RATIONALE IN PRESCRIBING THE ANTIPLATELET DRUG CLOPIDOGREL IN COMBINATION WITH ASPIRIN IN PATIENTS AT PRANBURI HOSPITAL PRACHUAP KHIRI KHAN PROVINCE

Abstract

Abstract

            This study was a retrospective descriptive study. The objective is to study the drug costs of using Clopidogrel that affect the financial management of Pranburi Hospital. Prachuap Khiri Khan Province and study the reasonableness of prescribing Clopidogrel in combination with Aspirin in terms of indications and duration of use in a sample of people who continuously prescribe Clopidogrel plus Aspirin and collecting basic patient information from a medical database electronic records of Pranburi Hospital, 108 cases. The study was conducted between 1 October 2021 and 31 December 2023. Data was analyzed using descriptive statistics, presenting frequencies and percentages with ready-made computer programs.            Results of data collection from a sample of 108 patients who received Clopidogrel in combination with Aspirin, average age 68.30±22.50 years, 66 males (61.11%), 40 patients aged 71-80 years (44.44 %) Clopidogrel drug expenses were valued at 510,314 baht. Classified as lump-sum health insurance medical treatment rights for 105 cases (97.22%), Clopidogrel drug value 488,744 baht (95.77%) and paid medical group treatment rights 21,570 baht (4.23 percent) to assess medical expenses. Drugs that affect financial management, Clopidogrel was found to have a decreased impact on financial management of Pranburi Hospital in the amount of 486,587 baht and considered the reasonableness of prescribing Clopidogrel in combination with Aspirin, 89 cases (82.40%) meet the requirements of Pranburi Hospital in terms of indications and duration of use and did not meet the requirements for 19 cases (17.60%). In addition, patients receiving Clopidogrel in combination with Aspirin used Omeprazole 20 mg, a proton pump inhibitor, to reduce the incidence of gastrointestinal bleeding in 92 cases (85.19%).            From evaluating the reasonableness of prescribing antiplatelet drugs it was found that the continued prescribing of Clopidogrel in combination with Aspirin should be reviewed in all patients sent back for continued medication at Pranburi Hospital, and the use of the drug should be evaluated before prescribing both drugs are used together by a doctor at Pranburi Hospital ,because of Pranburi Hospital do not have doctors who are experts in internal medicine or cardiology. 

Keyword: reasonableness in prescribing drugs, antiplatelet drugs, Clopidogrel, Aspirin