Antihypertensive prescription among black patients without compelling indications: prescription, effectiveness, quality and cost of medication

Akunne, Onyinye O.; Adedapo, Aduragbenro Deborah

doi:10.1186/s12913-019-4202-2

Cited by 13 publications

(30 citation statements)

References 30 publications

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“…Study characteristics are summarized in Table 1 , a more detailed version can be found in additional file 2 . Regarding the economic study design, 21 studies followed a partial economic evaluation (nine cost descriptions [ 33 , 35 – 38 , 44 , 47 , 49 , 56 ], eight cost analyses [ 41 , 45 , 46 , 48 , 50 , 57 , 58 , 64 ] and four cost-outcome descriptions [ 32 , 34 , 43 , 63 ]. The remaining studies followed a full economic evaluation design (seven cost effectiveness analyses [ 39 , 40 , 54 , 59 – 62 ], three cost utility analyses [ 42 , 51 , 52 ] and two cost minimization analysis [ 53 , 55 ]).…”

Section: Resultsmentioning

confidence: 99%

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The economic burden of treating uncomplicated hypertension in Sub-Saharan Africa: a systematic literature review

et al. 2022

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Background and Objectives Hypertension is one of the leading cardiovascular risk factors with high numbers of undiagnosed and untreated patients in Sub Saharan Africa (SSA). The health systems and affected people are often overwhelmed by the social and economic burden that comes with the disease. However, the research on the economic burden and consequences of hypertension treatment remains scare in SSA. The objective of our review was to compare different hypertension treatment costs across the continent and identify major cost drivers. Material and Methods Systematic literature searches were conducted in multiple databases (e.g., PubMed, Web of Science, Google Scholar) for peer reviewed articles written in English language with a publication date from inception to Jan. 2022. We included studies assessing direct and indirect costs of hypertension therapy in SSA from a provider or user perspective. The search and a quality assessment were independently executed by two researchers. All results were converted to 2021 US Dollar. Results Of 3999 results identified in the initial search, 33 were selected for data extraction. Costs differed between countries, costing perspectives and cost categories. Only 25% of the SSA countries were mentioned in the studies, with Nigeria dominating the research with a share of 27% of the studies. We identified 15 results each from a user or provider perspective. Medication costs were accountable for the most part of the expenditures with a range from 1.70$ to 97.06$ from a patient perspective and 0.09$ to 193.55$ from a provider perspective per patient per month. Major cost drivers were multidrug treatment, inpatient or hospital care and having a comorbidity like diabetes. Conclusion Hypertension poses a significant economic burden for patients and governments in SSA. Interpreting and comparing the results from different countries and studies is difficult as there are different financing methods and cost items are defined in different ways. However, our results identify medication costs as one of the biggest cost contributors. When fighting the economic burden in SSA, reducing medication costs in form of subsidies or special interventions needs to be considered. Trial registration Registration: PROSPERO, ID CRD42020220957.

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Section: Resultsmentioning

confidence: 99%

“…We identified convenient sampling [ 33 – 35 , 38 , 45 , 48 , 53 , 56 , 63 ] as the most used sampling method followed by random sampling [ 32 , 36 , 49 , 50 , 55 , 58 ].…”

Section: Resultsmentioning

confidence: 99%

The economic burden of treating uncomplicated hypertension in Sub-Saharan Africa: a systematic literature review

et al. 2022

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“…Studies suggested that non-adherence behaviour could be predicted based on its' association with sociodemographic variables such as gender, age, ethnicity, religious affiliation, marital status, household, education background, employment status, and income. [7][8][9][10] Other predictors included comorbidity, 7,9,10 polypharmacy, 11,12 health belief 13 and health literacy. 14 Knowledge associated with these predictors would facilitate formulation of various interventions to improve medication adherence.…”

Section: Medication Adherence Among Hypertensive Patientsmentioning

confidence: 99%

Exploring Culture, Religiosity and Spirituality Influence on Antihypertensive Medication Adherence Among Specialised Population: A Qualitative Ethnographic Approach

