Changes in ticlopidine utilization pattern after educational intervention

Background: Ticlopidine is used for the prophylaxis of thrombotic disorders. A disadvantage of its use is the development of serious adverse hematological effects, especially neutropenia. Therefore, prescribing of ticlopidine was evaluated before and after educational intervention in a medical center. Objective: To evaluate the effects of an educational intervention program on the appropriateness of ticlopidine usage at the National Cheng Kung University Hospital. Methods: A structured Drug Utilization Evaluation (DUE) program was conducted with educational intervention. The medical records corresponding to the designated periods were selected from a computerized database. A clinical pharmacist evaluated the medical records, applying the DUE criteria, before and after intervention. Results: Study subjects included 243 patients before intervention and 112 patients after intervention who received ticlopidine. Ticlopidine was mostly prescribed for patients with cerebrovascular stroke both before and after intervention (81.5 % and 80.4 %). The most frequently prescribed dose was 200 mg per day in the two periods (55.6 % and 60.9 %). After intervention, the concomitant use of aspirin and ticlopidine decreased significantly (P < 0.001). Compliance with usage guidelines (P = 0.005) and hematological monitoring (P = 0.016-0.041) improved significantly after intervention. Conclusion: The authors conclude that educational intervention by pharmacists may have a significant influence on the prescribing pattern of ticlopidine.