Sublingual nitroglycerin practices in patients with coronary artery disease in Australia

Sublingual nitroglycerin (SLNTG) medications are a recommended treatment for people with coronary artery disease (CAD); however, prescription and knowledge may be suboptimal. This study set out to determine how often SLNTG is prescribed and the knowledge and factors associated in patients with CAD.

Patients (n = 142) were recruited from cardiac rehabilitation and surveyed regarding SLNTG prescription and key knowledge areas related to SLNTG in those prescribed (n = 89). Multiple regression analysis was used to determine independent predictors of knowledge.

Despite having CAD, 37% were not prescribed SLNTG, and of those prescribed, only 43% received related instruction. Knowledge of SLNTG was low at a mean 7.11 (SD, 2.05) points of a possible 14. Most participants (96%) knew to use SLNTG to treat chest pain/discomfort, and no participant described inappropriate symptoms for treatment. Although most patients (80%) knew to have the SLNTG available at all times, only 46% did so in reality. One in 5 participants reported that they would not call an ambulance if chest pain was unrelieved by SLNTG. Participants had more SLNTG knowledge if they were married, were male, and had been instructed about SLNTG and had less knowledge if their hospital discharge diagnosis included angina. The reporting of calling an ambulance for unrelieved symptoms was increased by having more knowledge of SLNTG, but decreased if participants had prior use of SLNTG, were married, or had more comorbidities. Consideration of prescription for SLNTG and related instruction, particularly for their chest-pain action plan, needs to be provided more systematically for patients with CAD.