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Pharmacoepidemiological study of doctors habits in prescriptions of antihypertensive drugs in town of Orel  [cached]
G.I.Shvets,S.V.Povetkin
Rational Pharmacotherapy in Cardiology , 2008,
Abstract: Aim. To compare prescriptions of antihypertensive drugs in town of Orel with these in Russia in the whole.Material and methods. 23 cardiologists and 78 internists of Orel town were questioned about antihypertensive drug prescriptions in 2006.Results. ACE inhibitors, diuretics, beta-blockers, calcium channels antagonists were prescribed in order of popularity decreasing as mono- or combined therapy.About 70%of doctors prescribed pharmacotherapy, which cost 100 to 500 rubles per months. Not rational combinations were prescribed in 4,7% of cases.Only 55,4% of respondents used blood pressure level less than 140/90 mm Hg as a target one.Conclusion. Antihypertensive drug prescription for mono- or combined therapy was in accordance to modern guidelines but in the some cases did not meet them.
Initial Antihypertensive Prescription and Switching: A 5 Year Cohort Study from 250,851 Patients  [PDF]
Martin C. S. Wong, Wilson W. S. Tam, Clement S. K. Cheung, Ellen L. H. Tong, Antonio C. H. Sek, George John, N. T. Cheung, Bryan P. Y. Yan, C. M. Yu, Stephen Leeder, Sian Griffiths
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0053625
Abstract: Purpose Adverse effects of antihypertensive therapy incur substantial cost. We evaluated whether any major classes of antihypertensive drugs were significantly associated with switching as a proxy measure of medication side effects in a large Chinese population in Hong Kong. Methods From a clinical database, all adult patients newly prescribed an antihypertensive mono-therapy in Hong Kong between the years 2001–2003 and 2005 were included. Those who paid only one visit, died or stayed in the cohort for <180 days after the prescription, or prescribed more than one antihypertensive agent were excluded. The factors associated with switching at 180 days were evaluated by multivariate regression analyses. Age, gender, payment status, service type, district of residence, drug class, systolic and diastolic blood pressure levels were predictor variables. Results From 250,851 subjects, 159,813 patients were eligible. A total of 6,163 (3.9%) switched their medications within 180 days. Patients prescribed thiazide diuretics had the highest switching rate (5.6%), followed by ACEIs (4.5%), CCBs (4.4%) and beta-blockers (3.2%). When compared with ACEIs, patients on thiazide diuretics were significantly more likely to be switchers (adjusted odds ratio [AOR] 1.49, 95% C.I. 1.31–1.69, p<0.001), whilst patients prescribed CCBs and beta-blockers were similarly likely to have switching. Following these patients up for 5 years showed that thiazide had the most marked increase in switching rate. Conclusions The higher rates of switching among thiazide diuretics in this study might raise a probably greater incidence of their adverse effects in this Chinese population, yet other factors might also influence switching rates. Patients prescribed thiazide diuretics for longer term should be observed for their intolerability.
Determinants of Medication Adherence to Antihypertensive Medications among a Chinese Population Using Morisky Medication Adherence Scale  [PDF]
Gabrielle K. Y. Lee, Harry H. X. Wang, Kirin Q. L. Liu, Yu Cheung, Donald E. Morisky, Martin C. S. Wong
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0062775
Abstract: Background and Objectives Poor adherence to medications is one of the major public health challenges. Only one-third of the population reported successful control of blood pressure, mostly caused by poor drug adherence. However, there are relatively few reports studying the adherence levels and their associated factors among Chinese patients. This study aimed to study the adherence profiles and the factors associated with antihypertensive drug adherence among Chinese patients. Methods A cross-sectional study was conducted in an outpatient clinic located in the New Territories Region of Hong Kong. Adult patients who were currently taking at least one antihypertensive drug were invited to complete a self-administered questionnaire, consisting of basic socio-demographic profile, self-perceived health status, and self-reported medication adherence. The outcome measure was the Morisky Medication Adherence Scale (MMAS-8). Good adherence was defined as MMAS scores greater than 6 points (out of a total score of 8 points). Results From 1114 patients, 725 (65.1%) had good adherence to antihypertensive agents. Binary logistic regression analysis was conducted. Younger age, shorter duration of antihypertensive agents used, job status being employed, and poor or very poor self-perceived health status were negatively associated with drug adherence. Conclusion This study reported a high proportion of poor medication adherence among hypertensive subjects. Patients with factors associated with poor adherence should be more closely monitored to optimize their drug taking behavior.
