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Aim: To determine guideline-related pharmaceutical care issues for the prevention of coronary heart disease in hospitalised patients admitted for myocardial infarction (MI). Methods: Consecutive patients admitted with a diagnosis of Q-wave MI to two large teaching hospitals were studied. Relevant patient medical and drug histories, co-morbidities and total cholesterol concentrations were recorded. Primary or secondary prevention treatment prior to admission was assessed using a data collection tool of 16 criteria developed from the Scottish Intercollegiate Guidelines Network (SIGN) guidelines. Main outcome measures: Frequency of adherence to defined clinical guideline criteria. Results: There were 167 patients reviewed (mean age 65 years, 111 males), representing possible candidates for primary prevention (n=98) or secondary prevention (n=69) based on absence or presence of past history of coronary heart disease (CHD), respectively. Possible primary prevention candidates: eight guideline-based criteria were developed from the SIGN guideline. There were 85 (87%) patients with a total cholesterol concentration available on admission of whom 56 (66%) had a predicted CHD risk ≥ 15% and 10 (12%) had CHD risk ≥ 30%. Of those with CHD risk ≥ 15% 6 (11%) had been receiving an anti-platelet agent and of those with CHD risk ≥ 30% only 1 (10%) was recorded as taking a statin. Of known hypertensives with CHD risk ≥ 15%, 21% (5/24) were not recorded as having received treatment. Secondary prevention candidates: a further eight guideline-based criteria were developed from the SIGN guidelines. There were 42/65 (65%) candidates for aspirin documented as receiving it. There were 22/47 (47%) of those who had a total cholesterol ≥ 5mmol/l and/or known history of hypercholesterolaemia receiving a statin (representing 76% of the known hypercholesterolaemic patients identified in the community). Of statin-treated patients with a cholesterol measured on admission, 44% (7/16) had cholesterol remaining ≥ 5mmol/l. β-blocker use was 27/62 (44%) and ACE inhibitors use was 11/31 (36%) of those eligible. Sublingual GTN was recorded in 36/69 (52%). Conclusion: The study has identified opportunities for improved pharmaceutical care in primary and secondary CHD prevention among those destined to suffer an MI. Candidates for secondary prevention are potentially identifiable from community pharmacy patient medication records from which the contribution of pharmacists in primary care might be targeted. The findings were obtained during a period of evolution of the evidence-base and so they establish a baseline for future work.

Background. Smoking is the leading cause of preventable death. In Thailand, the prevalence of smoking is about 15-20 times higher among men than women. This study aimed to investigate gender differences among university students concerning smoking behaviors, nicotine dependence, and intention to quit smoking. Methods. A self-administered questionnaire was used to collect information from participants who were current smokers studying at a university in northern Thailand. Snowball sampling was used to recruit participants. Results. Of 364 participants, there were 321 males and 43 females. This study showed higher smoking behaviors among males than females; males were more likely to smoke every day than females (67.0 and 41.9%, respectively, p value=0.002), and the average number of cigarettes daily was higher among males than females (8.4 and 5.5, respectively, p value=0.006). The sources of cigarettes differed between males and females. The nicotine dependence level, as measured by the Fagerstrom Test for Nicotine Dependence, was quite low in both male and female smokers and did not differ significantly (mean score of 2.3±2.2 for males, 1.8±1.8 for females; p value=0.123). Females were more likely than males toward intention to quit in the next 30 days (51.2 and 34.0%, respectively, p value=0.041). The most common reason for intention to quit was awareness of harm to health, for which females were more concerned than males. Conclusion. Male and female university students who smoked differed in smoking behaviors and intention to quit, but not in nicotine dependence level. The university should provide health promotion to help students quit smoking.