Between-country variation in the utilization of antihypertensive agents: guidelines and clinical practice

Stolk, Pieter; Wijk, Boris L G Van; Leufkens, Hubert G. M.; Heerdink, Eibert R.

doi:10.1038/sj.jhh.1002089

Cited by 23 publications

(25 citation statements)

References 18 publications

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“…A similar utilization rate was observed in Scandinavia and other Baltic countries (7-15%) (17)(18)(19)(20)(21)(22)(23).…”

Section: Discussionsupporting

confidence: 49%

“…A similar trend could be observed in Latvia where the utilization of these drugs also reached 3.7-5% of all CV drugs (17). On the contrary, the utilization of alpha-receptor blockers is very low in Scandinavian countries -less than 1% in Sweden, Denmark and Finland -and in Estonia (18,19,20,21,23). Alpha-receptor blockers are recommended as the third-line therapy or in multiple drug combinations when other treatment options failed (24).…”

Section: Discussionmentioning

confidence: 99%

“…The use of CCBs was higher and is still increasing in all Scandinavian countries (12.8-16.3%) and in Latvia (16.8-20.1%) (17)(18)(19)(20)(21)(22)(23). Some data shows that CCB may reduce incidence of cardiovascular events (RR 0.71, 95% CI 0.57, 0.87), but not CHD (RR 0.77 95% CI 0.55, 1.09) or cardiovascular mortality (RR 0.86, 95% CI 0.68, 1.09) (9), cardiovascular complications in hypertensive diabetics (25) and in patients with metabolic syndrome (26).…”

Section: Discussionmentioning

confidence: 99%

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Trends and pattern of the utilization of cardiovascular medicines in Lithuania in 2003–2012

Lisauskienė¹,

Garuolienė²,

Gulbinovič³

2014

AML

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Background. Despite the wide use of cardiovascular (CV) drugs, CV diseases are still the leading cause of mortality and morbidity. Analysis of drug utilization gives a possibility to evaluate effectiveness of interventions. Materials and methods. The aim of the study was to evaluate CV medicines consumption in Lithuania in 2003–2012. Data was retrieved from the SVEIDRA database of the National Health Insurance Fund. Utilization of the following groups of CVM (ATC group C) was analyzed: C02 – antihypertensive drugs, C03 – diuretics, C07 – beta blocking agents (BBs), C08 – calcium channel blockers (CCBs), C09 – agents acting on the renin–angiotensin system, C10 – lipid modifying agents. ATC/DDD methodology was used. Data was expressed as a number of DDD per 1 000 inhabitants per day (DDD/TID). Results. Consumption of CVM went from 134.5 DDD/TID in 2003 to 352.2 in 2012. Angiotensin converting enzyme inhibitors (ACEI) were the most consumed ones (66–114.8 DDD/TID), followed by CCBs (19.4–38.8 DDD/TID) and BBs (12.5–52.6 DDD/TID).There was high consumption of antihypertensives (4.7–23.9 DDD) and low consumption of diuretics (9.4–16.9 DDD/TID) and lipid modyfing agents (0.4–7.4 DDD/TID). Increasing utilization was noticed in the angiotensin II antagonist (ARBs) group (42 DDD/TID), ACEI combinations (38.6 DDD/TID) and ARBs combinations (12.9 DDD/TID) in 2012. Conclusions. Utilization of CV medicines increased in Lithuania in 2003–2012. ACEI held the first position. An extremely low utilization of lipid modifying agents, diuretics and high consumption of alpha-receptor blockers showed the need of actions on changing the prescribing pattern of CV drugs.

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“…A similar utilization rate was observed in Scandinavia and other Baltic countries (7-15%) (17)(18)(19)(20)(21)(22)(23).…”

Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Trends and pattern of the utilization of cardiovascular medicines in Lithuania in 2003–2012

Lisauskienė¹,

Garuolienė²,

Gulbinovič³

2014

AML

View full text Add to dashboard Cite

show abstract

“…Furthermore, it must be taken into account the possible influence of pharmaceutical companies. The C09 group is the most widely group used also in Europe, as it is shown in different European studies [33,34,[38][39][40]. Within this group, the ACE inhibitors were the antihypertensive drugs most commonly used until 2007, at that moment they started to be replaced by ARBs.…”

Section: Discussionmentioning

confidence: 99%

Trends in Antihypertensive Drug Use in Spanish Primary Health Care (1990-2012)

P¹

2015

Adv Pharmacoepidemiol Drug Saf

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Objective: This study aimed to describe the use of antihypertensive in Extremadura (Spain) from 1990 to 2012 and its economic impact.Method: Information on antihypertensive drug (ATC C02, C03, C07, C08, C09) utilization was obtained from the community pharmacy sales figures reimbursed by the Health System of Extremadura (Spain). Data were expressed in Defined Daily Dose (DDD) and DDD per 1000 inhabitants per day (DHD).Results: Antihypertensive consumption in Extremadura increased from 67.1 DHD in 1990 to 315.2 in 2012 (an increase of 3.7 times). Agents acting on the Renin-Angiotensin System (C09) are responsible for 75% of the total increase. Since 2007 the use of Angiotensin II antagonist increased over ACE inhibitors.

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“…As recently highlighted in this journal, there is wide variation in adherence to management guidelines as well as inter-country differences, which are owing to many factors, including the patient. [14][15][16] However, before we throw away the 'baby' with the 'bathing water', 17 it must be emphasized that there is good evidence to support the use of b-blockers in patients with heart failure, post-MI and other indications, and it remains to be seen if the newer vasodilating b-blockers have a more favourable effect in patients with hypertension. 18 This brings up the, perhaps, somewhat philosophical question of the two for one (twofer).…”

mentioning

confidence: 99%