Use of oral antihypertensive medication preceding blood pressure elevation in hospitalized patients
Macedo, Cristiano Ricardo Bastos de;Noblat, Antonio Carlos Beisl;Noblat, Lúcia de Araújo Costa Beisl;Macedo, Jeane Meire Sales de;Lopes, Antonio Alberto;
Arquivos Brasileiros de Cardiologia , 2001, DOI: 10.1590/S0066-782X2001001000002
Abstract: objective: to evaluate the frequency of oral antihypertensive medication preceding the increase in blood pressure in patients in a university hospital, the drug of choice, and the maintained use of antihypertensive medication. methods: data from january to june 1997 from the university hospital professor edgard santos pharmacy concerning the prescriptions of all inpatients were used. variables included in the analysis were: antihypertensive medication prescription preceding increase in blood pressure, type of antihypertensive medication, gender, clinical or surgical wards, and the presence of maintained antihypertensive medication. results: the hospital admitted 2,532 patients, 1,468 in surgical wards and 818 in medical wards. antihypertensive medication prescription preceding pressure increase was observed in 578 patients (22.8%). nifedipine was used in 553 (95.7%) and captopril in 25 (4.3%). in 50.7% of patients, prescription of antihypertensive medication was not associated with maintained antihypertensive medication. prescription of antihypertensive drugs preceding elevation of blood pressure was significantly (p<0.001) more frequent on the surgical floor (27.5%; 405/1468) than on the medical floor (14.3%; 117/818). the frequency of prescription of antihypertensive drugs preceding elevation of blood pressure without maintained antihypertensive drugs and the ratio between the number of prescriptions of nifedipine and captopril were greater in surgical wards. conclusion: the use of antihypertensive medication, preceding elevation of blood pressure (22.8%) observed in admitted patients is not supported by scientific evidence. the high frequency of this practice may be even greater in nonuniversity hospitals.
Use of oral antihypertensive medication preceding blood pressure elevation in hospitalized patients  [cached]
Macedo Cristiano Ricardo Bastos de,Noblat Antonio Carlos Beisl,Noblat Lúcia de Araújo Costa Beisl,Macedo Jeane Meire Sales de
Arquivos Brasileiros de Cardiologia , 2001,
Abstract: OBJECTIVE: To evaluate the frequency of oral antihypertensive medication preceding the increase in blood pressure in patients in a university hospital, the drug of choice, and the maintained use of antihypertensive medication. METHODS: Data from January to June 1997 from the University Hospital Professor Edgard Santos Pharmacy concerning the prescriptions of all inpatients were used. Variables included in the analysis were: antihypertensive medication prescription preceding increase in blood pressure, type of antihypertensive medication, gender, clinical or surgical wards, and the presence of maintained antihypertensive medication. RESULTS: The hospital admitted 2,532 patients, 1,468 in surgical wards and 818 in medical wards. Antihypertensive medication prescription preceding pressure increase was observed in 578 patients (22.8%). Nifedipine was used in 553 (95.7%) and captopril in 25 (4.3%). In 50.7% of patients, prescription of antihypertensive medication was not associated with maintained antihypertensive medication. Prescription of antihypertensive drugs preceding elevation of blood pressure was significantly (p<0.001) more frequent on the surgical floor (27.5%; 405/1468) than on the medical floor (14.3%; 117/818). The frequency of prescription of antihypertensive drugs preceding elevation of blood pressure without maintained antihypertensive drugs and the ratio between the number of prescriptions of nifedipine and captopril were greater in surgical wards. CONCLUSION: The use of antihypertensive medication, preceding elevation of blood pressure (22.8%) observed in admitted patients is not supported by scientific evidence. The high frequency of this practice may be even greater in nonuniversity hospitals.
Prevalence of the use of antihypertensive medications in Greenland: a study of quality of care amongst patients treated with antihypertensive drugs
Maria Bundgaard,Dorte Ejg Jarb?l,Maja Skov Paulsen,Jytte Lindskov Jacobsen
International Journal of Circumpolar Health , 2012, DOI: 10.3402/ijch.v71i0.18834
Abstract: Objectives. The primary objective was to estimate the prevalence of patients diagnosed with hypertension using the proxy marker of antihypertensive drug therapy in Greenland and to compare the prevalences within the 5 health regions in Greenland. The second objective was to review 2 quality indicators in antihypertensive care. Study design. Observational and cross-sectional study reviewing electronic medical records. Methods. Information about age and gender was collected from all patients receiving antihypertensive drug prescriptions within a 2-year period prior to the data extraction in January 2011. Only patients aged 20 or above were included. The age- and gender-specific prevalence of patients in antihypertensive treatment was calculated using the population as it was 1 January 2010 in Greenland as background population. A subsample consisting of patients in antihypertensive treatment aged 20 or above born within the first 5 days of each month was identified. Review of electronic medical records 1 year back in time (1 January 2010 onwards) was carried out and information on blood pressure obtained. The quality of care was evaluated with respect to 2 indicators: follow-up management and blood pressure level, respectively. Results. The total number of patients in treatment with antihypertensive drugs was 4,462 (1,998 males and 2,464 females) corresponding to a prevalence of 11.4% (4,462/39,231). The prevalence was higher among females than among males. The prevalence increased with age and differed among the 5 health regions. The percentage of patients in antihypertensive treatment with minimum 1 follow-up visit within 1 year (blood pressure measured and registered in a health clinic) was only 77.7%. Some 45% of patients in antihypertensive treatment achieved blood pressure below 140/90 mmHg. Conclusion. Hypertension is a common disorder in Greenland. The quality of antihypertensive care is suboptimal and leaves room for improvement. A national strategy based on guidelines, use of electronic drug prescriptions and recording of blood pressures combined with continuous monitoring the quality is recommended in order to prevent complications of untreated hypertension.
