With the recent clinical trial documented the efficacy of cholesterol lowering for prevention of Coronary Heart Disease (CHD), the benefits of aggressive treatment of hypercholesterolemia have now been established. These clinical trials support the validity of NCEP guidelines for the management of hypercholesterolemia. There is no information demonstrates the application of NCEP guidelines in Saudi Arabia.

Objectives

  • To demonstrate the application of NCEP guidelines.
  • Pattern of antihyperlipidemic medication.
  • Occurrence of hospitalization.

Setting

This study carried out with patients of Prince Sultan Cardiac Center (PSCC).

Method/ Design:
Retrospective study, follow-up 1 year.
Inclusion:

  • Adult patient (≥ 18 years).
  • On antihyperlipidemic medication.
  • Not familial hypercholesterolemia.

Patients characteristics:

  • Number: 306 (170 males, 136 females)>
  • Age: 59 (21 – 92) years.
  • Weight: 77 (44 – 131) kg.
  • BMI: 29 (19 – 48).

Result

Applying NCEP guidelines:

According to NCEP guideline we found the applying of guideline as follow:



The distribution of NCEP categorize by gender showing in the following table:

Category

Male (%)

Female (%)

Total (%)

I

42 (27)

22 (14)

64 (41)

II

31 (20)

44 (27)

75 (47)

III

5 (3)

14 (9)

19 (12)


Were category defined as follow:

  • I: patients with CHD + LDL ≥ 3.4 mmol/L.
  • II: patients without CHD + LDL ≥ 4.1 mmol/L+ ≥ 2 CHD risk factor.
  • III: patients without CHD + LDL ≥ 4.9 mmol/L + < 2 CHD risk factor.

Antihyperlipidemic Medications:

The mostly prescribed antihyperlipidemic medications shown in the following graph:



Hospitalization:

Occurrence of hospitalization after starting treatment of antihyperlipidemic medications are shown in the following graph:



Conclusion

The value of NCEP guidelines has been well documented. Study for conformity of prescribing practices with NCEP guidelines is lacking. This study revealed that a high percentage of patients not compliance with NCEP guidelines. Although the reasons for not comply with NCEP guideline need to be further investigated, our findings may well serve as the basis for the development of hyperlipidemic clinic for better quality management and pharmacoeconomic analysis.