An analysis of prescriptions for coronary heart disease with comorbid conditions in health care institutions of Ukraine

Coronary heart disease (CHD) remains the leading cause of mortality among non-communicable diseases in Ukraine and is often accompanied by various comorbid conditions. Providing pharmaceutical care to patients with CHD and comorbid conditions requires a comprehensive approach that includes ensuring access to medications, supervising rational pharmacotherapy in accordance with domestic and international clinical guidelines, monitoring trends in medication consumption, optimizing the supply of medicines, and developing standards for pharmaceutical care during martial law and the post-war period. Aim. The objective was to analyze the frequency of medication use by physicians of various specialties for patients with CHD accompanied by type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). This was done to identify trends in medication consumption and to optimize the provision of essential medicines in the context of improving the population’s access to medicines during martial law. Materials and methods. The study was based on an anonymous online survey of 788 physicians from 22 regions of Ukraine, conducted using Google Forms between June and September 2024. The survey was facilitated by the Department of Cardiology at the Shupyk National Healthcare University of Ukraine. The study employed statistical analysis, comparison, generalization, and retrospective methods, alongside clinical-epidemiological approaches, content analysis, and ABC-, VEN-, ATC/DDD-, and frequency analyses. Results. The pharmaceutical component of CHD management was evaluated based on the frequency of drug prescriptions for pharmacotherapy of CHD with comorbid conditions, following the clinical protocol “Stable Coronary Heart Disease” and clinical guidelines from ESC, AHA, ADA, and KDIGO. Comprehensive ABC-, VEN-, ATC/DDD-, and frequency analyses were conducted to assess prescribing patterns and to optimize the supply of medications to pharmacies and healthcare institutions. Conclusions. It was found that only 23.65 % of prescribed medications for the pharmacotherapy of CHD with comorbid conditions are covered under the “Affordable Medicines” reimbursement program. This limited coverage negatively impacts treatment adherence, restricts patient access to necessary medications, and hampers the achievement of optimal clinical outcomes. It is recommended to revise and expand the list of reimbursable medications for CHD with comorbid conditions in alignment with current legislation and clinical needs.