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KMID : 0869620110280010023
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Journal of Korean Society of Hospital Pharmacists
2011 Volume.28 No. 1 p.23 ~ p.29
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Evaluation of the appropriate use of simvastatin for secondary prevention of CVD in diabetes patients
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Jung Ji-A
Jo Yun-Hee
Park Kyoung-Ho
Son In-Ja
Lee Hye-Sook
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Abstract
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Diabetes mellitus increases the risk of cardiovascular disease(CVD) and its associated
morbidity and mortality. HMG Co-A reductase inhibitors(statins), as effective antilipidemic
agents for lowering LDL-C levels, may reduce the risk of mortality from CVD in patients with
diabetes. This study was designed to evaluate drug use of simvastatin for secondary prevention of CVD in diabetes patients by American Diabetes Association 2006 guideline. In this retrospective study, A total of 65 outpatients with diabetes taking simvastatin in Seoul National
University Hospital from January 2006 to April 2007 were included. Patients under 40 years of
age or with previous simvastatin use were excluded. The criteria of drug use evaluation, based on the standards by the American Society of Health-System Pharmacists, were modified to fit our hospital settings. Using of drug were justified in 77% of patients. Laboratory test % for monitoring lipid profiles and adverse events was reduced gradually. The complications included minor symptoms such as GI problems, no patients withdrew from medication because of complications.
In outcome measures, 71% were met with criteria for the LDL level six month later, but 49% were met with criteria for the LDL decrement. As applied the criteria of the justification for use to 49% patients, 69.5% were incongruent. It was found that effects of simvastatin were lower in those with improper drug use than in the other groups. Therefore, it is necessary for pharmacists to participate in patient care in order to decrease LDL level of 100mg/dL or lower in patients with CVD.
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KEYWORD
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simvastatin, ADA guideline, DM, secondary prevention, DUE
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