Wahab¹,

Makmor‐Bakry²,

Ahmad³

et al. 2021

PPA

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Background: Hypertension is one of the major risk factors of stroke and leading risk factors for global death. Inadequate control of blood pressure due to medication non-adherence remains a challenge and identifying the underlying causes will provide useful information to formulate suitable interventions. Purpose: This study aimed to explore the roles of culture, religiosity, and spirituality on adherence to anti-hypertensive medications. Methodology: A semi-structured qualitative interview was used to explore promoters and barriers to medication adherence among hypertensive individuals residing in urban and rural areas of Perak State, West Malaysia. Study participants were individuals who are able to comprehend either in Malay or English, above 18 years old and on antihypertensive medications. Interview transcriptions from 23 participants were coded inductively and analyzed thematically. Codes generated were verified by three co-investigators who were not involved in transcribing process. The codes were matched with quotations and categorized using three levels of themes named as organizing, classifying and general themes. Results: Cultural aspects categorized as societal and communication norms were related to nonadherence. The societal norms related to ignorance, belief in testimony and anything "natural is safe" affected medication adherence negatively. Communication norms manifested as superficiality, indirectness and non-confrontational were also linked to medication non-adherence. Internal and organizational religiosity was linked to increased motivation to take medication. In contrast, religious misconception about healing and treatment contributed towards medication nonadherence. The role of spirituality remains unclear and seemed to be understood as related to religiosity. Conclusion: Culture and religiosity (C/R) are highly regarded in many societies and shaped people's health belief and behaviour. Identifying the elements and mechanism through which C/ R impacted adherence would be useful to provide essential information for linking adherence assessment to the interventions that specifically address causes of medication non-adherence.

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“…This review is relevant for several reasons. First, hypertension-related mortality and morbidity disproportionately affects the Black population [16,17,[26][27][28], who are at a higher risk of polypharmacy due to the higher prevalence of comorbidities associated with or caused by HTN [29]. Second, a critical appraisal of the current evidence on the clinical bene ts and harms for Black people with EH is required.…”

Section: Importance Of This Reviewmentioning

confidence: 99%

Clinical Benefits and Harms of Diuretics for Primary Prevention of Cardiovascular Outcomes in Black People With Essential Hypertension: A Protocol for a Systematic Review of Randomized Clinical Trials With Meta-analysis and Trial Sequential Analysis

Martí‐Carvajal

Alegría

Correa

et al. 2021

Preprint

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Background The overall mortality attributable to cardiovascular diseases (coronary heart disease, sudden cardiac death/sudden cardiac arrest, stroke/transient ischemic attack, and peripheral arterial disease) is higher in the Black population when compared to the White population. Essential hypertension (EH) is the most important modifiable risk factor for cardiovascular diseases. The prevalence of hypertension among Black adults is also higher. Diuretics are antihypertensive drugs, and their role in the primary prevention of clinical cardiovascular outcomes in the Black population with essential hypertension remains unknown. To assess the clinical benefits and harms of diuretics, as a primary prevention approach, compared with placebo or any other antihypertensive medications.MethodsWe will search the Cochrane Central Register of Controlled Trials (to update), OVID MEDLINE (1946 to update), Embase (1980 to update), LILACS (1986 to update), and Web of Science (to update). We will manually search the reference lists of the included papers and contact researchers in the field. There will be no language restrictions in the search. We will include parallel-design and crossover randomized clinical trials that has adult Black people with essential hypertension as the population. The primary outcomes are all-cause mortality, myocardial infarction, stroke, and serious adverse events. Pregnant women will be excluded from the study. We will perform study selection, risk of bias assessment, and data extraction in duplicate. We will estimate risk ratios (RRs) with a 95% confidence interval (95% CI) for dichotomous outcomes. For continuous outcomes, such as health-related quality of life, systolic blood pressure, and diastolic blood pressure, we will calculate the mean difference with 95% CI or the standardized mean difference with 95% CI. We will measure statistical heterogeneity using the I² statistic and use a fixed-effects and random-effects model. We will conduct a sequential trial analysis. DiscussionOur aim is to provide external validity and try to solve conflicts about the evidence regarding use of diuretics as a primary prevention of cardiovascular outcomes in Black people with essential hypertension to guide appropriate clinical practice.Systematic review registration PROSPERO registration number: CRD42021240864

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Antihypertensive prescription among black patients without compelling indications: prescription, effectiveness, quality and cost of medication

Cited by 13 publications

References 30 publications

The economic burden of treating uncomplicated hypertension in Sub-Saharan Africa: a systematic literature review

The economic burden of treating uncomplicated hypertension in Sub-Saharan Africa: a systematic literature review

Exploring Culture, Religiosity and Spirituality Influence on Antihypertensive Medication Adherence Among Specialised Population: A Qualitative Ethnographic Approach

Clinical Benefits and Harms of Diuretics for Primary Prevention of Cardiovascular Outcomes in Black People With Essential Hypertension: A Protocol for a Systematic Review of Randomized Clinical Trials With Meta-analysis and Trial Sequential Analysis

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