당뇨 환자에게 심혈관계질환에 대한 이차 예방목적으로서 simvastatin의 사용 적절성 평가

Abstract

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.