Patrones de prescripción de antilipémicos en un grupo de pacientes colombianos Prescription patterns for antilipidemic drugs in a group of Colombian patients

• Main Authors: Jorge Enrique Machado, Juan Carlos Moncada, Giovanny Mesa
• Format: Article
• Language: English
• Published: Pan American Health Organization 2008-03-01
• Series: Revista Panamericana de Salud Pública
• Subjects: Dislipidemias; hipercolesterolemia; hipertrigliceridemia; agentes antilipémicos; prescripción de medicamentos; Colombia; Dyslipidemia; hyperlipidemia; hypertriglyceridemia; drug therapy, lipid; drugs with prescription
• Online Access: http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S1020-49892008000300005

OBJETIVOS: Determinar los patrones de prescripción de medicamentos antilipémicos en un grupo de afiliados al Sistema General de Seguridad Social en Salud de Colombia. MÉTODOS: Estudio descriptivo observacional con 41 580 dislipidémicos de ambos sexos, mayores de 20 años, con tratamiento, al menos, de abril a junio de 2006 y residentes en 19 ciudades colombianas. Se diseñó una base de datos de registros sobre consumo de medicamentos, capturados por la empresa que distribuye los fármacos a los pacientes. RESULTADOS: Edad promedio de 58,4 &plusmn; 13,5 años; 58,9% de los participantes son mujeres. Del total de pacientes, 95,6% recibían monoterapia y 4,4% dos o más antilipémicos. El orden de prescripción de los medicamentos fue: estatinas (70,9%), fibratos (27,5%), resinas fijadoras de colesterol (0,9%) y otros (0,7%), todos a dosis bajas. Las combinaciones más empleadas fueron lovastatina + gemfibrozilo (n = 1 568), colestiramina + gemfibrozilo (n = 92), coles tiramina + lovastatina (n = 78). La comedicación más prescrita fue: antihipertensivos (60,9%), antiinflamatorios (56,5%), antiulcerosos (22,9%), antidiabéticos (20,6%), ASA (3,8%). Existe subempleo de antianginosos y ASA y sobreempleo de antiinflamatorios y antiulcerosos. CONCLUSIONES: La dislipidemia es un factor de riesgo primario para desarrollar enfermedad coronaria y accidentes cerebrovasculares, causas frecuentes de morbilidad y mortalidad en Colombia y el mundo. Todos los antilipémicos se emplean en dosis menores a las recomendadas. Se plantea la necesidad de diseñar estrategias educativas para corregir algunos hábitos de prescripción y explorar resultados clínicos de formulaciones estudiadas.<br>OBJECTIVES: To determine patterns in antilipidemic drug prescriptions among a group of patients covered by the General Social Security System (Sistema General de Seguridad Social) in Colombia. METHODS: A descriptive, observational study was conducted of 41 580 hyperlipidemics of both sexes, who were over 20 years of age, undergoing treatment from at least April to June 2006, and were residents of one of 19 cities in Colombia. A database was created to track prescription data collected by the pharmaceutical company that dispenses medications to the patients. RESULTS: The mean age was 58.4 &plusmn; 13.5 years; 58.9% of the participants were women. Of the total number of patients, 95.6% were receiving monotherapy, while 4.4% were receiving two or more antilipidemics. Prescriptions were ranked as follows: statins (70.9%), fibrates (27.5%), bile acid sequestrant resins (0.9%), and others (0.7%), all at low dosage levels. The most common therapy combinations were lovastatin + gemfibrozil (n = 1 568), cholestyramine + gemfibrozil (n = 92), and cholestyramine + lovastatin (n = 78). Comedications most frequently prescribed were: antihypertensive (60.9%), antiinflammatory (56.5%), antiulcer (22.9%), and antidiabetes drugs (20.6%), and acetylsalicylic acid (ASA, 3.8%). Antianginals and ASA were being underused, while antiinflamatories and antiulcer drugs were being overused. CONCLUSIONS: Dyslipidemia is a primary risk factor for developing coronary heart disease and stroke, frequent causes of morbidity and mortality in Colombia and the world. All of the antilipidemics are being used at lower-than-recommended dosage levels. Clearly there is a need for creating educational strategies to address these prescribing habits and for exploring clinical results of the pharmaceuticals studied.