Medication Use Evaluation Of Statins

Medication use evaluation (MUE) of statins is a program that focuses on evaluating and improving medication use processes with the goal of optimal patient outcomes. To explore a way for practicing MUE in hospitals, we evaluated the clinical use of statins (cholesterol-lowering agents) based on data from various reference databases and the Hospital Information Subsystems of Military Health Project No.1 (军卫1号工程).Profile of medication use evaluation of statins:① Clinical guidelines and references on statins were reviewed. Randomized controlled trials meeting the evaluation criteria were accepted for further analysis. A statistical software, PEMS 3.0, was applied to perform meta-analysis with original data. If meta-analysis could not be performed, we summarized the data qualitatively.② Clinical use of Statins was investigated in a 1600-bed hospital during the period between January 2003 to January 2004 in terms of sum of money, defined daily dose (DDD) and defined daily doses (DDDs).Statins at equivalent doses will show similar percent reduction in low-density lipoprotein cholesterol (LDL) and percent of patients meeting LDL goals. Cost-effectiveness in one percent reduction of LDL was evaluated at equivalent doses. The rationality of statins use in patients with coronary artery disease (CAD) and/or diabetes (DM) was evaluated.In addition, two products of Chinese medicine Zhibituo and Xuezhikang were included in this study, because they contain statins and are also used for hyperlipidemia, atherosclerotic disease and related complications. Main results of the study:Medication use evaluation of statins confirmed that statins were the first choice in reduction of LDL, but statins treatment strategies should be based on global risk-assessment,not merely on cholesterol level. For patients who require LDL reductions of less than 40 % to meet their goal, simvastatin was cost-effective. For patients requiring greater reduction in LDL, atorvastatin demonstrated the ability to achieve that goal. Statins have two serious adverse reactions, the elevation of transaminase levels and myopathy, which need to be monitored for sensitive factors. Some irrational applications of statins were found in comparison with corresponding guidelines, which strengthened the necessity and importance of repeated MUE.A practical profile for hospital MUE was tried and evaluated. MUE is necessary in hospitals for rational use of drugs. In the study, some methods were applied to evaluate the use of statins. Application of up-to-date guideline and systematic evaluations were regarded as the first choice in assurance of medication use based on extensive and objective evidence; comprehensive application of the principles of drug use, pharmacoeconomy, medication pattern evaluation, as well as ADR monitoring, was believed to be able to make it specific and direct in optimizing patient outcomes.