Darwish, Dana Abdel Bari; (2006) Cardiovascular drug utilisation in Jordanian hospitals. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

The overall aim of this project is to evaluate cardiovascular drug utilisation in Jordanian hospitals, to identify gaps in practice and to propose areas for pharmacists' contribution in patient care. In order to achieve this aim, several objectives had to be fulfilled. These comprised: I: Description of the health conditions and health care system in Jordan. This involved conducting a literature review and in-depth interviews with key health care professionals in Jordan. The epidemiological profile and primary health problems in the Jordanian population were identified. Furthermore, the health care sectors, services, facilities, manpower and performance were presented. In particular, the hospital systems were explored in terms of the factors which influence medical practice, drug use and availability, patient care, and role of medical team members, with focus on the role of hospital pharmacists. Additionally, the pioneer experience of clinical pharmacy practice at the army hospitals was described. II: Description of drug use practices in cardiac diseases at Jordanian hospitals. Patient records were prospectively reviewed for 98 patients over a five-day period at three hospitals. The prescribing patterns, therapy monitoring and follow up of cardiac patients were described. III: Development of a tool for the assessment of cardiovascular drug utilisation. Four templates of explicit drug use evaluation criteria were developed for the diseases: stable angina, unstable angina, myocardial infraction and heart failure. The templates were based on international cardiology guidelines, and adapted by a panel of senior cardiologists in Jordan to assure their applicability at local settings. The methods and outcome from developing local guidelines were discussed. IV: Evaluation of cardiovascular drug use in coronary heart diseases and heart failure. The ongoing prescribing and monitoring practices were assessed against the above developed templates in 61 patients. Gaps in practice were identified. The project concludes with recommendations on how to optimise drug use and the areas to which pharmacists can contribute to patient care at secondary level.

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