Tremblay Éric, Turgeon Mélanie, Gaudet Michel, Guénette Line
J Popul Ther Clin Pharmacol. 2014;21(3):e431-41. Epub 2014 Nov 17.
Choosing the initial pharmacotherapy for new antihypertensive users and ensuring adherence to therapy can be problematic.
We sought to assess the quality of pharmacotherapy among new users of antihypertensives in Quebec, and to measure persistence with treatment in the short and longer term.
Using provincial administrative databases, a historical population-based study was conducted with a cohort of Quebec adults who filled their first antihypertensive prescription between January 1, 2007, and December 31, 2009. We described antihypertensive treatment for those with a diagnosis of hypertension (HTN) in the 5 years preceding initiation of drug therapy. Conformity with criteria for optimal use based on the 2006 Canadian Hypertension Education Program (CHEP) was evaluated. Persistence with treatment was estimated at 3 months, 1 year and 2 years after pharmacotherapy initiation.
Among the 79,181 new antihypertensive users with HTN who started treatment between 2007 and 2009, 82.5% were first prescribed only one drug, usually an angiotensin II receptor blocker or an angiotensin-converting enzyme inhibitor and rarely a diuretic. 24.2% of newly treated hypertensive persons aged 60 or older in our sample received a beta-blocker, which is not recommended practice. The initial treatment conformed to CHEP recommendations for 72.8% of those with uncomplicated HTN. After 3 months, 69.8% of new users still persisted with their treatment. This proportion remained stable after 1 year (69.1%) and 2 years (69.2%).
Conformity of antihypertensive treatment with CHEP criteria, and patient persistence with therapy, was fairly high for new users in the province of Quebec. Research is needed, however, on how to further improve pÉÉharmacotherapy quality and persistence in new users.
为新的高血压患者选择初始药物治疗方案并确保其坚持治疗可能存在问题。
我们旨在评估魁北克新高血压患者的药物治疗质量，并衡量短期和长期的治疗持续性。
利用省级行政数据库，对2007年1月1日至2009年12月31日期间首次开具抗高血压处方的魁北克成年人群进行了一项基于历史人群的研究。我们描述了在开始药物治疗前5年内被诊断为高血压（HTN）患者的抗高血压治疗情况。根据2006年加拿大高血压教育计划（CHEP）评估了符合最佳使用标准的情况。在开始药物治疗后3个月、1年和2年评估治疗持续性。
在2007年至2009年开始治疗的79181名患有高血压的新抗高血压患者中，82.5%首次仅开具一种药物，通常是血管紧张素II受体阻滞剂或血管紧张素转换酶抑制剂，很少开具利尿剂。在我们的样本中，60岁及以上新治疗的高血压患者中有24.2%接受了β受体阻滞剂治疗，这不符合推荐做法。对于72.8%的单纯性高血压患者，初始治疗符合CHEP建议。3个月后，69.8%的新患者仍坚持治疗。1年后（69.1%）和2年后（69.2%）这一比例保持稳定。
魁北克省新患者的抗高血压治疗符合CHEP标准以及患者坚持治疗的情况相当高。然而，需要研究如何进一步提高新患者的药物治疗质量和治疗持续性。
