Clinical & Experimental Cardiology
Open Access
ISSN: 2155-9880
ISSN: 2155-9880
Elizabeth Thong and Peter Jiawei Huang
Imperial College London, UK
Posters & Accepted Abstracts: J Clin Exp Cardiolog
Clopidogrel, ticagrelor and prasugrel, in combination with indefinite aspirin, are indicated as part of a dual anti-platelet therapy (DAPT) regimen for management of patients with acute coronary syndrome and/or undergoing percutaneous coronary intervention. Dual treatment with clopidogrel/prasugrel/ticagrelor is only recommended for up to 12 months: extended treatment beyond these risks has adverse effects without additional clinical benefit. The audit aims to ensure ticagrelor; prasugrel and clopidogrel are prescribed in line with local and NICE guidance. Results from 10 patients on ticagrelor and/or prasugrel and 15 patients on clopidogrel and low dose aspirin (75 mg) were used. We analyzed and discussed whether ticagrelor, prasugrel and clopidogrel were prescribed in line with guidance and investigated reasons behind the lack thereof. 100% of patients on ticagrelor or prasugrel were co-prescribed aspirin. 92% had their DAPT initiated by a hospital consultant, 100% had the indication for their DAPT documented, 100% had a review or stop date documented, and 93% prescribed DAPT for more than 12 months had the on-going need documented. Upon investigation, the reasons behind a GP initiated therapy was clearly documented and explained with the subsequent specialist consultation supporting this. For the patient who was continued on ticagrelor after 12 months, no reason was given and this should be addressed through medication reviews. The results of this audit suggest that the practice has good regulations regarding medication review and adherence to guidelines. However, though 100% of patients had recent medication reviews, there was often no specific review date for their DAPT and general medication reviews were conducted. While medication reviews can be specific to DAPT and include more details for DAPT, no patient has their medication unchecked for prolonged periods of time and hence, the practice closely follows local and NICE guidelines.
Elizabeth Thong is a medical student at Imperial College London with a keen interest in cardiology. She has published articles in journals on women’s heart health and quality of life after mitral valve replacement, and has worked on projects on diffuse large B-cell lymphoma, outpatient hysteroscopy services and improving patient consent procedures. She has written chapters in a book answering patient questions regarding surgical procedures, and has presented posters at multiple national conferences. She hopes to continue exploring her interests in medicine whilst familiarizing herself with different types of research, with a particular focus on cardiology.