Statistical Pitfalls in Medical Research
VB Nyirongo, MM Mukaka, LV Kalilani-Phiri
Malawi Medical Journal , 2008,
Abstract: In conducting and reporting of medical research, there are some common pitfalls in using statistical methodology which may result in invalid inferences being made. This paper is aimed to highlight to inexperienced statisticians or non-statistician some of the common statistical pitfalls encountered when using statistics to interpret data in medical research. We also comment on good practices to avoid these pitfalls. Malawi Medical Journal Vol. 20 (1) 2008 pp. 15-18
Research Progress of Dunhuang Ancient Prescriptions
Bolin Yang, Xiping Liu
Open Access Library Journal (OALib Journal) , 2016, DOI: 10.4236/oalib.1102396
Abstract: Dunhuang medical examination paper contains about 1100 ancient prescriptions. From the ancient prescriptions of literature research, experimental study and clinical study summarized from three aspects, this article gets a conclusion: of Dunhuang ancient prescriptions dose research rarely, the formulas of TCM side cannot pass the secret lies in the dosage, so Dunhuang ancient prescriptions dose is worth of further clinical research.
Therapeutic Audit Of Dermatological Prescriptions  [cached]
Thawani V.R,Motghare V.M,Dani A.D,Shelgaonkar S.D
Indian Journal of Dermatology , 1995,
Abstract: Dermatological prescribing trends in outdoor patients attending Dermatology Clinic of Govt. Medical College Hospital, Nagpur were studied. In all 190 prescriptions were audited to find number of drugs per prescription, use of generic/brand names, dosage forms, frequency, duration of treatment, dose and categorywise drug consumption. The age and sex distributions of patients and disease distribution were also studied. Polypharmacy was found to be widely prevalent. More drugs were prescribed by brand names than generic. Dosage form, frequency and duration were mentioned in most of the prescriptions; however, doses of the drugs were not, in majority. The major drugs in the prescriptions were antihistaminics followed by antimicrobials , steroids and vitamins. Not much difference was found in sexes attending the Clinic. There were more female patients of acne vulgaris, disseminated lupus erythematosus and Hansena€ s disease. More males suffered from scables and tinea infections. There were 4 patients who were prescribed drugs without diagnosis. Except in some cases, the prescribing was relational.
Antipsychotics dosage and antiparkinsonian prescriptions  [cached]
Acquaviva Eric,Gasquet Isabelle,Falissard Bruno
Clinical Practice and Epidemiology in Mental Health , 2007, DOI: 10.1186/1745-0179-3-14
Abstract: Background To study the link between the dosage of several antipsychotics and the prescription of antiparkinsonians in an observational study. Methods In the context of a national naturalistic prospective observational study, a database containing all the prescriptions from 100 French psychiatrists during the year 2002 was analysed. The inclusion criteria were a diagnosis of schizophrenia or schizoaffective disorder and age over 18. The mean dosage of antipsychotics with and without antiparkinsonians was compared. Since there were multiple prescriptions for a given subject, generalised mixed linear models were also used to study the link between antiparkinsonian prescription and antipsychotic dosage. Results antiparkinsonians were prescribed to 32,9% of the patients. Two groups of antipsychotics were observed relating to differences in dosage when an antiparkinsonian was co prescribed or not : a first group, where the mean dosage was higher with antiparkinsonians (risperidone, amisulpride and haloperidol) and a second group (clozapine, olanzapine), in which antiparkinsonian co prescription was not related to the dosage of antipsychotics. Conclusion As a conclusion, it can be said that it is important to consider the dosage and the type of antipsychotic in the treatment of patients suffering of schizophrenia, because neurological side effects are frequent and can impair quality of life. Moreover the prescription of antiparkinsonians can lead to different side effects such anticholinergic effects.
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