THROMBOLYTICS - A DRUG UTILIZATION REVIEW IN A DISTRICT GENERAL-HOSPITAL

Background: Retrospective drug utilization review (DUR) can be of bene fit in determining the extent to which recommendations derived from cl inical trials are carried out in practice. Objective: To determine whe ther thrombolysis was given in accordance with hospital guidelines. Me thod: A retrospective DUR of the treatment of patients with a diagnosi s of myocardial infarction (MI) admitted to Borders General Hospital d uring April-December 1993 was carried out. Results: Forty-eight per ce nt of these patients received thrombolysis, representing 52% of all pa tients with a definite diagnosis of MI. The most frequent reason for t hrombolysis not being given was atypical presentation, particularly EC G changes not in accordance with those described in the hospital guide lines for diagnosis of MI. Contraindications and late presentations we re very few in number. Appropriate reasons were identified for all pat ients who did not receive thrombolytic therapy. Mortality both at disc harge and at 6 months was slightly greater in these patients than in t reated patients. Conclusion: Thombolytic drugs were used in line with the hospital guidelines in most cases, although there was no identifia ble reason for the use of alteplase instead of streptokinase in two ca ses.