PhD defence T. Nguyen
|When:||Fr 16-03-2018 14:30 - 16:00|
Medication use for acute coronary syndrome in Vietnam
Ischemic heart diseases (IHDs) including acute coronary syndrome (ACS) are the world's biggest killer. The thesis of Thang Nguyen aims to gain more insight into the medicine use process and interventions to improve medication use for these patients in Vietnam. The first part focused on physician adherence to prescribing medication according to guidelines. In a cross-sectional study, we found that physicians strictly adhered to prescribing most of the medications, except beta-blockers. In a cohort study, about half of the patients were prescribed all guideline-recommended medications. There was a 29% reduction in mortality and readmission to hospital in patients receiving these medications. In a systematic literature we found that changes in organization of care and training of professionals improved prescribing of only one type of medicines (statins) and improved blood pressure control, but had no effects on other medicines and patient health outcomes. The second part focused on patient adherence to treatment. We translated and cross-culturally adapted a number of questionnaires to measure patient's views of medication use into Vietnamese. In an observational study, over three-quarters of Vietnamese patients with ACS were adherent to treatment six months after discharge. In a randomized controlled trial, pharmacist-led medication counselling, tailored patient education, and medication aids enhanced the proportion of adherent patients by over 13% in three months after discharge, but not the quality of life, mortality or hospital readmission. Our results contribute to change the Vietnamese and similar low- and middle-income countries' health service for IHDs to improve patient care.
Promotores Prof.dr. K. Taxis and Prof.dr. B. Wilffert