Sanfélix-Gimeno Gabriel, Peiró Salvador, Librero Julián
Centro Superior de Investigación en Salud Pública, Valencia, España.
Gac Sanit. 2010 Sep-Oct;24(5):397-403. doi: 10.1016/j.gaceta.2010.05.004. Epub 2010 Sep 21.
To estimate consumption of five subgroups of antihypertensive drugs by primary care areas and to analyze its variation.
We performed an ecological, descriptive study of antihypertensive consumption in 239 primary care areas in the autonomous region of Valencia in 2005 followed by analysis of the variability observed. The 239 primary care areas were studied by descriptive analysis of dispensation [defined daily dose (DDD) per 1,000 inhabitants/day in pensioners (DDD/1000p/day) and in the active population (DDD/1000a/day)] and standardized consumption ratios. Small-area variation analysis was used to analyze the observed variability. Associations among dispensations of the distinct therapeutic subgroups were also analyzed.
Overall antihypertensive use in the autonomous region of Valencia in 2005 was 235.6DDD/1000/day. This consumption was concentrated in pensioners (800DDD/1000p/day vs. 73DDD/1000a/day). Consumption of antihypertensive subgroups oscillated from 442DDD/1000p/day for drugs with action on the renin-angiotensin system to 32DDD/1000p/day for doxazosin. The active population showed similar patterns. Variation in consumption was moderate, with coefficients of variation from 0.20 to 0.40 (slightly greater for the active population). Associations among dispensations of the different therapeutic subgroups were strong.
This study shows major variations in the overall consumption of antihypertensive drugs among primary care areas of the autonomous region of Valencia. These results suggest that variation may be associated with problems of underutilization in areas with lower consumption.
按基层医疗区域估算五类抗高血压药物的消耗量，并分析其变化情况。
我们对2005年巴伦西亚自治区239个基层医疗区域的抗高血压药物消费情况进行了一项生态学描述性研究，随后对观察到的变异性进行了分析。通过对配药情况进行描述性分析（以每1000名居民/天的限定日剂量（DDD）来表示，分别针对退休人员（DDD/1000p/天）和在职人群（DDD/1000a/天））以及标准化消费比率，对这239个基层医疗区域进行了研究。采用小区域变异分析来分析观察到的变异性。还分析了不同治疗亚组配药之间的关联。
2005年巴伦西亚自治区的总体抗高血压药物使用量为235.6 DDD/1000/天。这种消费集中在退休人员中（800 DDD/1000p/天，而在职人群为73 DDD/1000a/天）。抗高血压药物亚组的消耗量从作用于肾素 - 血管紧张素系统药物的442 DDD/1000p/天到多沙唑嗪的32 DDD/1000p/天不等。在职人群呈现出类似模式。消费变异性适中，变异系数在0.20至0.40之间（在职人群略高）。不同治疗亚组的配药之间存在很强的关联。
本研究表明，巴伦西亚自治区基层医疗区域之间抗高血压药物的总体消费存在重大差异。这些结果表明，消费差异可能与低消费地区的利用不足问题有关。
