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

P, Caceres MC Moyano

doi:10.4172/2167-1052.1000172

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…However, considering that there are few absolute contraindications for the use of diuretics, one may argue that the 41% usage rate should have been higher. On the other side, thiazide diuretics are more often used in Brazil than in Denmark, Finland, Germany, Norway, Sweden, Netherlands [25], Portugal [26], Spain [27], Mexico [28], and the United States [29]. Among other antihypertensive drugs, the use of beta-blockers was similar to that reported in other countries, but the prevalence of calcium channel blockers (CCB), ACE inhibitors, and ARBs use was much lower.…”

Section: Discussionmentioning

confidence: 99%

Hypertension Management in Brazil: Usual Practice in Primary Care—A Meta-Analysis

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Fuchs

et al. 2017

International Journal of Hypertension

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Knowing the usual clinical practice is relevant for evaluations in health care and economic policies of management of hypertension. This study aimed to describe the usual management of hypertension in the Brazilian primary healthcare system through a systematic review and meta-analysis. The search of population-based studies conducted in Brazil was undertaken using PubMed, EMBASE, and Brazilian databases. Eligible studies were those conducted in adults with hypertension (blood pressure (BP) ≥ 140/90 mmHg or using BP lowering drugs). Three datasets' data were analyzed: SESI study (in Brazilian workers); HIPERDIA (Brazilian Registration and Monitoring of Hypertensive and Diabetic Patients Program); and a population-based study. Meta-analysis has been performed using the fixed and random effect models. A total of 11 studies or data sets were included in the systematic review. Hypertensive individuals had, on average, 2.6 medical visits annually and 18.2% were on diuretics (n = 811 hypertensive patients) and 16.2% on ACE inhibitors (n = 1768 hypertensive patients). BP control rate ranged from 43.7 to 67.5%; 35.5% had measured total cholesterol and 36.5% determined fasting plasma glucose in the previous 12 months. Thiazide diuretics and ACE inhibitors were the most used BP lowering medications as single drugs, but the control rate of hypertension is insufficient.

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Section: Discussionmentioning

confidence: 99%

Hypertension Management in Brazil: Usual Practice in Primary Care—A Meta-Analysis

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Costa

Fuchs

et al. 2017

International Journal of Hypertension

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Adherence of doctors to hypertension clinical guidelines in academy charity teaching hospital, Khartoum, Sudan

Abdelgadir

Elfadul

Hamid

et al. 2019

BMC Health Serv Res

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Background Clinical guidelines are systematically proven statements that help physicians to make healthcare decisions for specific medical conditions. Non-adherence to clinical guidelines is believed to contribute significantly to poor delivery of clinical care, and hence poor clinical outcomes. This study aimed at investigating adherence of doctors to hypertension clinical guidelines in Academy Charity Teaching Hospital, Khartoum, Sudan. Methods A cross-sectional hospital-based study was conducted during the period from January 2017 to October 2017 on a sample of 150 doctors. Adherence of doctors to hypertension guidelines was measured through the modified JNC7 adherence tool. Descriptive statistics was used to summarize the data (mean, standard deviation, median) and analyzed by frequency tables. Chi square test used to determine association among categorized variables. Logistic regression analysis was conducted to determine the relation between adherence to hypertension guidelines and the explanatory variables. All statistical tests were considered statistically significant when p value < 0.05. Results Of the 150 participants, 92% (138/150) were aware of the major hypertension treatment guidelines. 71% (98/138) reported the use of guidelines recommendations in their practice. Whereas 52% (78/150) were aware of local Sudanese guidelines. High adherence rate was highly statistically associated with job titles ( p = 0.000), and also associated with age of the participants ( p = 0.024) and duration of clinical experience ( p = 0.012). However, the logistic regression analysis revealed despite all those variables were contributing to adherence to the treatment guidelines, only duration of clinical experience was statistically significant ( p = 0.022). Conclusion The overall adherence of doctors to hypertension treatment guidelines was very low. This study highlights how a gap in clinical governance contributes to low adherence to clinical guidelines. Establishing regular clinical audit, issuing regulations to enforce the use of updated guidelines, along with introducing training programs in hospitals and continuous assessment to the practicing doctors are suggested as crucial interventions. Considerable efforts to build clinical governance in Sudan are required.

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Trends for beta-blockers use in a large cohort of Polish hypertensive patients — Pol-Fokus Study

Prejbisz

Klocek²,

Gąsowski³

et al. 2015

Arterial Hypertension

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SummaryBackground Beta-blockers remain one of the most frequently prescribed antihypertensive drug classes. The aim of the analysis was to evaluate characteristics of patients treated with beta-blockers and factors associated with the treatment of beta-blockers. Material and methodsWe analysed the data from the large cross-sectional study evaluating 12,375 patients treated for hypertension for at least one year Results Overall, 7080 patients (57.2% of the whole group) were treated with beta-blockers. The rate of use of beta-blockers was higher in patients with diabetes (62.9 vs 55.6%), coronary artery disease (72.2 vs 46.4%), previous myocardial infarction (82.3 vs 54.1%), heart failure (73.1 vs 53.3%) and arrhythmias (73.1 vs 51.1%) than in patients without those conditions (all comparisons p < 0.001). Beta-blockers were used less frequently among patients with asthma/COPD than without asthma/COPD (54.0 vs 58.0%; p = 0.017). In patients aged 40 years and less, the compelling indications for these agents were found only in 21.7% of patients. In patients aged 40-65 years, none of compelling indications was found in 41.3% of patients. In patients 65 years or more, the most frequent compelling indications were coronary artery disease, previous myocardial infarction and heart failure, which were present in 70.1% of patients. Conclusions High utilization rate of beta-blockers in patients with hypertension, only second to renin-angiotensin blockers, has been shown. In middle age and, especially, in older patients it might reflect high cardiovascular burden of those patients, including coexistence of established cardiac disease. In younger patients beta-blockers are used more frequently with none of the compelling indications present.

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

Cited by 3 publications

References 17 publications

Hypertension Management in Brazil: Usual Practice in Primary Care—A Meta-Analysis

Hypertension Management in Brazil: Usual Practice in Primary Care—A Meta-Analysis

Adherence of doctors to hypertension clinical guidelines in academy charity teaching hospital, Khartoum, Sudan

Trends for beta-blockers use in a large cohort of Polish hypertensive patients — Pol-Fokus Study

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