Objective:Blood pressure control in France leaves room for improvement. Analysis of the data from the 2015 ESTEBAN study found treatment to be insufficient, with disproportionate use of monotherapies. The 2016 French National Authority for Health (HAS) guidelines emphasise the importance of logical treatment titration giving preference in primary prevention to a triple therapy combining a renin-angiotensin system blocker, a thiazide diuretic and a dihydropyridine. The impact of these guidelines on the prescription of triple therapies has not been studied in France.Design and method:Data from the IQVIA Longitudinal Patient Database (LPD) France were used. LPD France is a permanent observatory to which a nationally representative panel of physicians – including general practitioners (GPs) (n = 1200) and community cardiologists (n = 100) – contribute anonymised electronic medical records (EMR). The analysis included all antihypertensive treatment prescriptions from July 2020 to June 2021, which were then extrapolated to the entire population of mainland France.Results:In 2021, a total of 2 455 065 patients had received a triple therapy. A figure that accounted for 17.4% of the patients seen by a GP (n = 2 016 689) and 19.0% of the hypertensive patients followed by a cardiologist (n = 438 376). The most common (>5%) triple therapy combinations are given in the table. The ‘standard’ triple therapy recommended by the guidelines accounted for only 24.7% of the prescriptions in general practice. The prescriptions made in the cardiology and general practice settings have more similarities than differences.Conclusions:These findings confirm not just the insufficient use of triple therapies, but also their misuse, with the overrepresentation of the beta-blockers class not always justified by preferential indications. These observations should call into question both the quality of the guidelines’ dissemination and the continuing education of the primary care practitioners for this disease.

Objective:Hypertension (HT) is the leading reason for visits to general practitioners (GPs). Due to insufficient adherence and marked therapeutic inertia, there is room for improving blood pressure control in France. The objective of this study is to describe the antihypertensive treatment prescribing behaviours in French general practice.Design and method:Data from the IQVIA Longitudinal Patient Database (LPD) France were used. LPD France is a permanent observatory to which a nationally representative panel of physicians – including GPs (n=1200) – contribute anonymised electronic medical records (EMR). The analysis included all antihypertensive treatment prescriptions from July 2020 to June 2021, which were then extrapolated to the entire population. The following definitions were used to categorise the prescribing behaviours: INITIATION - for hypertensive patients already registered with the GP and who had been prescribed an antihypertensive treatment for the first time in 24 months; RENEWAL - for hypertensive patients whose therapeutic class had not changed, apart from dosage modifications, changes of molecule within the same class and titrations; CHANGE - for hypertensive patients for whom a therapeutic class had been added, withdrawn, and/or changed.Results:In 2021, a total of 11 557 545 hypertensive patients had received an antihypertensive treatment prescription following consultation with a GP. These were distributed as follows:Conclusions:These findings provide informative data on the prescribing behaviours of GPs, primarily marked by a renewal rate that does not appear to reflect the reality of blood pressure control in France. Prescription modifications are in the minority, and essentially consist of class rotations. This observation requires urgent reflection when it comes to the training of prescribers and the value placed on blood pressure control under the French public health objectives pay-for-performance scheme.*IQVIA EMR LPD Médecins Généralistes ‘. EMR = Electronic Medical Records, LPD = Longitudinal Patient Data

Objective:Hypertension (HT) is the leading reason for visits to general practitioners (GPs). The diagnosis of HT and the decision to initiate drug treatment form an integral part of their natural field of practice. The recent national and international guidelines have made proposals that are specifically dedicated to this sequence of care. The objective of this study is to analyse the prescribing behaviours of GPs when initiating treatment for patients newly diagnosed with hypertension.Design and method:Data from the IQVIA Longitudinal Patient Database (LPD) France were used. LPD France is a permanent observatory to which a nationally representative panel of physicians – including GPs (n = 1200) – contribute anonymised electronic medical records (EMR). This analysis included all antihypertensive drug prescriptions made by the GPs from July 2020 to June 2021, which were then extrapolated to the entire population of mainland France. Initiation was defined by the establishment of an antihypertensive treatment for a patient already registered with the GP and who was receiving antihypertensive treatment for the first time in 24 months.Results:Over the 12-month period analysed, 869 283 patients had received an initial antihypertensive drug prescription following consultation with a GP. Monotherapy was prescribed in 71.5% of cases (versus 67.3% the previous year) and dual therapy in 21.5% of cases (versus 23.2% the previous year). Fixed-dose combinations accounted for 62% of the dual therapies.The therapeu tic classes of the prescribed monotherapies were distributed as follows:Conclusions:These findings reveal prescriptions that appeared to be consistent with the latest guidelines in which the first-line use of renin-angiotensin system blockers and calcium channel blockers is preferred. It is also interesting to note that treatment initiation with dual therapies was much less common, with a use rate of fixed-dose combinations slightly higher than that of the free-dose combinations.*IQVIA EMR LPD Médecins Généralistes / Cardiologues Libéraux’. EMR = Electronic Medical Records, LPD = Longitudinal Patient Data